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 According to Wheeler (2014), cognitive behavioral therapy (CBT) is effective and widely used for the treatment of psychiatric disorders and mental health issues such as depression, anxiety, personality disorders, and substance abuse in group, family, and individual therapy. Therapists use CBT to focus on specific problems, feelings, thoughts, and behaviors in order for the client to recognize negative thoughts and behaviors affecting their lives (Wheeler, 2014). Gonzalez-Prendes and Resko (2012) state that maladaptive behavior and emotions are caused by faulty thinking patterns. Self-monitoring, goal setting, and problem solving are strategies of CBT (Gonzalez-Prendes & Resko, 2012). According to Gonzalez-Prendes and Resko (2012), individuals experience a reduction in symptoms with more realistic, balanced thinking as a result of becoming more aware of negative patterns and cognitions when CBT is utilized in therapy.

        The goal of using CBT in group therapy is to change or decrease thoughts that provoke anxiety and symptoms that maintain behaviors through the use of cognitive and behavioral strategies (Safak et al., 2014). In group CBT, individuals learn skills to help themselves feel better, cope with and manage their difficulties, and decrease their risk for future relapse of symptoms (Wolgensinger, 2015). Group therapy is more cost-effective and allows therapists to provide therapy to more individuals during their sessions (Thiruchselvam, 2020). Group therapy offers individuals social support. Individuals in groups that utilize a CBT approach find it helpful to meet others with similar issues, since they are able to help one another and share their experiences (Wolgensinger, 2015).   

        The use of CBT in family therapy is more cost-effective than individual therapy and is comprised of fewer individuals than group therapy (Nichols & Davis, 2020). Family therapy that utilizes CBT helps the clients examine and restructure the thoughts and perceptions family members have (Nichols & Davis, 2020). The cognitions, emotions, and behavior of individuals can cause conflict within a family. According to Nichols and Davis (2020), family CBT assumes that individuals in a family influence and are influenced by the other family members. The behaviors of one member of a family prompt behavior, cognitions, and emotions in other family members, which then cause reactive cognitions, behavior, and emotions in the original family member (Nichols& Davis, 2020). Therapists that use family CBT promote collaborative relationships and work toward getting the family to function better as a whole.

        The identification of altered cognition between family members can be modified with the use of CBT (Nichols & Davis, 2020). An example from practicum is a family, consisting of a father, mother and teenage son who attend family counseling every other week. The family is seeking counseling to find ways to cope with the son’s behaviors and disregard for authority within the home. The parents state the son has total disregard for consequences of his actions. The son states his parents are too controlling and micromanage everything he does. In family CBT, the cognitions, emotions, and behaviors are seen as having a mutual influence on one another (Nichols & Davis, 2020).  CBT would benefit this family since it promotes a collaborative relationship and increases cooperation in treatment (Nichols & Davis, 2020). The family was encouraged to journal their thought and emotions, which were discussed during therapy sessions. The importance of communication within the family was discussed and they were encouraged to talk about their thoughts and emotions without arguing or verbally attacking one another. Communication skills can be strengthened with family therapy through exploring roles and behaviors and how they affect the family as a whole.

         Challenges that counselors might encounter when using CBT in a group setting include getting all individuals to participate without monopolizing the group and maintaining cohesiveness between group members. Individuals in group therapy may not be willing to share their personal experiences or express their emotions freely (Wolgensinger, 2015). To ensure the effectiveness of group therapy, the therapist should select members that are willing to participate and share their experiences with the other individuals in the group. When selecting individuals to participate in a group, the therapist should also be mindful of the characteristics of the group members (Wolgensinger, 2015). The characteristics and personalities of group members play an important role in the atmosphere of the group and cohesion of group members.

References

Gonzalez-Prendes, A., & Resko, S. M. (2012). Cognitive-behavioral therapy. In S. Ringel & J. Brandell (Eds.), Trauma: Contemporary directions

       in theory, practice, and research (pp. 14-40). Thousand Oaks, CA: SAGE Publications, Inc. http://dx.doi.org/10.4135/9781452230597.n2

Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Pearson.

Safak, Y., Karadere, M. E., Ozdel, K., Ozcan, T., Turkcapar, M. H., Kuru, E., & Yucens, B. (2014). The effectiveness of cognitive behavioral

         group psychotherapy for obsessive-compulsive disorder. Turkish Journal of Psychiatry, 25(4), 225-233. https://doi.org/10.5080/u7510

Thiruchselvam, T., Patel, A., Daros, A. R., Jain, E., Asadi, S., Laposa, J. M., Kloiber, S., & Quilty, L. C. (2020). A multidimensional investigation

          of anxiety sensitivity and depression outcomes in cognitive-behavioral group therapy. Psychiatry Research, 293, 1-8.

          https://doi-org.ezp.waldenulibrary.org/10.1016/j.psychres.2020.113446

Wheeler, K. (Eds.). (2014). Psychotherapy for advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.).

         Springer Publishing Company.

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