COGNITIVE BEHAVIORAL THERAPY: COMPARING GROUP, FAMILY, AND INDIVIDUAL SETTINGS
COGNITIVE BEHAVIORAL THERAPY: COMPARING GROUP, FAMILY, AND INDIVIDUAL SETTINGS
There are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this cognitive behavioral therapy: comparing group, family, and individual settings Discussion, as you compare the use of CBT in individual, group, and family settings, consider the challenges of using this approach with groups you may lead, as well as strategies for overcoming those challenges.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
To prepare:
- Review the videos in this week’s Learning Resources and consider the insights provided on CBT in various settings.
BY DAY 3
Post an explanation of how the use of CBT in groups compares to its use in family or individual settings. Explain at least two challenges PMHNPs might encounter when using CBT in one of these settings. Support your response with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly and attach the PDFs of your sources.
Read a selection of your colleagues’ responses.
BY DAY 6 OF WEEK 1
Respond to at least two of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own experiences with clients.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!
COGNITIVE BEHAVIORAL THERAPY: COMPARING GROUP, FAMILY, AND INDIVIDUAL SETTINGS DISCUSSION POST
Cognitive Behavioral Therapy (CBT) is an evidence-based approach widely used in the treatment of various mental health disorders. It can be implemented in different settings, including groups, families, or individual sessions. This response will compare the use of CBT in groups to its use in family or individual settings, highlighting the unique characteristics and challenges in each context. Furthermore, it will discuss two challenges that psychiatric mental health nurse practitioners (PMHNPs) might encounter when using CBT in one of these settings, supported by examples from the provided sources.
CBT in Groups vs. Family or Individual Settings:
CBT in group settings involves conducting therapy with multiple individuals who share similar concerns or diagnoses. It offers several advantages, such as the opportunity for peer support, social learning, and the development of interpersonal skills. Group therapy also promotes a sense of universality, where individuals realize that they are not alone in their struggles (James et al., 2020). Additionally, it allows for the exploration of interpersonal dynamics and provides a platform for practicing new skills within a safe and supportive environment.
ORDER A CUSTOM-WRITTEN PAPER HERE
In contrast, CBT in family or individual settings focuses on tailored interventions specific to the individual or family system. Individual therapy allows for personalized attention, fostering a strong therapeutic alliance and addressing individual needs and goals. Family therapy, on the other hand, involves working with the entire family unit to address patterns of communication, conflict resolution, and dysfunctional dynamics (James et al., 2020).
Challenges of Using CBT in Group Settings:
One challenge that PMHNPs may encounter when using CBT in group settings is the heterogeneity of group members. Each individual may have different symptom presentations, levels of motivation, or treatment goals, making it challenging to address everyone’s specific needs. For example, Sigurvinsdóttir et al. (2020) highlighted the issue of variability in treatment response and suggested the need for subgroup analyses to determine which individuals benefit the most from group-based CBT interventions.
Another challenge is the potential for group dynamics to hinder therapy progress. Conflicts or disruptions within the group can create a challenging therapeutic environment. For instance, Storch et al. (2013) discussed how children with autism spectrum disorders participating in group CBT for anxiety may struggle with social interactions or have difficulty engaging with peers, affecting the group’s overall dynamics and therapeutic outcomes.
The provided sources are considered scholarly as they are peer-reviewed and provide empirical evidence for the effectiveness of CBT in various settings. The Cochrane database of systematic reviews is a reputable source that critically evaluates the available evidence, ensuring the reliability and validity of the included studies (James et al., 2020). The Nordic Journal of Psychiatry and the Journal of the American Academy of Child & Adolescent Psychiatry are both peer-reviewed journals that publish original research articles, adhering to rigorous scholarly standards (Sigurvinsdóttir et al., 2020; Storch et al., 2013).
References:
James, A. C., Reardon, T., Soler, A., James, G., & Creswell, C. (2020). Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane database of systematic reviews, (11).
Sigurvinsdóttir, A. L., Jensínudóttir, K. B., Baldvinsdóttir, K. D., Smárason, O., & Skarphedinsson, G. (2020). Effectiveness of cognitive behavioral therapy (CBT) for child and adolescent anxiety disorders across different CBT modalities and comparisons: a systematic review and meta-analysis. Nordic Journal of Psychiatry, 74(3), 168-180.
Storch, E. A., Arnold, E. B., Lewin, A. B., Nadeau, J. M., Jones, A. M., De Nadai, A. S., … & Murphy, T. K. (2013). The effect of cognitive-behavioral therapy versus treatment as usual for anxiety in children with autism spectrum disorders: A randomized, controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 52(2), 132-142.
