Good Self-Exploration Of The Helping Process Research Paper Example
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Part One: Self-Exploration
Theoretical orientation of a counsellor need not be cast in stone nor so exhaustive that there is a confusion for choice. Theoretical Orientation for a counsellor is like a tool box and this gets organized and systematized over a period of constant practice. It must be remembered that the tool box must have sufficient set of tools to organize and cater to problems that are encountered regularly. Despite the fact that there are over 400 odd theories that are essentially part of treatment paradigms, very few may, may be between 20 and 20 are applied and used on a regular basis in clinical practice. Each counsellor, depending on personal interest and nature would begin to use a specific set of theories that can be applied to a broad range of situations. However, a practitioner needs to first diagnose a problem before choosing a tool. It must not be that the problem is a loose nut and the practitioner chooses a hammer to tighten the nut. Doing so would never solve the problem. It is only after identification of a problem that a practitioner can choose to apply a specific theory or at times even a mix of theories to the situation. The only thing that the practitioner needs to keep in mind while applying more than one theory is that the theories that are chosen must not be contraindicating each other, but in consonance with each other.
As mentioned earlier, at this point of time, it is difficult for me to identify a theory or a set of theories to base my future work on. However, some of the most commonly used theories like the CBT (Cognitive Behaviour Theory) for instance, which are well-researched and documented would be a thing of choice. Learning would not stop ever for practitioners since continuing education is a must and also is a professional necessity, which allows a practitioner to keep abreast of the latest developments in theoretical research that would also enable the practitioner to pick and choose newer theories to work on as well as allow to even do away with some of the earlier theories that the practitioner might have worked with. This way, the choice of a theory is dynamic in my view and would never be a constant nor cast in stone as mentioned at the beginning of this essay. I would prefer to work with an established therapeutic theory like CBT among may be one or two more. I prefer to choose CBT over others predominantly because of the extent of literature that is available on this particular therapy.
Part Two: Theoretical Application of Cognitive Behaviour Therapy (CBT)
Cognitive Behaviour Therapy, commonly called as CBT is a combination of both cognitive and behavioural therapies. CBT is used for health disorders related to anxiety and mood. The fundamental premise on which CBT is based upon is human emotions cannot be changed so easily and thus this particular therapy attempts to change emotions by working on the behaviours and thoughts of the patient that result in stressful emotions.
The process in which the therapy of CBT works is that the process tries to create a specific skill set which actually aides the person to understand the thoughts and emotions; recognize and understand the way in which situations and behaviours influence the individual’s emotions. The therapy also aides in improving the feelings of the patient through modification of the behaviours and thoughts that are dysfunctional.
CBT skill acquisition is essentially a collaborative process. It is both skill acquisition and plenty of practice that set this particular therapy apart from other similar counselling or interactive therapies. It is important that counsellors try and address the problem that is presented and not just offering advice to the patients. In this paper, CBT is applied to the case s of anxiety disorders.
Irrespective of the amount of significant development in the field of managed care for post-traumatic stress disorders (PTSD), there continues to be increased awareness about neuroleptic medication being insufficient for treating anxiety disorders in a majority of cases. There has been enormous amount of research that was conducted on the application and success of CBT interventions in cases of anxiety disorders and the results have been pretty positive.
What is CBT and why is it required?
PSTD is an unbearable health disorder that is largely linked with psychiatric issues and is regarded to be a chronic ailment in most cases. Given the universal and permeating nature of intimidating or calamitous trauma, this particular health disorder is becoming increasingly more prevalent and common.
Brief CBT is normally used as the first step of the treatment process for patients suffering from PTSD. Brief CBT is actually a compressed process of the normal session lengths of CBT. The actual CBT treatment encompasses 20 odd sessions of counselling and treatment and brief CBT just has 4-8 sessions. Treatment specificity is highly important as the number of sessions are limited and also due to the reason that there is a need for increased diligence from the side of the patient in using the additional reading materials and other homework that actually help the patient in the therapeutic growth.
The number of sessions in Brief CBT may vary from one patient to another and also from one therapist to other. The compressed sessions in brief CBT may comprise of aspects like orientation of the patient, goal setting, and case conceptualization, problem solving, using relaxation techniques, and continuing other intervention techniques, among others.
Indications or Contraindications for the therapy
A few problems are highly appropriate for applying Brief CBT as the use of this therapy is highly helpful in primary care, especially for the patients suffering from stress and anxiety disorders, which is again linked with some sort of a medical condition.
