Cognitive Behavioral Therapy: Case Study

Cognitive Behavioral Therapy –
D Locke

Recently a client named Jorge was struggling with relational issues and reported he had begun drinking as a result of the issues with having and keeping a girlfriend. Jorge continued by stating he was struggling with quitting and now he finds that he is often drinking more and more, and that he does not seem to function normally if he does not drink. He stated it has not really helped his social situation either, but he does at least have friends and girl friends that he can hang with while he is drinking and partying. Jorge states he does not like feeling this need so much and since it did not help his situation he really does not like it. He did report that recently he had been
charged with driving under the influence due to his drinking, that his court appointed attorney had suggested he seek assistance from a practitioner who works with clients with alcohol-related situations, and that the judge would likely be more lenient on his sentence. Through meeting with Jorge, as a practitioner that has worked with more than seventy-five previous substance abusing clients, one would want to ensure he felt confident in the practitioners’ abilities, therefore clarifying and explaining these pieces modality in practice pursuant to NASW guidelines for principles of practice (NASW, 2008).
Through explaining this, you ensure a discussion is had about how Cognitive-Behavior Therapy (CBT) is an extension of cognitive therapy (Beck, 2007), and that his behavior or perceptions from the behavior enhance the use of CBT. You further discuss how cognitive therapy (CT) does have an inclusion of studying perceptions to situations and how they affect our processors through feelings, thoughts and reactions or behaviors (Beck,
2007) In order to determine the intervention for use with Jorge and the other previous clients, research of effectiveness with CBT is important as well. M. P. McGovern et al (2011) provided a basis for this methodology in their study through supportive studies which centered on providing effective treatment to clients who may face dual diagnosis. One of the studies conducted within their research provided validation with this method and resulted in findings of it being invaluable in providing safety to clients, and an efficacy in delivery to clients which may be suffering from PTSD as well as substance use. Another series of McGovern et al (2011) studies identified multiple factors for screening as follows:
At least 18 years of age
Enrolled in outpatient services and met criteria for substance abuse disorder
PTSD was identified as confirmed through screening
Legally advised of consent
Confirmed diagnosis of PTSD by certified assessor with a score higher than 44 on assessment tool
No acute symptoms of psychotic needs
No recent psychotic episodes or being institutionalized
And plateaued legal and medical matters at time of presenting for study.
There was various measures utilized to determine the multiple studies effectiveness such as addiction severity scales, semi-structured interviewing, Beck depression scales, toxicology measures, and much more (McGovern, M. 2011). This selection was provided on individual levels to multiple participants with significant supporting results as previously indicated. A second review of effectiveness for CBT with respect to substance use in clients can be supported within the article titled Quality versus quantity: acquisition of coping skills following computerized cognitive–behavioral therapy for substance use disorders (Kiliuk, D., et al, 2010), conducted research over similar time periods as McGovern, M., et al (2011), and within the same period of 8 weeks, discovered a supportive level of evidence with CBT. Behavioral role playing and individual reflection/assessments were particular assignments within this CBT methodology which proved beneficial to those individuals studied (Kiliuk, D., et al, 2010). This study yielded effective coping strategies for response through the role playing as well as quality problem solving through reflection of self and assessment measures. Another portion of Kiliuk et al (2010) studies which was relevant to a choice/selection was media exposure through usage of online training modules which assisted with respect to decision making as a substance user. As much of this information was supportive of Jorge’s this article as well supports the effectiveness of CBT as a treatment approach. The last article of review for practitioner support incorporated CBT for substance abusing clients, but with a clinical twist in incorporating spiritual needs as well. Hodge, D. (2011) sought to demonstrate effective research is available for practitioners-who specifically deal with substance abuse, through exploration of one’s spirituality and religion. Hodge (2011), further supported claims of the inclusion by encouraging other practitioners to be diligent in incorporating this as accrediting bodies within the United States-the Joint Commission had begun requiring the use of spiritual/religious exploration as a must. Hodge (2011) further encapsulated on utilizing spiritual strengths and spiritual supports through CBT with substance abuse clients, reporting through their self-reports the percentages of desired usage/exploration was greater than three-fourths of the sample sizes used. A great measure of this need through the survey used was how spirituality and spiritual supports attributed to more purposeful living within the client populations, allowing them to seek more of a desire to sustain treatment and recovery. Hodge (2011) notes that use of this in CBT further yielded embedded treatment, greater abstinence of substance use, quicker resolve on partialized matters, and a reduction in discrepancies in part of spiritual/religious inclusion. As a practitioner, using clear and supportive evidence of modality is of importance and thus these three articles reviewed supported practitioner claims of benefit to CBT as well.
In a related article toward effectiveness of using CBT within a group setting, Petrocelli, J. (2002) also validates a contradicting point toward CBT’s effectiveness or not in that through his research, he was able to determine that practitioners often times have over fifty percent allegiance toward such a behavior module due to their preference to a familiar practice method. This self-awareness piece would need to have surfaced and been disclosed as well in order to be effective in delivering professional expectations within the field.

References
Beck, A. (2007, February ). Cognitive Behavior Therapy News/Beck Instititute Blog. Retrieved from Beck Instititute for Cognitive Behavior Therapy: http://www.beckinstituteblog.org/2007/02/does-cognitive-therapy-cognitive-behavior-therapy/
Hodge, D. (2011). Alcohol Treatment and Cognitive-Behavioral Therapy: Incorporating Spirituality and Religion. Social Work, 56: 21-31.
Kiluck, B. N. (2011). Quality versus quantity: acquisition of coping skills following computerized cognitive–behavioral therapy for substance use disorders. The Authors, Addiction, 105, 2120–2127.
McGovern, M. L.-H. (2011). A Randomized Controlled Trial Comparing Integrated Cognitive Behavioral Therapy Versus Individual Addiction Counseling for Co-occurring Substance Use and Posttraumatic
Stress Disorders. JOURNAL OF DUAL DIAGNOSIS, 7(4), 207–227.
National Association of Social Workers. (2008). National Association of Social Workers. Retrieved from Code of ethics of the National Association of Social Workers: http://www.socialworkers.org/pubs/code/code.asp
Petrocelli, J. (2002). Effectiveness of Group Cognitive-Behavioral Therapy for General Symptomatology: A Meta-Analysis. Journal for Specialists in Group work, 27:1. 92-115.