Introduction: Case Conceptualization
40-year-old Latina Natasha sought treatment to cope with her homosexuality. Natasha fears her family may discover her lesbianism. Natasha’s Catholic family opposes homosexuality. Her family is “die-hard Catholics” who consider homosexuality sinful. She fears disownment. She stays home and avoids activities. She’s also lost 20 pounds, has nightly sleep issues, does not like everyday tasks, does not feel valued, and worries about losing her work.
Presenting Problem
Natasha has exhibited significant concern with her sexuality. She has used phrases such as being terrified and conflicted. Her anxiety has led to disturbed sleep, a dread of disownment, poor eating habits, and a decline in her professional life. According to the American Psychological Association (APA) (2013), individuals with anxiety disorders experience repeated intrusive thoughts or anxieties. Due to fear, they may avoid specific circumstances. I have determined that Natasha suffers from an anxiety problem. Heimberg et al. (2004) stated that anxiety disorder’s anxiety leads to maladaptive behavior in non-threatening situations. Naturally, we attempt to avoid the dreaded consequence through avoidance and other means.
Counseling Intervention
Cognitive Behavioral Therapy (CBT) has been known to decrease the symptoms of anxiety disorder. CBT can help the client focus on a tangible goal through guided steps. By teaching the client specific skills, we will be able to change the automatic negative thoughts of a person who suffers from an anxiety disorder. CBT will help the client identify, challenge, and replace the thoughts.
Research Question
To assist Natasha with her illness, one would inquire, “Is cognitive behavioral therapy beneficial for reducing anxiety disorder symptoms?” According to studies, CBT is a standard treatment for anxiety and associated illnesses. The targeted strategies of this treatment are applied to anxiety-related counterproductive thoughts, behaviors, and feelings. CBT can be used alone, in combination with traditional drugs for treating anxiety disorders such as selective serotonin reuptake inhibitors), or in conjunction with innovative therapies (e.g., mindfulness) (Curtiss et al., 2021). Through CBT, clients can learn problem-solving skills to deal with challenging situations and gain confidence in their abilities. I am confident that CBT would be the best strategy for my client. I anticipate that Natasha can acquire healthy coping strategies and problem-solving techniques to assist her with her anxiety disorder through continuous counseling.
Search Strategy
I used the keyword search technique to select the three articles in the annotation below. Keywords are free-text phrases and library search algorithms that utilize a mixture of complimentary and related terms, as appropriate. I used the keyword embodied in the report’s title, Cognitive Behavioral Therapy for Adults with Anxiety Disorders, to identify the articles in this paper. Additionally, I used Boolean’s, AND and NOT, key terms in conducting my search. For instance, the key phrase NOT in Boolean enabled me to single out any other age group that does not fall under adulthood, such as children and teenagers. The following features distinguish the three publications as journal articles that have been peer-reviewed: First, they are authored by educators, investigators, or other specialists in the topic and are frequently attributed to their academic place of employment. Secondly, they are produced by professional organizations, university printers, and other intellectual presses to announce scientific findings and debate ongoing research in depth.
Annotations
Article 1
Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and Anxiety, 35(6), 502-514.
Summary: This study aimed to assess the effectiveness of cognitive behavioral treatment (CBT) for anxiety-related illnesses using randomized, placebo-controlled examinations. The research question utilized by the researchers is, what is the efficacy of CBT in treating anxiety-related conditions utilizing placebo-controlled assessments? The moral implications of the study encompassed willing participation by subjects in the experiments and non-utilization of patient medical records. The sampling procedure implemented in the article is a random selection technique. The shortage of total homogeneity in control circumstances reduces the accuracy of the analysis, notwithstanding the absence of a discrepancy in regulated or pre-post placebo response proportions across cognitive and pharmaceutical placebo research.
The strength of this quantitative study is that cognitive behavioral therapy is a somewhat successful therapy for mental illnesses compared to placebo. Participants with acute stress disorder (ASD), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder (PD), post-traumatic stress disorder (PTSD), or social anxiety disorder (SAD) were allocated randomly to CBT or a cognitive or pharmaceutical placebo scenario in 41 investigations. The results revealed significant placebo-controlled impacts of CBT on focus symptomatology (Hedges’ g = 0.56) and minor to medium improvements on other anxiety symptoms (Hedges’ g = 0.38). This article is relevant to my report as it utilizes CBT to treat adult anxiety disorders.
Article 2
Otte, C. (2022). Cognitive behavioral therapy in anxiety disorders: Current state of the evidence. Dialogues in Clinical Neuroscience, 13(4), 413-421.
Summary: The purpose of this article is to evaluate and analyze the present state of evidence on Cognitive Based Therapy (CBT) intervention for obsessive-compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and post-traumatic stress disorder (PTSD). CBT was used to demonstrate its usefulness in randomized supervised studies and natural settings for managing adult stress disorders. The research question posed by the paper’s authors is, what is the current affair on CBT strategies for obsessive-compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and post-traumatic stress disorder (PTSD)? The authors maintained ethical considerations that the informed consent of participants of the trials was taken into account and that none unwillingly undertook the process.
The article implemented a randomized supervised methodology in its research. The controlled outcome measures from 27 standardized placebo-controlled trials included 1,496 individuals varying from 0.35 in social phobia, little effect, to 1.37 in obsessive-compulsive behavior, significant impact. The advantage is that the study suggested that CBT performed better than placebo in all anxiety disorders. Nonetheless, the meta-analyses indicate that CBT is the most dependably experimentally verified psychotherapy strategy in managing anxiety disorders, hence a limitation. As highlighted by the investigators, an area of concern is the absence of intention-to-treat (ITT) assessments in the majority of included trials. This article is relevant to my report as it utilizes CBT to treat adult anxiety disorders.