As the patients suffering from PTSD and other anxiety related disorders normally have to deal with issues that are acute rather than chronic and have a plethora of coping strategies that already exist, Brief CBT might be highly helpful in enhancing the adjustment.
The Case of CBT Therapy
The following is a conversation between a counsellor and a patient suffering from PTSD following the 9/11 attacks. The patient in question is a fireman on duty who rushed in response to a 9/11 call and witnessed the crashing of the twin towers.
The patient, Fireman Smith was part of a team that reached the periphery of ground zero and barely had a few seconds to respond when the towers started collapsing. He was a witness to the falling towers as well as screaming people who were running away from ground zero in an attempt to save themselves.
Patient (Fireman Smith): I wake up in the middle of the night sweating profusely and drenched in sweat in spite of the cooler running in peak in my bedroom. I see images of screaming people rushing out and I can still feel the dust beginning to hit my face.
I wake up in the middle of the night clenching the sheets, my heart racing and the screams keep ringing in my years. There was not a single night that I did not have these nightmares. They keep coming back, and even today I am literally at my wits ends and feel frozen when I need to concept and response to a 9/11 call. I cannot make a decision whether to rush out, as my fireman code dictates or attend to my shivering hands and gain control of myself. I have seen my people trip and fall as they were rushing out of ground zero and there was intense panic on all of their face. It strikes me even today.
Counsellor: Fireman Smith, are you able to understand that this event is over and I acknowledge the trauma that you have undergone and witnessed. Thanks to the brave officers like you – the number of causalities and injuries were limited. The role of fireman and police has been greatly acknowledged. Are you not proud of that?
Patient: In my waking hours, I consciously remind myself that this holocaust is over and will never ever come back. However, I am unable to respond quickly and agilely like I used to do earlier. At times, even when I am on duty at work, I suddenly tend to see images of what happened that day. Maybe, I could have done something to save more number of people that day. Have I failed my duty?
Counsellor: Fireman Smith, you, like all your colleagues have been exemplary and responded appropriately that day. I think you must make an effort to replace those traumatic imagery from your mind with positive imagery. Think of all those times and events when you were able to successfully rescue people and save lives. Was that not a result of your own action? You yourself have admitted earlier in the course of our conversation as to how difficult was the rescue on the 44th street was, which you pulled off by your sheer presence of mind. This proves that you are capable. I think you are feeling unnecessarily guilty. The situation on that eventful day was that not only you but hundreds of other fireman on duty could not do much beyond than what they did. It was a terrible tragedy that was inflicted by unfertile minds on our great nation.
People like firefighter Smith continue to be haunted with PTSD that brings 9/11 nightmares back to them. People like these often overreact to noise, phone ringing, and alarms. The number of PTSD cases are not established fully even till today, despite several programs that have been officially announced like the Zadroga program.
Use of CBT in treating PTSD affected officers in the drastic 9/11 attack has been greatly useful, which has helped rescue many serving firemen and police officers from experiencing major depressive disorder and has been found to be a highly effective approach in handling PTSD.
Corey, G. (2009). Cognitive Behaviour Therapy. In G. Corey, Theory and Practice of Counseling and Psychotherapy (pp. 290-327). Belmont, CA: Cengage Learning.
Laura Smith, P. N. (2003). Cognitive Behaviour Therapy for Psychotic Symptoms: A Therapist's Manual. Retrieved from Center for Clinical Intervention: Psychotherapy, Researc and Intervention: http://www.cci.health.wa.gov.au/docs/Psychosis%20Manual.pdf
Office of the Mayor - The City of New York. (2015). James L. Zadroga 9/11 Health & Compensation Act. Retrieved from Office of the Mayor - The City of New York: http://www.nyc.gov/html/doh/wtc/html/health_compensation/health_compensation_act.shtml
Panevska, L. S. (2012). Case of Panic Disorder with Agoraphobia - Continuum Through Cognitive‐Behavioural Therapy. Scientific Journal of the Faculty of Medicine; 29(13), 159-163.
Slone, F. H. (2013). Understanding Research on the Epidemology of Trauma and PTSD - Special Double Issue of the PTSD Research Quarterly. PTSD Research Quarterly, 24(2-3), 1050-1835.
True, W. R. (1993). A Twin Study of Genetic and Environmental Contributions to Liabbility for PTSD Symptoms. Arch Gen Psychiatry, 50, 257-64.
Victor, R. V. (2005). Beyond Trauma: Conversations on Traumatic Incident Reduction, 2nd Edition (Explorations in Metapsychology). Loving Healing Press.
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