COGNITIVE BEHAVIORAL THERAPY: COMPARING GROUP, FAMILY, AND INDIVIDUAL SETTINGS RESPONSE
Hello XX, I agree that CBT is a psychotherapeutic approach that is very widely used in various settings. As you have pointed out rightly, its effectiveness has made it a preferred choice of talk therapy for individual patients with psychiatric disorders, families, and also groups of patients (David et al., 2018). Indeed, CBT is the present gold standard of psychotherapy for mental illnesses in individual, family, and group settings.
I also concur with you that group CBT is for clients with similar diagnoses or complaints. True, it has a number of advantages as you state. You have given examples of social learning, peer support, a sense of universality, and interpersonal skills. I see these as Yalom’s so-called group curative factors that are very critical to bringing about desired outcomes in group psychotherapy (Hauber et al., 2019). I will add existential factors, imitative behavior, catharsis, instillation of hope, and self-understanding as additional beneficial curative factors in group CBT.
On family and individual CBT, you give some very crucial insights. The individual is a single person and so their CBT focuses on personalized attention. I fully agree with this observation and statement. Nevertheless, the analogy you inadvertently make between the individual and the family intrigues me. The family is also a single unit and might be treated as an individual unit. They have similar concerns that as you put it are usually connected to some problem with communication and interpersonal conflict.
About the challenges that the PMHNP may face when using CBT in group settings, I think you are spot on. You have offered heterogeneity of group members and group dynamics as two of these challenges. I would not agree with you more on this. Group members are individuals in their own right and they come to the group with their own individual peculiarities and habits. These might present a challenge to the therapist. Also, group dynamics usually involve the inevitable interpersonal conflicts due to divergence in personalities and preferences. All these must be addressed before any progress is made.
References
David, D., Cristea, I., & Hofmann, S.G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry, 9(4), 1-3. https://doi.org/10.3389/fpsyt.2018.00004Links to an external site.
Hauber, K., Boon, A.E., & Vermeiren, R. (2019). Therapeutic factors that promote recovery in high-risk adolescents intensive group psychotherapeutic MBT programme. Child and Adolescent Psychiatry and Mental Health, 13(1), 1-10. https://doi.org/10.1186/s13034-019-0263-6Links to an external site.
COGNITIVE BEHAVIORAL THERAPY: COMPARING GROUP, FAMILY, AND INDIVIDUAL SETTINGS RESPONSE 2
Hi XX, I want to express my gratitude for the thoughtfulness and research that went into your writing on cognitive behavioral therapy. You did an outstanding job examining the differences and similarities between individual treatment and therapy conducted in groups or families, as well as identifying the potential obstacles that may be encountered by PMHNPs. Your thesis that cognitive behavioral therapy (CBT) is a successful technique for treating a wide variety of mental problems is supported by research. According to Verhey et al. (2020), cognitive behavioral therapy (CBT) is adaptable enough to be utilized by non-professionals who provide psychological treatments in areas that are facing a scarcity of mental health specialists. According to your research, the most significant difficulties that PMHNPs face are limits and fear. For instance, patients who are engaged in family, group, or individual therapy may be reluctant to participate in treatment out of concern that their private health information would be compromised.
Patients are shielded from the occurrence of such incidents by the federal government by a broad variety of rules, one of which is the Health Insurance Portability and Accountability Act (HIPAA). Fear can be mitigated in healthcare facilities by ensuring or demonstrating compliance with the Health Insurance Portability and Accountability Act (HIPAA). According to Cohen et al. (2018), HIPAA requires patients to provide their consent prior to the disclosure of any identifiable health information kept by protected organizations, with the exception of specified circumstances in which certain exclusions apply. Crossing boundaries is a substantial obstacle that can be detrimental to the efficacy of group therapy. According to Zur (2018), therapists have a responsibility to ensure that boundary crossing is a well-established and articulated intervention that takes into consideration a variety of factors, including the participants’ personalities, health conditions, cultures, and histories.
References
Cohen, I. G., & Mello, M. M. (2018). HIPAA and protecting health information in the 21st century. Jama, 320(3), 231-232.
Verhey, I. J., Ryan, G. K., Scherer, N., & Magidson, J. F. (2020). Implementation outcomes of cognitive behavioural therapy delivered by non-specialists for common mental disorders and substance-use disorders in low-and middle-income countries: a systematic review. International Journal of Mental Health Systems, 14(1), 1-14.
Zur, O. (2018). To cross or not to cross: Do boundaries in therapy protect or harm. Psychotherapy bulletin, 39(3), 27-32.
