Cognitive Behavioral Therapy Report: EBP, Diversity, and Case Studies

This report provides an in-depth analysis of Cognitive Behavioral Therapy (CBT), focusing on its application within Evidence-Based Practice (EBP) and its relevance to cultural and human diversity. The report begins by introducing CBT and its evolution in treating psychological disorders, emphasizing its systematic cognitive model. It then addresses issues related to cultural and human diversity in EBP, highlighting the importance of considering diverse populations in psychotherapy. Recommendations are provided for integrating EBP with diverse populations, including the need for proper knowledge, research, and culturally sensitive approaches. The report further details recommendations for the EBP of CBT, using case studies of Kelly and Lorena to illustrate the practical application of CBT. It outlines the elements of CBT, such as session structure, cognitive models, and the importance of building rapport between the counselor and client. The conclusion summarizes the limitations and complexities in the field of psychiatry, emphasizing the need for flexible interventions and culturally sensitive practices. The report references relevant literature to support its arguments, providing a comprehensive overview of CBT and its applications.

Running head: COGNITIVE BEHAVIORAL THEORY
COGNITIVE BEHAVIORAL THEORY
Name of the student
Name of the university
Author note

1COGNITIVE BEHAVIORAL THEORY
Table of Contents
1 Introduction.............................................................................................................................2
2 Issues relating to cultural and human diversity in Evidence Based Practice (EBP)...............3
3 Recommendations for relating EBP with Diverse population................................................4
4 Recommendations of EBP of CBT.........................................................................................5
5 Elements of the CBT...............................................................................................................7
6 Conclusion...............................................................................................................................8
References..................................................................................................................................9

2COGNITIVE BEHAVIORAL THEORY
1 Introduction
The ever-changing world has led to the emergence of different disorders, both
physical and psychological, with complexities that grow with time. The advancement in the
diseases have resulted to the advancements in the medical setups and procedures of
medication. Psychological disorders are now a common factor nowadays. The Cognitive
Behavioral Therapy (CBT) is an advanced branch of psychotherapy that originally dealt
mainly with the analysis and treatment of depression and the like, but is now used in treating
a number of psychological disorders. This report deals with the systematic cognitive model,
which is developed in order to focus mainly on the needs of Kelly and Lorena.
Human behavior is characterized by the set of assumptions and the idiosyncratic rules
that uphold the traits of their reactions to the outer world and the environment in which they
survive. Every human uses this set of rules or the values, which is generally termed as ethics
frames their outlook to life. Anxiety and depression is the cause of the unfulfilled
expectations and the vacant thoughts that dwells deep within the human mind (Beidas et al.,
2013). Some most common elements, relating to the ego and self esteem, are those which are
essentially egocentric where an individual expects that the world will function according to
the person’s likes and dislikes. CBT evaluates these areas of the human psyche, uncovers the
truth underlying beneath the existentialism and eccentric outlook, and aims at manipulating
and modifying the thinking process of the patients assuring a positive change in the behavior
(Al-Naggar, Abdel-Salam & Al-Haggar, 2015).

3COGNITIVE BEHAVIORAL THEORY
The above figure helps in illustrating the correlation and interdependence between the
factors that influence the behavior of an individual. The figure stresses more on the core
beliefs of the individuals which can be classified broadly under three categories- self, others
and future. The report aims at analyzing the important factors pertaining to the psychological
traits and distortions and the ways in which the cognitive behavioral theory with close
association with the Evidence Based Practice (EBP) helps in curing and allocating the
distortions accordingly.
2 Issues relating to cultural and human diversity in Evidence Based Practice (EBP)
Psychotherapy is an evidence-based evaluation, but the term ‘evidence based’ should
be used carefully as the study and the evaluation is a limiting factor in assessing the
verification due to the availability of more diverse cases based on the population. Diverse
population is a limiting factor it brings out a general outlook to the psychiatric problems.
The growth and expansion of the population in USA, and reports indicate that by the
end of 2050 there will be a very few inhabitant identified as European or American. The
concept of diversity should be made clear before one concludes the topic to their own insight.
The application of psychotherapy differs from densely populated areas to less populated
areas. From an individual point of view the differences in the techniques of psychotherapy
differs from individual identities as well as collective identities. Culture and heritage also

