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Tuesday, 30 September 2008

CBT? This is my way...

Cognitive Behavioral Therapy (CBT) is used to refer to behavior therapy, cognitive therapy and based on the pragmatic combination of the principles of behavior and cognitive theories. The reason why I choose CBT as my major reference in counseling is that clients will not only able to ‘see’ their problems but they also will learn how conscious thought, beliefs and behavior play a central role in the development and maintenance of emotional distress, health and illness
The processed of CBT are as follows:-

Knowledge and understanding of a range of CBT assessments like Beck Inventories.

To drive formulations of presenting problems or situations which integrate information from assessments with in a coherent CBT framework based on the theories.

Based on the formulation, the counselor will be able to implement therapy/ intervention techniques appropriately to address the presenting problem, psychological and behavioral circumstances.

To implement appropriate methods to evaluate the effectiveness of the interventions (NLP, mental imagery, relaxation, solution focused etc)

Elements in CBT Techniques

There are several elements of CBT. This will include the main structure in using CBT techniques that I feel comfortable and easy to use it. During the intake interview, these are the aspects that I (as the counselor) would do:-

Establish Trust and Rapport
Socialize patient into therapy
Educate patient about disorder
Normalize difficulties and instill hope
Elicit expectations for therapy
Gather additional information
Collaboratively develop goal list for therapy

When the session is taken place, I will use certain inventories to help the client to understand the presenting problem. These are the steps that may take in my counseling session:-

Do a mood check (BDI, BAI, BHS)
Update from previous session
Set an agenda
Review Homework
Discuss agenda items
Final summary
Assign Homework

In the session(s) I may do some interventions with the client. It could be done in the first session if it is an ‘easy client’. Normally, I will begin the intervention in the second on third session.. Along the sessions, I also will use Mental Status Examination (MSE) to monitor client’s development.

Some of the interventions are:-

Mental Relaxation (for stress, anxiety, depression)

Mental Imagery (for students/employees to excel or hoping for the betterment in their life)

NLP (swish pattern, meta yes/no, circle of excellence, phobia cue etc) Brief overview of session


Other behavior modifications

CBT is also known for its effectiveness in helping clients with many issues. The followings are some of the issues I have tried to my clients using CBT:-

Anxiety & Panic Attacks
Phobias (e.g. agoraphobia, social phobia)
Chronic Fatigue Syndrome
Eating problems
General Health problems
Habit problems (e.g. tics)
Problems associated with a learning disability
Sleep Disorders

It is important that to apply CBT, I have to have high level skills, knowledge and strong ethical values in managing the client. Able to think critically, reflectively and evaluatively are significant in CBT.

The evaluation of the sessions is important for me especially to get the commitment from the client through out the sessions. This can be done through collaborative relationship, preparing them for increased independence from the counseling sessions and discharging the clients from active treatment into a planned follow-up process that lead to more positive and outcome measures. This is indirectly could facilitate and generalize effective change.

In conclusion, I have learnt that CBT is helping me in many ways, as well as my clients. It is aimed to directly target distressing symptoms, re-evaluate thinking and promote behavioral responses of offering problem focused skilled based treatment interventions which are pragmatic, practical and easy.

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