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Small Group Discussion Notes Chris

How is the issue manifested? What areas of functioning (family/social, emotional, physical,
educational/employment, etc.) are being impaired? Here you may reference specific emotions,
behaviors, relationships, and/or events described in the case study.

Chris has admitted to substance abuse with alcohol since he was 15 years old. He seems to use it
as an escape because he states that he enjoys the way that alcohol makes him feel. Chris also has
begun using marijuana and has a history of using other hallucinogens such as acid and
mushrooms, and cocaine. He also struggles with depression. He also states having feelings of
unworthiness and not being able to enjoy life like he once did. Chris also deals with
preoccupation with death & thoughts on the purpose of life.

Chris struggles with feeling disconnected with family. He reports that he feels as though his
mother does not care for him because of his rebellious ways due to her religious beliefs.
His environment seems to have an effect on his drinking problems.There is a history of drinking
problems in the family. His primary support system in college encourages and normalizes his use
and was sought out by Chris for increased opportunities for use. Although he drinks a lot, Chris
reported feeling the happiest when he was sober for 13 months at the rehabilitation
center/boarding school .Chris also has underdeveloped social skills, self-esteem, self-identity,
and self-regulation skills. He thinks negatively about himself, others, and his future.

What ethical considerations may need to be addressed when implementing this theory within
the case study?

Chris has dealt with preoccupation with death & thoughts on the purpose of life. He seems to use
alcohol as a gateway. He also has low self esteem and thinks negatively about himself or others.
This can be concerning in case he still continues to have beliefs that can be connected to suicide.
If the client seems to be considering self harm or shows any signs then it would have to be
reported.

What multicultural considerations may need to be addressed when implementing this theory
within the case study?

Chris is a Caucasian male and is considered a dominant culture.

Now, overlay Ellis’ REBT to develop a more complex understanding of the case. What is
causing or contributing to this issue from a theoretical perspective? Here, you must use
theoretical terminology and key concepts in application to the case study.
From an REBT approach, it would assume that Chris’ feelings of depression and unworthiness
may come from his beliefs.Chris has underdeveloped social skills, self-esteem, self-identity, and
self-regulation skills. He also struggles with substance abuse and has limited insight into severity
of alcohol use & contemplates only at times about changing behaviors.REBT would use the
ABC Model & take a look at his irrational beliefs and show how Chris can change his beliefs. A
would be the activating event or adversity, B would be the behavior, C is the consequence which
refers to a healthy or unhealthy reaction. This theory would also challenge the three musts which
are wanting approval from others, assuming that we must be treated fairly, and that the world
will be provided with what we want. REBT therapists would encourage a client to challenge
these beliefs and learn how to recognize irrational (self-defeating) beliefs from rational (self-
helping) beliefs .

Chris also thinks negatively about himself, others, and his future.Chris seems to struggle with
feelings of detachment and isolation from others. He feels quite disconnected from his family
members and often does not share personal information with them. From an REBT standpoint,
the therapist would encourage unconditional self acceptance to be able to accept oneself and then
to be able to accept others even with imperfections.

Next, overlay Beck's CT to try to develop a slightly different understanding of the case. What is
causing or contributing to this issue from a theoretical perspective? Here, you must use
theoretical terminology and key concepts in application to the case study. (Refer to your graphic
organizer).
From a CT standpoint, it would look into the client’s thoughts and beliefs. It would explain that
Chris’ depression stems from negative thinking or also genetic, neurobiological, or
environmental changes. CT would also state when we think about things in erroneous or
distorted ways, we experience exaggerated or distorted emotional and behavioral reactions as
well. CT would challenge these core beliefs in hopes that it will then help lessen substance
abuse. Like REBT , CT also emphasizes recognizing and changing unrealistic thoughts and
maladaptive beliefs.

CT would also challenge the client’s cognitive distortions.A cognitive distortion Chris may be
dealing with is labeling and mislabeling.He seems to deal with feelings of unworthiness that
could be tied to what he believes and past mistakes that he is identifying himself with. Another
cognitive distortion he is dealing with is dichotomous thinking. He can identify to a certain
extent his values but his behaviors do not match.
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Discuss which of the two theories (REBT or CT) helped you better understand the main issue
the primary character is facing? What are the underlying themes? Be specific in explaining why
one made more sense to you personally than the other.

