Intervention and Cognitive Behavioural Therapy (cbt)

In this essay, I will look at an intervention used to help young people who suffer from mental health issues such as, low self-esteem, depression, anxiety, obsessive-compulsive disorder and post–traumatic stress disorder. The intervention I have chosen to focus on is Cognitive Behavioural Therapy (CBT). I will explain both what an intervention is and what cognitive behavioural therapy is. I will briefly describe how cognitive behavioural therapy works and provide both the positives and negatives of this intervention. I will also use a variety of sources to back up these findings. The term “intervention” refers to the actions taken in order to interfere with an ongoing process and modify for the better. (Reber et al, 2009, p. 397)

Understanding Cognitive Behavioural Therapy

Cognitive behavioural therapy (CBT) is a psycho-social intervention that focuses on changing our thought and behavioural patterns. (O’ Brien, 2011) Cognitive behavioural therapy summarises many of Albert Ellis and Aaron T. Becks ideas. “Macleod (2003) relates that cognitive behavioural therapy is the most recent of the major therapy orientations with new elements being added to it, including strategies for cognitive intervention.” (O' Brien 2011 p. 163) Cognitive behavioural therapy is based on the ideology that our thinking process, our feelings and our behaviour, are all connected together. It is that our thoughts and feelings can decide how we behave. The aim of cognitive behavioural therapy is to help people gain an awareness of when they are making negative judgments, and to learn to identify behavioural sequences that emphasise the negative thinking. Cognitive behavioural therapy helps people to form different ways of thinking and acting, which aims to decrease the psychological affliction they are going through. This approach is known as cognitive reconstructing.

The Mechanism of Change in CBT

The overall aim is for the individual to attribute improvement in their problems making their own efforts, in collaboration with the therapist. This therapy tries to address issues in a straight forward way. It concentrates on a shared model of understanding, using a psycho-educational approach. Its effectiveness as a model is shown by its continual and increasing use and acquired recommendation by a range of evidence-based guidelines. (Roth & Fonagy, 2005) This theory allows for the young people to evaluate their own situation, become aware of what their issue is and find where it is coming from. Once they know where the problem comes from, the young person can take appropriate actions to slowly work towards resolving the issue. Once the young person has the problem resolved, they will see the benefits of cognitive behavioural therapy.

Benefits and Duration of CBT

An advantage of cognitive behavioural therapy is that it is usually short, only needing from five to ten months for most emotional problems. The young people attend one session per week and each session lasts roughly 50 minutes. During the session, the young person and therapist will work together to understand what the problems are and develop new ways to help deal with them. Cognitive behavioural therapy introduces young people to a set of principles that they can apply whenever they need to, and that’ll last them a lifetime. (Martin, B, 2016)

Evidence Supporting CBT's Effectiveness

The effectiveness of cognitive behavioural therapy is supported by evidence from randomised controlled trials (RCTs), uncontrolled trials, case series and case studies. Cognitive behavioural therapy has been widely tested since the first outcome study was published in 1977 (Rush et al, 1977). By this stage, there has been more than 500 outcome studies that have shown the effectiveness of cognitive behaviour therapy used for a wide range of psychiatric disorders, psychological problems and medical problems with psychological components. This book by Beck (2011, P.4) went on to list a variety of disorders that had been successfully treated by cognitive behavioural therapy such as, obsessive-compulsive disorder, bi-polar disorder, family issues, insomnia and severe anxiety. This evidence was provided to demonstrate how the treatment is extremely beneficial.

Critiques and Limitations of CBT

From the book Cognitive Therapy and Emotional Disorders by Beck (1979) it quoted Allport (1968) referring to cognitive behavioural therapy as “a significant revolution”. Allport went on to refer to this approach as an “attitudinal” therapy; he identified similar points of agreement in the theories of such different writers such as Adler, Erikson, Horney, Maslow and Rogers. He stated that the work of Albert Ellis should be added to this list of great writers. To further prove that cognitive behavioural therapy has its strengths, Butler and Beck (2000) decided to review 14 meta-analyses to examine the efficiency of Beck’s cognitive therapy and they found that around 80% of the participants had benefited from the therapy. This suggests that having an awareness of the cognitive explanation can in fact improve the quality of a young person’s life.

Also agreeing with Butler and Beck that cognitive behavioural therapy is an effective treatment is Hoffman & Smits (2017). They stated in their book that as cognitive behavioural therapy is problem-focused; it makes it exceedingly productive in the treatment of an array of mental health and adaption issues as therapists have a variety of strategic interventions to implement based on each patient’s clinical presentation, their treatment goals and their preferences. However, even though there are many sources in favour of cognitive behavioural therapy because of all the benefits that can be gained from it, there are others that oppose. Driessien & Hollon (2011) say that Motivational Interviewing can make cognitive behavioural therapy work better by specifying strategies to build clients’ own motivation to do the hard work. Although cognitive behavioural therapy has evidence proving its strengths, LeBeau et al (2013) states that many individuals do not respond to treatment or adhere to treatment tasks; discontinue treatment and are unable to maintain change after initial success. (Naar & Safren, 2017). Driessien & Hollon are not completely against the idea of cognitive behavioural therapy but just feel that it can be enhanced greatly if it were linked with motivational interviewing.

Conclusion

To conclude, the overall aim of cognitive behavioural therapy is for the individual to attribute improvement in their problems making their own efforts in collaboration with the therapist. This essay has analysed the Cognitive Behavioural Therapy intervention used to help young people who suffer from mental health issues such as low self-esteem, depression, anxiety, obsessive-compulsive disorder and post–traumatic stress disorder. The sources have proven through their studies that there are positive effectives to be gotten from part taking in cognitive behavioural therapy. The research done has provided information to show that cognitive behavioural therapy can have both positives and negatives as an intervention. However, the sources have proven it to be mostly successful and a favourable intervention when working with young people.