A Case Study in Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is an evidence-based psychological treatment. It aims to alter negative thoughts and behaviors that lead to negative emotions and behaviors. CBT can be utilized with a wide range of individuals with proven success rates.
Fundamental to its principles are that humans possess multiple levels of cognition and they often think differently at each one. Thus, this approach takes a holistic approach to counseling and utilizes multiple techniques that address all these levels simultaneously.
The therapeutic relationship is essential in the success of psychotherapy. Yet it can often be challenging for therapists to feel authentic and apply cognitive behavioral techniques in a way that makes sense to their clients.
This paper details a case study of a trainee psychologist who struggled to be authentic and apply CBT techniques in her sessions with a client who had an extensive trauma history, severe depression and anxiety. The therapist tailored the CBT model according to the client’s experiences, working together to uncover the roots of her issues. The results suggest it is possible to form an authentic therapeutic relationship when working from this CBT model even when dealing with vulnerable clients.
She employed a hermeneutic approach with an emphasis on phenomenology to examine the psychotherapy process and its effect on therapeutic relationships between therapists and clients. This alternative research method allowed her to gain insight into therapists’ perception of clients, the therapeutic relationship, as well as her own responses to working with them.
Clinical Interview and Summative Evaluation: The patient had a complex medical condition that necessitated frequent emergency visits and hospitalizations, leading to anxiety symptoms and OCD. She also suffered from an emotional pattern of over-attachment and overprotection that contributed to her condition. Her mother’s guilt and controlling nature allowed her daughter to become completely dependent on her, leading her to develop compulsive behaviors in response to her anxiety symptoms and OCD.
Observations during the clinical interview revealed that she appeared underweight and looked younger than her stated age; additionally, she was very shy, usually making eye contact only with her mother. Her responses were verbalized in a low tone, often pointing to her mother to answer for her.
Psychoeducation about OCD was an integral component of the treatment, tailored to each patient’s ability and knowledge base. She was educated about OCD, exposed to the cognitive behavioral model of OCD, and addressed mother-daughter interaction patterns that had contributed to its persistence. Furthermore, she was taught ways of dealing with feelings caused by her mother’s actions. This was done to reduce her distress and anxiety. Eventually, she was taught how to replace her obsessional thoughts with positive and empowering ones. This change enabled her to stop relying on her mother’s negative and controlling reactions when it came to anxiety or OCD; instead of reacting exaggeratedly, she learned how to manage her own emotions instead of becoming overwhelmed by them.