COGNITIVE BEHAVIORAL THERAPY: COMPARING GROUP, FAMILY, AND INDIVIDUAL SETTINGS DISCUSSION POST TWO
- Cognitive Behavioral Therapy: Comparing Group, Family, and Individual SettingsThe use of Cognitive Behavioral Therapy (CBT) in groups, family, or individual settings can have distinct characteristics and challenges. Here’s an explanation of how the use of CBT in groups compares to its use in family or individual settings, along with two challenges that Psychiatric-Mental Health Nurse Practitioners (PMHNPs) might encounter when using CBT in a group setting.CBT in Groups
In group therapy, CBT involves a therapist facilitating a structured session with multiple participants who share a common mental health concern. Group members benefit from sharing their experiences, insights, and coping strategies, which can foster a sense of belonging and reduce feelings of isolation. Observing others’ progress and learning from their perspectives can be empowering and inspiring for group members.
Challenges in group CBT can arise from individual differences in needs, personalities, and symptom severity, which may require tailoring interventions to accommodate diverse group dynamics.
CBT in Family
CBT in a family setting focuses on addressing and modifying dysfunctional patterns of interaction and communication among family members. Family therapy aims to improve relationships and enhance family functioning by involving multiple family members in the therapeutic process. The therapist helps family members identify and challenge unhelpful thoughts and behaviors while promoting healthy communication and problem-solving skills.
Challenges in family CBT may arise from conflicting agendas, power imbalances, or resistance to change within the family system. Therapists need to establish trust, engage all family members, and navigate complex dynamics to facilitate meaningful progress.
According to the Beck Institute for Cognitive Behavior Therapy (2018), CBT for Couples teaches clients to understand what they can control in the relationship by evaluating their own cognitions while considering their partner’s cognitions as well. CBT for Couples is a therapeutic approach that focuses on empowering individuals in a relationship by helping them evaluate their own thoughts and considering their partner’s thoughts (Beck Institute for Cognitive Behavior Therapy, 2018). The goal of CBT for Couples is to assist clients in understanding and recognizing the aspects within their control within the relationship (Beck Institute for Cognitive Behavior Therapy, 2018). CBT for Couples provides a framework for improving communication, resolving conflicts, and fostering healthier relationships through cognitive evaluation (Beck Institute for Cognitive Behavior Therapy, 2018).
PMHNPs may encounter challenges in fostering group cohesion and ensuring active participation from all members. Some individuals may be more reserved, reluctant to share or feel overshadowed by dominant group members. Balancing participation and encouraging engagement while maintaining a safe and supportive environment is crucial.
PMHNPs may face the challenge of tailoring interventions to meet individual needs within the group context. Group members may present with varying levels of severity, readiness for change, or specific treatment goals. PMHNPs must strike a balance between addressing individual concerns and maintaining the group’s focus and progress.
Overall, while CBT in groups offers unique advantages such as shared support and diverse perspectives, PMHNPs must navigate challenges related to group dynamics, individual differences, and tailoring interventions to optimize the effectiveness of CBT in a group setting (PsychExamReview, 2019).
The cited articles are considered scholarly because they are all peer-reviewed journals; they have been written by experts in the field, of psychotherapy and mental health research; each one includes an extensive list of references and citations which demonstrates that the authors have a deep understanding of their subject and that they have reviewed the existing literature on the topic, and are contributing new research findings to that body of knowledge. Also, all three articles have DOIs.
Reference
Beck Institute for Cognitive Behavior Therapy. (2018, June 7). CBT for couplesLinks to an external site.Links to an external site.
[Video]. YouTube.https://www.youtube.com/watch?v=JZH196rOGscLinks to an external site.DeMarce, J. M., Gnys, M., Raffa, S. D., Kumpula, M., & Karlin, B. E. (2021). Dissemination of cognitive behavioral therapy for substance use disorders in the Department of Veterans Affairs Health Care System: Description and evaluation of Veteran outcomes. Substance Abuse, 42(2), 168–174. https://doi.org/10.1080/08897077.2019.1674238Links to an external site.
MedCircle. (2019, December 13). What a cognitive behavioral therapy (CBT) session looks likeLinks to an external site.Links to an external site.
