Cognitive Behavioral Therapy in Social Work
Cognitive Behavioral Therapy (CBT) is widely used in the field due to its success with multiple populations and various mental health issues.
Cognitive behavioral therapy in social work is a theoretical framework that understands the importance of both cognition and behavior, with the outcomes based on cognitive, behavioral and emotional changes.
Because this therapy is based on a combination of both cognition and behavior, there are numerous techniques that can be utilized.
For more info on social work therapies, read Narrative Therapy in Practice: Counter Documents and Therapeutic Letters and Collaborative and Narrative Therapies
How Cognitive Behavioral Therapy in Social Work is Utilized
Cognitive behavioral therapy emphasizes that it is not a situation nor circumstance that causes client distress; rather, it is how the client interprets or views a particular event that will cause internal distress.
Cognitive behavioral therapy states that thoughts, emotions, and behavior are intertwined and affect one another. Consistent maladaptive thoughts and/or behaviors can present problems for a client.
Cognitive behavioral therapy in social work helps to challenge negative thoughts as well as teach a client how to change damaging behaviors.
An example of an activity to provide for a client is an “Automatic Thought Record”. This simply allows clients to start being more aware of their thoughts which lead to understanding and, hopefully, change.
The following are common cognitive distortions clients may present throughout therapy:
- Mind reading: They assume they know what other people are thinking.
- Fortune telling: They predict the future by expecting that the worse will happen.
- Catastrophizing: They believe that anything that has or will happen is going to be so horrendous that they won’t be able to get through it.
- Labeling: They see blanket negative traits both within themselves and other people.
- Discounting positives: They downsize the positives that they or other people attain.
- Negative filter: They see much more of the negatives and rarely notice positive happenings.
- Overgeneralizing: They perceive a global pattern of negatives on the basis of a single incident.
- Dichotomous thinking: They view events, or people, in all or nothing terms.
- Shoulds: They see things in terms of how they should be instead of seeing things for what they are.
- Personalizing: They blame themselves a disproportionate amount for negative events and fail to see other peoples’ roles in the events, as well.
- Blaming: They blame other people for their internal negative feelings instead of taking responsibility.
- Unfair comparisons: They interpret events in terms of standards that are unrealistic— for example, they focus primarily on others who do better than they and find themselves inferior in the comparison.
- Regret orientation: They focus heavily what they did not do or what they did wrong in the past as opposed to focusing on what can be better in the now.
- What if? They keep asking a series of questions about “What if” something happens and fail to be satisfied with any of the answers.
- Emotional reasoning: They let their feelings guide your interpretation of reality.
It is also important to understand the basis of Cognitive behavioral therapy in social work therapeutic session. Before a case can be formulated, there are five major components that need to be addressed:
- Problem List
- Working hypothesis
- Strengths and Assets
- Treatment Plan
Difficulties Using Cognitive Behavioral Therapy in Social Work
A comprehensive list is created stating the difficulties in concrete behavioral terms. Usually, on average, five to eight problems are identified and can include areas such as psychological symptoms, interpersonal, occupational, medical, financial, housing, legal and leisure.
The diagnosis will then be determined based upon a therapist’s use of the current Diagnostic and Statistical Manual of Mental Disorders (DSM). It is important to note that diagnosis is not always required but can be important in determining which treatment will be the most useful.
Next, the working hypothesis is the way for the therapist to connect the issues presented on the problem list and will address the client’s maladaptive cognitions and behaviors. Once these problems are connected, it is equally important to address a client’s strengths and assets. It is vital to be aware of the positive elements of a client’s life to aid in the success of a client’s thoughts and/or behaviors changing.
Finally, a treatment plan is created. This is the outcome of the case conceptualization and will be connected to the working hypothesis. The treatment plan will outline the goals of therapy, with the consent of the client, and will outline how progress and success will be measured.
- McLeod, S. A. (2015). Cognitive Behavioral Therapy. Retired from: http://www.simplypsychology.org/cognitive-therapy.html
- NIDA Publication: A Cognitive Behavioral Approach: Treating Cocaine Addiction.
- R.. L. Leahy, Cognitive Therapy: Basic Principles and Applications. Jason Aronson Publishing Co., 1996.