Aaron Beck's Cognitive Behavioural Therapy (CBT)

Following the referral letter and based on the description of the Diagnostic and Statistical Manual of Mental Disorders ((DSM-IV, 1994), Mrs Tan is diagnosed with clinical depression. She suffers from insomnia, feelings of worthlessness and inappropriate guilt. Thus, the most suitable therapy for her is Cognitive-behavioural therapy. Aaron Beck’s ‘Cognitive Therapy’ (CT) is one main stream of source for Cognitive-behavioural theory.
An obvious characteristic of depression is when a subject continuously sees things around him in a dysfunctional manner. According to Beck (1967), this is called the ‘negative triad’. These negative thinking patterns bring about symptoms such as a depressive disorder, affective, behavioural, somatic and motivational;
According to the cognitive model, depression contains negative thinking itself. Mrs Tan’s low mood and self-neglect compound the problem, creating further lowering of mood. Cognitive behaviour therapy is a directive, structured, and psycho-educational approach. There are three main assumptions underlying CBT. Firstly, emotions and behaviours are determined by thinking, secondly, emotional disorders result from negative and unrealistic thinking, lastly, by altering this negative and unrealistic thinking, emotional disturbances can be reduced. CBT requires the following procedures to be taught to the client. It is important to monitor the client’s emotional upsets and activating events; identify the connections between thinking, emotions and behavior; test out maladaptive thinking and beliefs by examining the evidence for and against them; identify maladaptive thinking and beliefs; substitute the negative thinking with more realistic thinking. (Trower & Casey, 1988, as cited in Nichols,
In Mrs Tan’s case, these include assertive difficulties whereby Mrs Tan feels useless because her mum is kept at a nursing home. Guilt and self-blame because she feels guilty for eight year old son’s theft case in school.
The assessment phase should begin with Mrs Tan’s perception of what was wrong with her and her thoughts about being diagnosed with clinical depression. The following must be examined: the severity of Mrs Tan’s clinical depression and the effect it is having on her life, including factors which contributed to her mother being kept in a nursing home and her son’s theft case, negative thoughts about herself, Mrs Tan’s personal and social history, personality factors such as overweight issues, general health status; history of substance abuse namely sleeping pills.
Next, Mrs Tan should be introduced to the concept of CBT as a treatment method. She should be made receptive to the idea of rational and irrational thoughts and recognize their relevance to her own experiences. Intervention would be to ensure particular care is taken to prioritise dealing with her feelings of hopelessness, and negative expectations of treatment. Intention must be to assess Mrs Tan’s self-confidence level and intervene