[Video]. YouTube.https://www.youtube.com/watch?v=8-2WQF3SWwoLinks to an external site.Nyman-Carlsson, E., Norring, C., Engström, I., Gustafsson, S. A., Lindberg, K., Paulson-Karlsson, G., & Nevonen, L. (2020). Individual cognitive behavioral therapy and combined family/individual therapy for young adults with Anorexia nervosa: A randomized controlled trial. Psychotherapy Research, 30(8), 1011–1025. https://doi.org/10.1080/10503307.2019.1686190
COGNITIVE BEHAVIORAL THERAPY: COMPARING GROUP, FAMILY, AND INDIVIDUAL SETTINGS DISCUSSION POST THREE
Cognitive Behavioral Therapy: Comparing Group, Family, and Individual Settings
Cognitive Behavioral Therapy (CBT) is an extensively acknowledged form of psychotherapy that centers on recognizing and changing undesirable thoughts and behaviors that lead to emotional distress and psychological challenges (Murphy et al., 2020). It aids people to develop more adaptive ways of thinking and behaving. It highlights the role of thoughts in impacting emotions and behavior by helping people identify and challenge irrational thought patterns, like distorted thinking or cognitive biases such as the thought of being unlovable as highlighted in the “Cognitive Behavioral Therapy Session” video (MedCircle, 2019). Through cognitive restructuring, individuals learn to substitute these unhelpful contemplations with more accurate and balanced ones (PsychExamReview, 2019). It also addresses behavioral patterns that can lead to psychological issues by encouraging individuals to participate in positive and healthy behaviors while decreasing avoidance or withdrawal behaviors (PsychExamReview, 2019). By enhancing rewarding and fulfilling activities, clients can advance their mood and overall well-being.
How the Use of CBT in Groups Compares To Its Use in Family or Individual Settings
CBT use in groups differs from its use in individual or family settings especially because of the legal and ethical considerations involved in the three settings because of the dynamics and complexities involved in working with multiple individuals or close members which impact the therapeutic approaches. For instance, in confidentiality and privacy requirement, individual therapy confidentiality is between the therapist and client, permitting open and private discussion while in group and family therapy, it is more complex because it involves establishing clear confidentiality guidelines and stressing the need to respect each other’s privacy in the group or family setting (Wrape & McGinn, 2019). Similarly informed consent in individual therapy is obtained directly from the client ensuring that they comprehend the nature of therapy, its benefits, and risks while in group and family therapy, it entails getting informed consent from multiple individuals which makes the process more complex (Wrape & McGinn, 2019). Also, when navigating boundaries and relationships within the therapy, individual therapy is less complicated because the relationship is between the therapist and the client while in family and group setting it involves navigating multiple relationships simultaneously (Wrape & McGinn, 2019).
Challenges PMHNPs Might Encounter When Using CBT in Group Settings
Balancing individual needs and group dynamics: In a group therapy setting, PMHNPs need to navigate the balance between addressing individual needs and managing the dynamics within the group (PsychExamReview, 2019). Each group member may have different issues, goals, and progress levels. It can be challenging to ensure that each individual receives adequate attention and personalized interventions while also promoting a supportive and cohesive group environment (Fraino & Selix, 2021). PMHNPs must effectively manage group interactions, conflicts, and varying levels of participation to ensure a productive and inclusive therapeutic experience for everyone (Fraino & Selix, 2021).
Maintaining confidentiality and privacy: Group therapy relies on establishing a safe and confidential space for participants to share their thoughts, emotions, and experiences (Murphy et al., 2020). However, ensuring confidentiality and privacy can be more challenging in a group setting compared to individual therapy. PMHNPs must establish clear guidelines and protocols regarding confidentiality, emphasizing the importance of maintaining the privacy of other group members’ personal information (Murphy et al., 2020). Managing breaches of confidentiality or potential conflicts between group members can require careful navigation to maintain trust and a secure therapeutic environment (Murphy et al., 2020) cognitive behavioral therapy: comparing group, family, and individual settings
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Why the three articles are considered scholarly
The three articles used in the above review are published in reputable academic journals. “The Journal for Nurse Practitioners” and “Journal of Marital and Family Therapy” are renowned journals in their corresponding fields, while “The Cognitive Behavior Therapist” is a renowned journal concentrating on CBT. Publishing in academic journals shows that the articles have gone through a rigorous peer-review process to guarantee the quality and validity of the research.
References
Fraino, J., & Selix, N. (2021). Facilitating well-rounded clinical experience for psychiatric nurse practitioner students. The Journal for Nurse Practitioners, 17(8), 1004-1009.
Murphy, R., Calugi, S., Cooper, Z., & Dalle Grave, R. (2020). Challenges and opportunities for enhanced cognitive behavior therapy (CBT-E) in light of COVID-19. The Cognitive Behaviour Therapist, 13, e14.
MedCircle. (2019, December 13). What a cognitive behavioral therapy (CBT) session looks like links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=8-2WQF3SWwo
PsychExamReview. (2019, April 30). Cognitive therapy, CBT, & group approaches (intro psych tutorial #241)Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=A2_NN1Q7Rfg
Wrape, E. R., & McGinn, M. M. (2019). Clinical and ethical considerations for delivering couple and family therapy via telehealth. Journal of Marital and Family Therapy, 45(2), 296-308. cognitive behavioral therapy: comparing group, family, and individual settings
