Cognitive Behavioral Therapy: Comparing Group, Family, and Individual Settings
Cognitive Behavioral Therapy (CBT) is a widely used psychotherapeutic approach that focuses on identifying and modifying dysfunctional thoughts, emotions, and behaviors (Gautam et al., 2020). CBT can be effective in various settings, including individual, group, and family therapy, but each setting has its own unique challenges and considerations for Psychiatric Mental Health Nurse Practitioners (PMHNPs). CBT in individual settings involves one therapist dealing with one client at a time. It allows the therapists to tailor the CBT techniques to the unique needs and goals of the clients, allowing for a personalized approach and deep exploration of the client’s dysfunctional thought patterns, emotions, and behaviors (Gautam et al., 2020). It also allows the therapists to solely focus on the client, which is essential in developing a strong therapeutic relationship with the client. On the other hand, CBT in family settings involves one or more therapists offering psychotherapy interventions to two or more clients who are family members at a go to improve communication, understand, handle, and solve family issues (e.g. marital issues, parent-child conflict, sibling rivals, etc.), and establish a more functional family (Varghese et al., 2020). This allows the members to offer each other support and feedback, encourages learning, and validation, reduces feelings of isolation and stigma, and creates a sense of belonging, and support (Rosendahl et al., 2021). It also helps the family members to understand each other’s perspectives and how their behaviors influence one another.
The key challenges in family CBT are complex dynamics, confidentiality concerns, and focusing on one or some clients. In family CBT, the PMHNP must navigate complex family dynamics, including each other’s perspectives, communication patterns, power struggles, and intergenerational conflicts, which can complicate the CBT implementation and progress (Varghese et al., 2020). In one of the week’s media, the Beck Institute for Cognitive Behavior Therapy (2018, June 7), dealing with the different perspectives of each member is mentioned as a key challenge couple CBT. Maintaining confidentiality when dealing with more than one client, even when they are families is challenging, particularly when discussing sensitive topics (Rosendahl et al., 2021). The PMHNP must develop clear guidelines for confidentiality and ensure that each family member understands the importance of maintaining confidentiality through education and training (Brown & Lefforge, 2023). According to Varghese et al. (2020), focusing on one client, especially the index one is a common challenge that PMHNPs face in family CBT. Most families present with the belief that the index client is the key cause of their problem which may push the therapist to focus on him or her and not include or involve all the members in the sessions. This can leave many issues unresolved especially if the family’s beliefs are untrue and the problem is complex. The strategy to address this is to inform the patient from the beginning of the session that the problem may lie with the family and not necessarily with any one member. The PMHNP should also advise and encourage all the members to attend and actively engage in the therapy sessions (Varghese et al., 2020).
References
Beck Institute for Cognitive Behavior Therapy. (2018, June 7). CBT for couples. YouTube. https://www.youtube.com/watch?v=JZH196rOGsc
Brown, N. W., & Lefforge, N. L. (2023). Education and training guidelines for group psychology and group psychotherapy. Training and Education in Professional Psychology, 17(2), 126–132. https://doi.org/10.1037/tep0000417
Gautam, M., Tripathi, A., Deshmukh, D., & Gaur, M. (2020). Cognitive behavioral therapy for depression. Indian Journal of Psychiatry, 62(Suppl 2), S223. doi: 10.4103/psychiatry.IndianJPsychiatry_772_19
Rosendahl, J., Alldredge, C. T., Burlingame, G. M., & Strauss, B. (2021). Recent developments in group psychotherapy research. American Journal of Psychotherapy, 74(2), 52-59. https://doi.org/10.1176/appi.psychotherapy.20200031
Varghese, M., Kirpekar, V., & Loganathan, S. (2020). Family interventions: Basic principles and techniques. Indian journal of psychiatry, 62(Suppl 2), S192-S200. doi: 10.4103/psychiatry.IndianJPsychiatry_770_19
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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 Discussion, as you compare the use of CBT in individual, group, and family settings, consider 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.
Upload a copy of your discussion writing to the draft Turnitin for plagiarism check. Your faculty holds the academic freedom to not accept your work and grade at a zero if your work is not uploaded as a draft submission to Turnitin as instructed.
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!