4COGNITIVE BEHAVIORAL THEORY
plays an important role in determining the psychological realms of the individuals. There are
different parameters that must be considered in order to make use of an effective
psychotherapy. Many scholars have considered the issues of cultural diversity and its
influence on the CBT yet no such rules limited the practitioners from making use of the
diversity as a tool and adapting themselves to the specific cultural group (Gorenstein, 2007).
Diverse research methods and techniques have been encored by the researches in
order to integrate issues for different and diverse cases. The very first evaluation and a
framework was created by Bernal and colleagues which focuses mainly on ecological validity
in accordance with the diverse nature of the community (Gilson, 2009). The framework
conceptualized eight dimensions depending on the prevalent culture of the specific group.
They are being illustrated in this section of the analysis.
1. Suitable language should be used for the interventions.
2. Metaphors to be used in the interventions.
3. Intellectual knowledge must be kept in the fields of values, customs and traditions of
the members.
4. Acknowledging the contextual influences in the client’s life
5. The bonding between the client and the therapist should be simple and brief.
6. A theoretical approach in solving the issues of the client
7. Targets to be achieved depending on the rules and norms.
8. The techniques that are involved in achieving the goal of healing
An implementation or an adaptation of the intervention will take no time, but before
doing so a researcher must consider the manner in which the researcher is going to organize
the intervention in order to bring forth the desired therapeutic effect. Organizing an
intervention is an important step before choosing an intervention because the proper
organization helps in making the intervention work out in the best possible manner. There are
general discussions too relating to the frequency of the interventions being delivered to the

5COGNITIVE BEHAVIORAL THEORY
clients or if the intervention should be delivered in groups or on an individual basis and the
like.
3 Recommendations for relating EBP with Diverse population
Proper knowledge and research must be undertaken as for a particular population or a
cultural group before even adapting or considering any interventions. The diversity in the
group and the difference in the needs of the clients is the only reason behind undertaking this
research work. The balance in the group and individual characteristics determines another
important factor that denotes the effectiveness of the interventions on the clients from a
different point of view.
In this modern era evidences and research into the refined psychological traits is a
phenomenal work to be undertaken in order to make advancements in the CBT. Education
and financial status plays an important role before considering and allocating the
interventions accordingly (Inerian, 2007).
Diversity in the clinic helps in effectively mingling with the customs and traditions of
the client, by which an effective psychiatric treatment can be provided, keeping in mind the
diverse requirement of the clients (Hwang, 2006).
4 Recommendations of EBP of CBT
The cases of Kelly and Lorena, on which this report concentrates, is an evidence
based application of CBT. Lorena is being portrayed, in the case, as a person who had a
previous history of family violence and her probable tendency of hanging out or maybe to
figure out what could be done. It might be because of the injustice that infested her when she
saw her mother working for the family’s source of income and her father unemployed. On the

6COGNITIVE BEHAVIORAL THEORY
other hand, Kelly enjoys her absolute freedom through her impulsive nature- a sudden urge to
do anything she desires at any point of time irrespective of the environment or the time.
A detailed plan has been formulated in this section to bring out the best results in an
organized manner (Winterowd, Beck & Gruener, 2003).
Session Zero
 Rapport building and creating an interest in the mind of the client
 Evaluating the subject of the program clinically
First session
 A brief discussion based on the expectations the subject holds from this recovery
program.
 A continuous monitoring of the change of moods of the subject bringing out the
negative attitude for stressing on the subject’s peculiarity
 Describing the Cognitive behavioral theory and the strategies that they are going to
follow
Second session
 Mood check and taking a feedback about the first session
 A discussion on the reactions of the cognitive model of depression
Third session
 Evaluation and feedback on the home based assignments (if assigned)
 A set of general guidelines to identify negative thought and how to prevent them from
coming
Fourth session

7COGNITIVE BEHAVIORAL THEORY
 Discussion based on eliminating negative and automatic thoughts
Fifth session
 Adhering to the general discussion that took place in the fourth session.
 Reviewing and establishing a discussion on the source of the automatic thoughts
 The participant or the client, being aware of the negative thoughts and by then can
identify the negative thoughts that come in the mind, demonstrate to the person ways
of correcting cognitive distortions.
 Arrangement should be made for further sessions in the same format.
Sixth, seventh and eighth sessions
 Follow the previous formats
 Exercises and drills to release the patient of the psychological barrier and getting
engaged into daily activities
 Continuation in the process of eradicating the negative thoughts
Closing session
 Preparing for the termination of the patient’s therapy
 Defining the future problems to the clients helps them in anticipation and formulating
strategies
 At the termination of the session participants or the clients should be encouraged to
take hold on to the assignments and continue performing them at home so that the
automatic thoughts does not arise out once again (Valmaggia et al., 2008)

