Cognitive behavioral therapy
She was an attentive listener, allowing me to continue with my explanation uninterrupted. I had told her to make notes of words or points she did not understand, that she will be given information to take home, which she can read as many times as she wanted and that she can bring questions with her on her next appointment.
L, explained that, (CB) is a psychotherapeutic approach with the aims to teach clients new skills, on how to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-orientated, systematic procedure.
It is effective for the treatment of a variety of problems, including mood, anxiety, personality, eating, substance abuse, and psychotic disorders and in this instance to help H in her fight against a severe form of anxiety. She acknowledged the fact that she could have benefited with some help earlier, but, was never one to verbalizes herself keeping her feelings locked-up.
CB is used in individual and group settings, with the techniques often adapted for self-help applications, developed by merging of behavior therapy with cognitive therapy resulting with the finding of a common ground in focusing on the “here and now”, and on alleviating symptoms..
Further focus is on behavioral strategies designed to activate clients in the environment with a view to effect desired behavior change.
Distinctive features of CB: ) Use of homework and outside-of-session activities 2) Direction of session activities 3) Teaching of skills used by clients to cope with problems 4) Emphasis on clients’ future experiences 5) Providing clients with information about the course of treatment 6) An interpersonal/cognitive focus Satisfied with the explanations given, H, agreed and signed to have 6 sessions of counseling with myself as her therapist. The session ended after I reminded her to confirm her attendance for her next appointment which she did the following day. 1st session- 17/03/2013.
H, was on time for her appointment looking fairly composed and looking slightly riskier than she was at our 1st meeting. I reminded H of her responsibilities and our roles with her in the Lead and the whole stage reserved Just for her.
With an almost perfect health history other than the symptoms she presented herself with at rules meeting, she has now realized that she should have taken a bolder step much earlier. She told me that she has been married for 10 years and that her life remained unchanged, not one to free mix and hardly going out except on Sundays being her husband’s only day-off.
They will set off for their morning walk, stopping at ere in-laws for breakfast, one routine that she can remember having. She told me that she very rarely visits her mother as she is always at work to pay the bills. She has two brothers whom she said “My mother will be better off without them in the house. Both are unemployed.
Hence mum, has to provide them with almost everything. To think, I lived with them for about 24 years. Countless number of times they had Tormenter to PICK me up Trot cocoons. Eve never trusted teem. I could never nave a conversation with them as they always screamed at me”.
My childhood, growing in such an environment, being bullied at school/home and enable to do anything about it, I dreaded going to school and of being at home with my brothers. I did complain to my mum, who reprimanded them. They always denied screaming or being harsh towards me. How, I wished for my dad to be alive. He always protected me as I was his, pretty princess. I was never short of affections from both my parents.
” She asked if she can stop for a break as at that very moment, she just burst out sobbing her heart out, tears running from her eyes.
She withdrew herself from my study, going towards the front entrance as she told me, Just to have some fresh air. Returning about 10 minutes later, she appeared refreshed and ready to continue with the session. I asked her to bring a list of affirmations with her to the next appointment, should she decide to come, to which she said, “of course, I am coming back. You are the 1st person with whom I can have a conversation knowing that you’ll never let me down.
This is the point where I brought the session to its end, reminding her to be positive and to remember her homework.
Thanking me, and, apologizing for her unsettled period, she made her way to the front lobby, where her husband was waiting to pick her up. ND session- 24/03/2013 H was on time again. Telling me of her activities during the week, she said, that she wished for her appointment to come faster. I was pleased for her as she proved that she had listened to my request asking her to improve her own skills which she had used very rarely.
She provided me with a list of affirmations ( Attachment 4) which were: 1) I feel good about myself. ) I take good care of myself, and attend to my personal hygiene needs. 3) I spend my time with people who are nice to me and make me feel good about myself. 4) I am a good person. ) I deserve to be alive. 6) I want to achieve 7) I have a purpose in this life 8) I am positive and hopeful for the present and future Thanking her for doing her homework, I asked her to keep increasing her affirmations, making sure to go over them a few times daily to remind herself of her positive qualities.
She’s always thought of herself as being useless.
All of a sudden, she said, “To think that I was the only girl in the family with two brothers, both older to me, I felt suffocated,” claiming to never been encouraged to make her feelings known with her brothers always teasing her. Growing up was not easy for her, as was her work history “Work was too much of a hassle, being reprimanded about my timings and times off work which led to my dismissals” “Maybe I never understood and has not come to term with the reasons of our expulsions from our country, constantly AT our properties Ana toner valuables. ” “l Nils Is a very sore area Tort my mother and me.
My brothers don’t want to go back, but, I DO,” she exclaimed.
“After all the years, my real-self is responding. Hurray, Hurray,” she shouted happily showing me a quotation from one of the army generals at the time of the mass expulsion during a conversation with the President, “If you want to remove this tree from here, you don’t Just cut off the branches. The idea of only non-citizens leaving is like a branch. Remove the whole tree. An Indian is an Indian. ” And, ever since then, she promised to herself to return to her Motherland and to claim all their properties and valuables ” No one at home would talk about this issue.