Article 3
Christensen, A. B., Wahrén, S., Reinholt, N., Poulsen, S., Hvenegaard, M., Simonsen, E., & Arnfred, S. (2021). “Despite the differences, we were all the same”. Group cohesion in diagnosis-specific and trans-diagnostic CBT groups for anxiety and depression: A qualitative study. International Journal of Environmental Research and Public Health, 18(10), 1-14.
Summary: Using a qualitative comparative methodology, the purpose of the research was to examine patients’ perceptions of unit cohesion in diagnosis-specific against transdiagnostic CBT programs. The research question was, what is patient view of togetherness in diagnosis-specific and transdiagnostic CBT? The sampling approach employed consisted of semi-structured interviews, and the sample was standardized. Upon the management’s conclusion, semi-structured interviews were scheduled with 23 patients. Participants were diagnosed with major depressive disorder, panic disorder, agoraphobia, or social anxiety disorder. Participation was entirely voluntary, and all subjects provided written permission after being made aware. The information was encrypted, and only ABC and three different research associates who reproduced the audio files had access to the original manuscripts.
Without additional research, the conclusions of this type of study cannot be applied to larger populations or circumstances, although they are beneficial for understanding processes and providing vivid explanations. In addition, no patient who had discontinued medication was questioned. The results of a systematic conceptual investigation show three concepts that forms it strength: the transition from disparities to commonalities, the importance of cohesiveness in group CBT, and factors that promote and inhibit group identity. In diagnosis-specific and transdiagnostic CBT groups, group cohesion emerged and was deemed to be of paramount importance.
Evidence-based Practice and Application to Case Study
The three articles show that CBT, done by a counselor or group therapy, is essential in treating adult anxiety and its related disorders. In answering the report’s research question, the three studies enumerate that CBT reduced anxiety symptoms among the sample populations. The first two articles and the last are related but do not match. As such, in drawing my conclusions, I used the results from the research methodology sections, as they all focused on CBT as an intervention. I would apply various CBT phrases in the article to better manage Natasha’s anxiety. A clinical application of CBT with Natasha would be CBT treatment for evasion. CBT use for exposure treatment will assist Natasha in progressively confronting her concerns while educating her on meditation techniques to control her anxiety.
Treatment Plan
Treatment Plan
Outpatient Treatment Plan
Today, November 1st, 2022, a care plan for Natasha was established.
Meeting Began: 1230HRS – Meeting End: 1300HRS.
This was the commencement session of the therapeutic team.
Contributors in the Plan’s Development:
- Friedrich Mateo (Counselor)
- Natasha (Client)
Diagnosis
Clinical anxiety of General Anxiety Disorder (GAD) severe without psychotic manifestations: F32.2 (ICD-10) (Active) (Giacobbe & Flint, 2018)
Problem: Anxiety
Her anxiety has been diagnosed as an active issue requiring therapy. It is demonstrated by:
- Fear of disownment
- Lack of interest in daily tasks such as house chores
- Difficulty falling asleep
- Worry about losing her job
- Isolation
Long-Term Goal
Natasha will reveal an anxious mood less than once a week.
Target Date: 11/01/2022.
Short-Term Goals
- Natasha will identify and be able to describe the specific sources of her anxiety.
Frequency: Once per week Duration: 1hr Progress: Working on
Target Date: 11/01/2022. Completion Date: ______ Status: _____
- Natasha will document her mood-related thoughts and feelings in a notepad. This will enable Natasha to comprehend the link between emotional experiences and detect and examine her emotions as they emerge. A weekly diary with a counselor aims for anxiousness to develop no more than thrice a week.
Duration: Two weeks Progress: Working on
Target Date: 11/01/2022. Completion Date: ____ Status: ____
______________________________________________________________________________
Status
On 12/01/2022, the authorized practitioner met with the patient one-on-one to construct this therapeutic approach in collaboration.
Transition Plan
Refer to Psychiatrist/Counselor: _____
Electronically Signed
By: Friedrich Mateo
On: 11/01/2022 0154HRS
Conclusion
In conclusion, CBT is an essential therapeutic intervention in managing anxiety and related disorders. As annotated in the three articles in this report, findings show that CBT and group-based CBT function to minimize anxiousness and linked manifestations among study participants. Therefore, since Natasha is diagnosed with anxiety disorder, CBT would seem effective in combating the symptoms she experiences, such as isolation, fear of disownment, and difficulty sleeping. However, as enumerated by the authors of the three studies, more research on effective strategies for anxiety should be undertaken to fill the research gap identified within the articles.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Web.
Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and Anxiety, 35(6), 502-514. Web.
Christensen, A. B., Wahrén, S., Reinholt, N., Poulsen, S., Hvenegaard, M., Simonsen, E., & Arnfred, S. (2021). “Despite the differences, we were all the same”. Group cohesion in diagnosis-specific and trans-diagnostic CBT groups for anxiety and depression: A qualitative study. International Journal of Environmental Research and Public Health, 18(10), 1-14. Web.
Curtiss, J. E., Levine, D. S., Ander, I., & Baker, A. W. (2021). Cognitive-behavioral treatments for anxiety and stress-related disorders. FOCUS, 19(2), 184–189. Web.
Giacobbe, P., & Flint, A. (2018). Diagnosis and management of anxiety disorders. CONTINUUM: Lifelong Learning in Neurology, 24(3), 893-919.
Heimberg, R. G., Turk, C. L., & Mennin, D. S. (Eds.). (2004). Generalized anxiety disorder: Advances in research and practice. Guilford Publications.
Otte, C. (2022). Cognitive behavioral therapy in anxiety disorders: Current state of the evidence. Dialogues in Clinical Neuroscience, 13(4), 413-421.