8COGNITIVE BEHAVIORAL THEORY
5 Elements of the CBT
The above guidelines being a general approach towards the EBP are essentially
flexible for treating depression in a valid and effective way (Taylor, 2006). Certain
modifications can be made depending on the situation and the level of requirement of the
client. The essential elements of CBT that can be taken as a part of any psychiatric program
are briefly discussed in this section:
1. The counselor must follow the same structure for every counseling session though in
certain cases the invariant nature does not work out.
2. The counselor must introduce to the clients the apparent cognitive model and make
their perceptions clear as to the functioning of the model
3. The counselor is needed to formulate all possible guidelines and itinerary of the case
in order to make the case lucid and then establish the cognitive formulation in the first
two sessions of the recovery program.
4. The counselor is required to build a rapport with the client in order to make the client
feel at home and easy to converse verbally. It makes the client open up to the
counselor by which it becomes possible for the counselor to read the psychological
traits and advancements of the client (Rimondini, 2011).
6 Conclusion
Therefore, from the above analysis it can be concluded that though the fields of
psychiatry and the study of human brain and its nature and advancements relating to the
cognitive behavioral treatments and the EBP, there are still significant limitations and
backdrops that are needed to be avoided and removed. Interventions, in the modern era, are
not always helpful and due to the diverse cultural population, researchers cannot stick on to
the pre-formulated intervention. The advent of modernization and globalization and with the

9COGNITIVE BEHAVIORAL THEORY
introduction of different psychological issues complexities tend to emerge. There are
different ways in which they can be treated and the ways are defined through the above
analysis.

10COGNITIVE BEHAVIORAL THEORY
References
Al-Naggar, Z., Abdel-Salam, M., & Al-Haggar, M. (2015). Biofeedback and cognitive
behavioral therapy for Egyptian adolescents suffering from chronic fatigue syndrome.
J Pediatr Neurol, 04(03), 161-169. http://dx.doi.org/10.1055/s-0035-1557320
Beidas, R. S., Mychailyszyn, M. P., Podell, J. L., & Kendall, P. C. (2013). Brief cognitive-
behavioral therapy for anxious youth: The inner workings. Cognitive and behavioral
practice, 20(2), 134-146.Culliney, T. (2014). Notes on Predatory Behavi our in
Rhinacloa forticornis (Hemiptera: Miridae ). Curr. Agri. Res. Jour, 2(1), 01-04.
http://dx.doi.org/10.12944/carj.2.1.01
Gilson, M. (2009). Overcoming depression. Oxford: Oxford University Press.
Gorenstein, E. (2007). Cognitive-Behavior Therapy for Reduction of Persistent Anger
(Gorenstein et al.). Cognitive And Behavioral Practice, 14(2), 243.
http://dx.doi.org/10.1016/j.cbpra.2007.02.003
Hwang, W. (2006). Cognitive-Behavioral Therapy With Chinese Americans: Research,
Theory, and Clinical Practice (Hwang et al., pp. 293–303). Cognitive And
Behavioral Practice, 13(4), 339-340. http://dx.doi.org/10.1016/j.cbpra.2006.04.017
Inerian, A. (2007). Considerations for Culturally Competent Cognitive-Behavioral Therapy
for Depression with Hispanic Clients (Interian, et al.). Cognitive And Behavioral
Practice, 14(1), 122-123. http://dx.doi.org/10.1016/j.cbpra.2006.10.002
Rimondini, M. (2011). Communication in cognitive behavioral therapy. New York: Springer.
Rosner, R., Lyddon, W., & Freeman, A. (2004). Cognitive therapy and dreams. New York:
Springer Pub. Co.
Taylor, R. (2006). Cognitive behavioral therapy for chronic illness and disability. New York:
Springer.
Valmaggia et al.,. (2008). WITHDRAWN: Continuing Education Quiz: Cognitive Behavioral
Therapy across the Stages of Psychosis: Prodromal, First Episode, and Chronic
Schizophrenia. Cognitive And Behavioral Practice.
http://dx.doi.org/10.1016/j.cbpra.2007.02.008
Winterowd, C., Beck, A., & Gruener, D. (2003). Cognitive therapy with chronic pain
patients. New York: Springer.

11COGNITIVE BEHAVIORAL THEORY