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Cognitive Behavioral Therapy for Individuals, Families, and Groups

The benefits of Cognitive Behavioral Therapy (CBT) has been proven over time, study after study. The question becomes is group CBT and family CBT as effective as individual CBT and how are they different? A recent study showed that  guided CBT over the phone to be as effective as individual therapy for depression (Mayor, S, 2019). More studies on the use of CBT  teletherapy will start to surface after this last year and a half of COVID restrictions and continued efforts to support clients with mental health issues.

The elements of individual CBT which involve identifying automatic negative thoughts and ultimately core beliefs can be discovered in family and group therapy with the caveat that obviously not as much time is spent on one individual. With couples CBT it is important to evaluate the automatic negative thoughts, core beliefs, vicious cycles of each partner and how these play out in their relationship (Beck Institute for Couples Cognitive Behavioral Therapy, 2018). It is extremely helpful and gives insight to the practitioner since the therapist has both view points and this leads to extremely valuable information and potentially, quicker results. The therapist works on identifying what each individual has control over which includes how they behave and how they interpret the other person’s behavior (Beck Institute for Couples Cognitive Behavioral Therapy, 2018).

With group therapy there are different elements involved that are not present in individual therapy. There is a system of relationships and individual processing takes place in a group environment (Wheeler, K., 2013). In the group setting the individual can work on social behaviors and social skills and can get feedback from others in the group. The group setting can relieve feelings of isolation and stigmatism, especially if associated with a mental health disorder that is judged in society (Michael P. Nichols; Sean D. Davis, 2019). There are some disadvantages to group therapy with the possibility of group members comparing themselves to other group members with the same issue and coming away with the belief they are not as bad and therefore do not really have a problem; the member can have the assumption that other people in the group has the same needs; problems don’t come up in the sessions due to time limitations; as well as being part of a group can normalize the behavior that is the problem (Psych Exam Review, 2019).

CBT Family Therapy focuses on behavioral observations made by the therapist who identifies patterns,  stressors, and areas of major concern as well as areas of major strength.  The therapist along with the family develop a plan of action by acknowledging interventions and setting priorities of change (Michael P. Nichols; Sean D. Davis, 2019).  Families learning how to identify their own automatic thoughts and how they may be inaccurate as well as other cognitive behaviorism can help promote collaboration and strengthen relationships (Michael P. Nichols; Sean D. Davis, 2019). Even in a study on alternatives for families and outcomes of community-based child protection programs Abuse-Focused CBT (AF-CBT),  it was concluded that AF-CBT improved the child’s externalizing behavior. The child felt more safe, less scared, less sad, and more comfortable with peers (Kolko, D.J., et al, 2011).

It is not a question as to whether CBT is effective. We know that it is. What should be done is to teach it to adolescent children, so that they learn how to recognize automatic negative thoughts and self-defeating core beliefs, before they spend years struggling. In an effort to make CBT more accessible it is also important to note the strength of CBT group therapy as being equally effective in some cases and more cost effective. Another idea is telehealth CBT, which is now showing to be equally effective as in person CBT. A study on telehealth for veterans suffering from insomnia utilized CBT-I  and found it to be as effective as in person CBT-I (Gehrman, P., et al, 2018). CBT is a powerful tool to help individuals identify self-limiting beliefs which affect emotions and behaviors and should be taught on a large scale to help individuals learn how to recognize these connections and learn strategies to help them cope and overcome their hurdles, whatever they may be.

References

Beck Institute for Cognitive Behavior Therapy. (2018, June 7). CBT for couples

           [Video}. YouTube.

Gehrman, P., Bellamy, S., Medvedeva, E., Barilla, H., Brownlow, J., Prigge, J., Rehman, W., & Kuna, S. T. (2018). 0370 Telehealth Delivery Of Group Cbt-i Is Non-inferior To In-person Treatment In Veterans With Ptsd. Sleep, 41(1, Number 1 Supplement 1), A141–A142.

Michael P. Nichols; Sean D. Davis. (2019). The essentials of family therapy (7th ed.). Pearson Education (US).

Kolko, D. J., Iselin, A.-M. R., & Gully, K. J. (2011). Evaluation of the sustainability and clinical outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) in a child protection center. Child Abuse & Neglect, 35(2), 105–116. https://doi-org.ezp.waldenulibrary.org/10.1016/j.c…

Mayor, S. (2019). Guided self led or group therapy as effective as individual CBT for acute depression, finds review. BMJ (Clinical Research Ed.), 365, l1833. https://doi-org.ezp.waldenulibrary.org/10.1136/bmj.l1833

PsychExamReview. (2019, April 30). Cognitive therapy, CBT, & group approaches (intro psych tutorial #241) [Video]. YouTube.

Wheeler, K. (2013). Psychotherapy for the Advanced Practice Psychiatric Nurse (3rd ed.).  Springer Publishing. https://doi.org/10.1891/97808261938