Although these theories have many similarities, there are a few differences. They both helped me
understand the case but in different ways. REBT assumes that cognitions, emotions, and
behaviors interact significantly and have a cause-and-effect relationship. Our emotions are
created from our beliefs which influence interpretations that fuel our reactions to certain life
situations. REBT looks at the underlying reason for irrational beliefs such as “shoulds,” “musts,”
“oughts.” REBT explains that we learn these irrational beliefs from childhood from others and
continue to carry them on. REBT also emphasizes unconditional self acceptance-we have to
accept ourselves & others despite imperfections. It also encourages us to stop blaming ourselves
& others so we can be psychologically healthy. In REBT, the role of therapist is looked at as an
expert. Therapists are more confrontational & direct. A basic aim is to teach clients how to
change their dysfunctional emotions and behaviors into healthy ones.
Cognitive Therapy is based on the idea that we can change our thoughts and our behavior and
that will result in changes in feelings. CT explains that clients tend to have distorted beliefs as
the result of cognitive errors. It also believes that people’s beliefs have highly personal meanings
& that people can discover these meanings themselves. Therapeutic alliance is emphasized in CT
and Socratic dialogue is used. Rather than being taught, clients are encouraged to question so
they can recognize cognitive distortions. It also emphasizes recognizing and changing unrealistic
thoughts and maladaptive beliefs.

INTERVENTION PLAN – Explain how you would intervene with the primary character. Notice
how the treatment approach and techniques may change based on the theoretical viewpoint
used to understand the case. In formulating your response, you may wish to consider the
following:

I think the theory I would use is Beck’s Cognitive theory. I chose this theory because I think it
would be helpful to allow the client to identify their own misconceptions. I think it would be
beneficial to the client so that when they face difficulties in the future, they will already have
skills necessary to recognize when problems arise. CT explains that we can change our thoughts
and our behaviors that will end up changing our feelings. CT takes a deeper look into core beliefs
and some beliefs can turn into cognitive distortions. The main goal for CT is to change
unrealistic thoughts and maladaptive beliefs. Change would typically take place after looking at
results from homework and determining progress made. Them working together to look at
progress that was made and allowing the client to reflect.

Some techniques I would use are Socratic questioning, recognizing cognitive distortions, giving
the client home work to work on, doing behavioral experiments, and gathering data on
assumptions made. I would use open-ended questions to clients with the aim of getting clients to
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reflect on personal issues and arrive at their own conclusions. I would also use collaborative
empiricism if needed and work on reevaluating any faulty beliefs when there is contradictory
evidence. I would also attempt to use bibliotherapy to help the client understand more about
cognitive therapy and to help them develop skills. Since the client struggles with social skills and
feelings of isolation, I would assign homework such as talking to others in public. I would make
sure that he is ready before completing the assignment. I would also talk to him before assigning
the homework and speak about how he feels about the assignment and what his thoughts are. If
there is any anxiety or things he may think would get in the way I would discuss with him and
help him come up with ways that would help him become mentally strong before doing the
homework. I would also ask questions to challenge his own beliefs or distortions. Then I would
discuss once the homework is completed and then see where to go from there. I would also
discuss more about his substance abuse and ask him about his goals. I would also discuss his
feelings of depression and ask more questions so that he can come to a conclusion and realize
some of his own cognitive distortions.CT is based on empirical research. There have been many
studies done by Beck and have shown effectiveness for many disorders.

There was a study conducted that integrated cognitive theory to adolescents with depression.
They studied adolescents because that age period is a critical period in the development of
depressionThe study was found to be effective.
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References
Pössel, P., & Smith, E. (2020). Integrating Beck’s Cognitive Theory of
Depression and the Hopelessness Model in an Adolescent Sample. Journal of
Abnormal Child Psychology, 48(3), 435–451. https://doi.org/10.1007/s10802-
019-00604-8