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Anxiety disorder is a common and disabling condition that mostly begins during childhood, adolescence, and early adulthood (Craske & Stein, 2016). Anxiety is persistent and impairs daily functioning. Most anxiety disorders affect almost twice as many women as men. Anxiety mostly co-occurs with major depression, alcohol, substance-use disorders, and personality disorders (Craske & Stein, 2016).

Anxiety disorders, when untreated, tend to recur chronically. The recommendation is to treat psychological treatments, particularly cognitive behavioral therapy, and pharmacological treatments, particularly selective serotonin-reuptake inhibitors and serotonin-noradrenaline-reuptake inhibitors. The combination of the two drugs works more effectively. (Beesdo, Knappe, & Pine, 2009) Childhood and adolescence is the core risk phase for the development of anxiety symptoms and syndromes, ranging from transient mild symptoms to full-blown anxiety disorders (Beesdo, Knappe, & Pine, 2009)

      I learned from the information you gave about enhancing client medication dosing using cytochrome B450 and gene testing in checking how a person metabolizes medication. This client, her Celexa, was increased to 5mg because she was fast in metabolizing her pills. 

I will be very interested to learn her outcome.

Reference,

Beesdo, K., Knappe, S., & Pine, D. S. (2009). Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V. The Psychiatric clinics of North America, 32(3), 483–524. https://doi.org/10.1016/j.psc.2009.06.002

Craske, M. G., & Stein, M. B. (2016). Anxiety. Lancet (London, England), 388(10063), 3048–3059. https://doi.org/10.1016/S0140-6736(16)30381-6

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Cognitive Behavior Therapy

Cognitive behavior therapy (CBT) is a practical therapeutic approach to psychotherapy. According to Eidelmen et al. (2019), CBT effectively treats 50-60 % of individuals with depression and anxiety, sustainably decreasing their symptoms by targeted therapeutic approaches. CBT is a form of psychotherapy that provides clients with the insight that thoughts, feelings, and behavior are connected and teaches clients how to change negative cognition that leads to psychopathology(Tovote et al., 2017).

Contrasting CBT

Spillane-Grieco (2000) noted that in contrasting CBT with families to CBT with individuals, CBT with families focuses on cognition, beliefs, perception, behavior, and current interaction between family members, which overlap and affect how the family functions. On the other, In CBT with individuals, the therapist works with the client to set and achieve specific goals and explore how the client’s behavior, thoughts, and feelings contribute to the difficulties the client is currently facing.

An example from my practicum experience is a couple presenting for psychotherapy due to marital challenges because of the husband’s mother’s strong involvement in the marriage, which displease the wife and causes strife. This family’s treatment goal was to help the couple describe a healthy and positive relationship in their family systems and rebuild essential family relationships.

Stigma

Stigma is a challenge mental health counselor can encounter in CBT with families. According to Halder and Mahato (2019), although awareness of mental health continues to increase, some families remain in denial of the mental health illness of their family members and can blame their ward, not giving them the attention needed and not developing real insight concerning the challenges their ward faces. For instance, in this week’s video resource, some female group members talked about stigma, feeling blame, and being blamed by others even though they were dealing with very severe traumatic experiences. In conclusion, CBT is a useful tool for both families and individuals; however, healthcare providers must recognize the difference and its impact when treating families or individuals.

References

Eidelman, P., Jensen, A., & Rappaport, L. M. (2019). Social support, negative social exchange, and response to case formulation-based cognitive behavior therapy. Cognitive Behavior Therapy, 48(2), 146–161. https://doi-org.ezp.waldenulibrary.org/10.1080/16506073.2018.1490809

Halder, S., & Mahato, A. (2019). Cognitive behavior therapy for children and adolescents: Challenges and gaps in practice. Indian Journal of Psychological Medicine, 41(3), 279–283. https://doi-org.ezp.waldenulibrary.org/10.4103/IJPSYM.IJPSYM_470_18

Hauksson, P., Ingibergsdóttir, S., Gunnarsdóttir, T., & Jónsdóttir, I. H. (2017). Effectiveness of cognitive behavior therapy for treatment-resistant depression with psychiatric comorbidity: comparison of individual versus group CBT in an interdisciplinary rehabilitation setting. Nordic Journal of Psychiatry, 71(6), 465–472. https://doi-org.ezp.waldenulibrary.org/10.1080/08039488.2017.1331263

Shryane, N., Drake, R., Morrison, A., & Palmier-Claus, J. (2020). Is cognitive-behavioral therapy effective for individuals experiencing thought disorder? Psychiatry Research, 285. https://doi-org.ezp.waldenulibrary.org/10.1016/j.psychres.2020.112806

Spillane-Grieco, E. (2000). Cognitive-Behavioral Family Therapy with a Family in High-Conflict Divorce: A Case Study. Clinical Social Work Journal, 28(1), 105–119.

Tovote, K., Schroevers, M., Snippe, E., Emmelkamp, P., Links, T., Sanderman, R., & Fleer, J. (2017). What works best for whom? Cognitive Behavior Therapy and Mindfulness-Based Cognitive Therapy for depressive symptoms in patients with diabetes. PLoS ONE, 12(6), 1–16. https://doi-org.ezp.waldenulibrary.org/10.1371/journal.pone.0179941