My husband has been supportive. ” My mum is still very traumatized and I could never talk to her about this. In a way I supposed, by getting me to grow up quickly, they did me a big favor. I would not let my dad’s property go to thieves. I often felt sad and I used to cry sometimes, and had times where I got tired and couldn’t work even losing few Jobs. ” This is when she realized that she had the will to fight.
Stopping, the session, I asked her to keep being Positive at all times and that when the time is Ready, she will most likely get whatever were taken away as the present government has pledged to “PUT RIGHT SOMEONE’S WRONGS. Ending the session, I reminded her to continue being POSITIVE, to try adding some new features to her life to add more sparks to herself. Rd session- 31103/2013 H, continued in the very same positive manner during the course of the week. Indeed, I told her, she is winning her battle, by making slight adjustment to her dark days. Replying, she said, “In some Asian families there are rigid rules about what can and can’t be talked about and intimate things aren’t mentioned, so I never spoke to anyone about how I felt or what it was like growing up. I Just pushed the sadness down within myself.
It’s quite a strict culture and people are afraid of talking to someone from their own community in case private information gets back to your Emily. It can even affect girls chances to get married. L, got married to my husband 10 years ago. He is from a different part of Africa. ” I still didn’t talk about my sadness to him at the start of our married life.
But, a bit like holding a ball underwater, there’s only so long you can keep your feelings hidden and by the summer of 2012, aged 38, I was suffering from what I now know was severe anxiety with depression.
I was very tired, sad and weepy, and I couldn’t work. I did visit my local G. P, a few times who for some reason didn’t prescribe any treatment. A friend of my husband, on a visit suggested your name which was mentioned at one of the Asian function by the in- house Bandit (priest) who provided me with your contact number, leading me calling you”. “To me, Just hearing the few words you said at the time, made my decision to see you and to accept any help you can offer to get my dull life the boost it NEEDED.
I just knew that my Life changing Decision was RIGHT. , liked the simple way you describe, CB, which involved talking through my problems and finding ways to tackle them.. ” “Admittedly, I was anxious, like Eve always been at the beginning, wondering how therapy would work. But, thanks to you for allowing me to express myself freely which helped in establishing a very good rapport with you. And, honestly, you dealt with sensitive issues in the proper manner.
” “level seen things change since I was younger Like tenure are spectacles services Tort anyone kneeing Nell. ” ” I found leaving our home behind quite traumatic, and then a year after we arrived here, my father died.
It was difficult, losing him on top of everything else. “l was the only girl and I had to grow up quickly as pressure was put on me to help at home and take care of my brothers. As I grew up I often felt sad and I used to cry sometimes, ND had times where I got tired and couldn’t work. .
It was good for me to be referred to somebody as understanding like you. ” On this positive comment, I told H that we had reached the end of this session and wishing to see her for the next one. 4th session- 07/04/2013 H, continued showing improvement all round.
She told me that, she hasn’t felt under any sort of pressures lately and that introducing the Affirmations, a positive move and that she’ll continue revising and adding more positive affirmations. We then started exchanging views on other subjects- about the time when being an attentive Sistine is best, that whenever there is a need to change behavior we need to be sure if we have the confidence and knowledge to do so, About being careful with our approach, knowing our limits and Never to leave anything to Lady Luck and to Be Factual Not Fictional.
At this point H told me that “Eve started building my own life and learnt not to get so bogged down with the pressures of having to look after everybody else. ” “My husband has been my biggest supporter” This session ended up here and as normal, He’s husband was there waiting for her at the front door. 5th session-14/04/2013 Seeing H this afternoon took me by surprise. She appeared so well physically and emotionally. “l am not surprise. I listened at cues from you, which helps keep me Healthy.
She informed me of her brothers’ flying visits on the way to have a meal in the local restaurant. In truth, their behavior never troubled me. ” She told me that she will concentrate on herself as a priority and her husband and that she would invite her mother for dinner- someone who cared, loved and still loves her. This session ended, with me giving her homework asking him to bring with her Ideas which could help maintain her progress next Sunday. H and Final session I informed H that as she has maintained her progress, I felt the time is right to discharge her and that if she needs a booster session in the future, I’ll be prepared to see her again unless she decides otherwise.
Telling me, she knows who to turn to, she then talked of ways to occupy herself from: going for a morning walk daily, do some running, and go swimming as well besides getting together with the Asian community arranging events, paying hospital visits and other activities promoting Friendship and also telling me that she will go to her country to get what’s hers and deed to get back on the employment ladder.
This, the final session went well with H showing her willingness to succeed, be a good wife, daughter and friends to everyone. This session ended with H and myself saying our Thanks and Good-Bye to each other. LIMITS AND FLAWS I understand my limits and know my boundaries which are very important and paying attention to details as to my remits as a student therapist, otherwise I may leave to criticisms which can affect my position as a future counselor. I admit that I need my work to De Telesales to attract clients c
We should really be thankful to the pioneers in the fields of counseling such: Arnold Lazarus for his fusion of the Cognitive and Behavior therapies in giving us the Cognitive Behavioral Therapy, not forgetting the likes of Freud, Moscow, Jung Pavlov and many more. This case-study taught me a lesson that we should approach our clients appropriately, allowing them to be freely expressive without cutting them off when in free flow.
H indeed needed Just that initial Recognition and for her voice to be heard. .1 certainly see her as an Achiever with success waiting for her.
