Cognitive Behavior Therapy (Essay Sample)

Cognitive Behavior Therapy (CBT) – Bipolar 1 Disorder Case Study Name of Student University Affiliation Introduction What causes the highs and lows of bipolar disorder? According to a study, bipolar mood swings are influenced by your thoughts. The researchers found that having extremely negative thoughts may bring on what’s called "descent behaviors" (such as withdrawing from friends) associated with depression, while overly positive thoughts can lead to "ascent behaviors" (such as risk taking) associated with mania. Practicing CBT may be a way to level out these extremes. "Cognitive behavioral therapy capitalizes on the fact that our thoughts, actions, and emotions are all interconnected and can influence one another. CBT teaches you how to catch, challenge, and change flawed thoughts as well as identify and correct troublesome behavior patterns. CBT teaches you to respond to situations with calmer thoughts, such as that your boss may simply want to ask you some questions about your work, which keeps your mood stable. "People often feel better emotionally and attain a better quality of life after undergoing CBT," Dr. Rego says. According to the literature in recent years structured psychological therapies which combine both kind of methods including psycho education and cognitive behavioral therapy are being increasingly used in the treatment of bipolar disorders. While psycho educational programs have been shown effective on bipolar disorder both for preventing manic and depressive episodes, research has suggested that cognitive-behavioral therapy is particularly useful in the treatment and prevention of depression. So the combination of both therapies has been shown equally effective in treating bipolar disorders. Psycho education programs have also been reported very effective for several other mental health disorders including schizophrenia, etc. Long term studies conducted on the bipolar patients also showed that participants who received cognitive-behavioral therapy in addition to psycho education experienced 50% fewer days of depressed mood over the course of 1 year and less antidepressant increases comparatively with those who only received psycho education. Objectives of the Case Report The main objective was to treat client mainly with talk therapy or psychotherapy rather than medication. Psychotherapy is considers an important part of treatment for many people diagnosed with bipolar disorder. In psychotherapy therapist helps the client in modifying behavioral or emotional patterns that contribute in the development of bipolar disorder. People with bipolar disorder usually benefit from a combination of medication and psychotherapy. Past research has supported that bipolar disorder can be best treated by a combination of pharmacotherapy, cognitive therapy, social support and family interventions. Although antidepressants have been suggested to be effective in treating bipolar disorder but they have also been reported to provoke manic switch and rapid cycling. Diagnostic Criteria of Bipolar 1 Disorder In Bipolar I disorder there is at least one episode of mania or mixed depressive and manic symptoms. The sign and symptoms must cause social or occupational distress. Symptoms of Bipolar I disorder should not be better accounted for by schizoaffective disorder. The manic or mixed episodes must not be superimposed on schizoaffective disorder, schizophrenia, delusional disorder or other psychotic condition. Manic episodes are characterized by expansive, elevated or irritable mood and increased activity and energy level, which last for a week or more, accompanied by 3 of the following (4 if the mood is irritable), psychomotor agitation or increased goal-directed activities or behavior, inflated self-esteem or grandiosity, decreased need for sleep, flight of ideas, distractibility, increased talkativeness or increased risky behavior. These sing and symptoms must be severe enough to cause social impairment, hospitalization and should not be batter accounted by the medical condition or substance abuse. Treatment process Mr. X was coped with 12 psychotherapeutic sessions. Cognitive behavioral therapy was applied to Mr. X. As he was suffering from mood swings, by using CBT he was able to learn how to changes his distorted cognitions. As being a psychotherapist I help him to identify which negative behavior patterns he would like to work on. Through CBT I taught him coping skills to handle the problem correctly. CBT focus on both behavior and cognition and client was taught to improve his maladaptive behavior by behavioral techniques. Psychotherapy was started after Mr. X achieved remission phase. During first few sessions, therapist builds repo with the client and ensures him that maximum level of confidentiality will be maintained throughout sessions. In next few sessions I identified with his help that which thought pattern are problematic for him. According to him, he really wanted to get rid of his problematic thoughts and associated behaviors like he told during sessions that he is the victim of bad luck and all that is happening to him is the result of bad circumstances and he often thought to commit suicide to get rid from this bad world. Through a thorough investigations it was revealed that his poor socio economic condition has played significant role in his though pattern. During sessions I identified more stressors in his life which were creating troubles for him. After identifying negative thoughts patterns from which he wanted to get rid, I discussed with him that how we will work on them mutually. In next few sessions focus of the therapeutic session was on the cognitive restructuring of the client. Cognitive restructuring involves systematic identification of the problematic thought patterns which contribute to the onset and maintenance of the symptoms. Mr. X was made aware how negative thought patterns and their associated behaviors like aggression in his case were enhancing his problems like stress, depression and mania symptoms. I started to work with him on his negative thought pattern and problem behaviors one by one. We set our targets of psychotherapy priority wise. First of all we identified problem thoughts and behaviors then decided strategies to work on them. His main problems include sleep deprivation, stress, anger and racing thoughts. Follow up session were also conducted for accessing his level of achievement for achieving targets of psycho-therapy. For sleep management the client was educated about the role of disruptions in the sleep/wake cycle in heralding new episodes and it was discussed with the client what level of activity and sleep seems most reasonable for the client. After identifying desired hours of sleep client was asked to calculate a regular bed time relative to daily demands and waking times. After knowing all the client activities before sleep time, he was asked to avoid thinking hard and doing all kinds of behaviors which divert the attention before sleep. Behavioral therapies were applied on Mr. X in latter sessions to change his maladaptive behaviors. He was taught muscle relaxant techniques to cope with stress. During sessions he was also taught stress management and anger management techniques. Stress management techniques were applied on the client to cope with stress in future by problem solving, communication skills and cognitive-restructuring. Psycho-education program was given to Mr. X about his disorder. In psycho-education session client was made aware about the relationship between activities, physical feelings and mood. He was given training about how to identify and monitor the early warning symptoms in order to deal with them in future and in present. Subsequently he was trained in the use of anxiety-control techniques (relaxation and breathing, self-instructions and cognitive distraction), sleep hygiene habits and planning gratifying activities. In latter sessions he was trained in detecting distorted thoughts and using the process of cognitive restructuring. Problem solving and improvement of self-esteem techniques were taught to the client in order to prevent relapses. During psychotherapy Mr. X was also taught social skills (assertiveness, non-verbal communication, conversational skills, giving and receiving compliments, giving and receiving criticism and asking for favors). In the final session Mr. X reported of having less frequency of his sign and symptoms. He was in happy mood and was determined to improve his life. He was recommended the follow up session to check his progress of recovering. Other CBT Techniques 1. Accepting your diagnosis. The first step is to understand and acknowledge that you have a disorder that's responsible for your symptoms. This is often difficult for people with bipolar disorder to accept, so teaching the signs, symptoms, causes, and course of the disorder is essential. It helps people embrace the idea of getting help while also knowing they’re not alone, Rego says. 2. Monitoring your mood. This is often done using a worksheet or journal, which is kept up on a daily basis between sessions and then reviewed with your therapist. People are asked to rate their mood daily on a 0-to-10 scale, in which 0 represents "depressed," 5 stands for "feeling OK," and 10 is equivalent to "highly irritable or elevated mood." The purpose is to become more aware of mood triggers and changes. 3. Undergoing cognitive restructuring. This process focuses on correcting flawed thought patterns by learning how to become more aware of the role thoughts play in your mood, how to identify problematic thoughts, and how to change or correct them. The therapist teaches the patient how to scrutinize the thoughts by looking for distortions, such as all-or-nothing thinking, and gene...