REBT Cognitive Theory Case Study of Chris: A Conceptualization and Treatment Plan Abstract Rational emotive behavior therapy, REBT, considers human beings as responsibly hedonistic in the significance that they attempt to stay alive and attain some level of happiness. However, it also holds that humans are likely to accept illogical beliefs and actions which continue to be in the way of accomplishing their aspirations and intentions.
Often, these irrational beliefs or ideas come into being tremendous musts, shoulds, or oughts; they differ with realistic and adaptable wishes, needs, inclinations, and desires. The existence of great ideas can make all the distinction among vigorous depressing emotions, such as sadness or regret or concern, and harmful depressing emotions, such as depression or guilt or anxiety. REBT Cognitive Theory Case Study of Chris: A Conceptualization and Treatment Plan
These theories developed by Albert Ellis and Aaron Beck are focused on the idea that people’s viewpoints of events, others, and circumstances can have a deep impact on their thoughts and dealings. A person may become fixated with circumstances and trouble themselves unreasonably about a certain situation because of maladaptive or delinquent belief systems. These belief systems have repeatedly been created on incidents of the past, and may include practices and makeup of a particular culture or beliefs that have been recognized within a family situation.
Principles such as these often have the result of restricting or one way or another modifying the events and/or needs of individual—often in an illogical way. The main term used by Beck to describe an individual’s value system or way of thinking is “maladaptive cognition,” while Ellis uses the terms “irrational belief”. Each of these cognitive theorists have developed a therapeutic model which looks for a way to erase or alleviate the troubles of these beliefs. Rational Emotive Behavior Therapy (REBT), formed by Ellis, contains the ABC Model of Human Functioning/Emotional Disturbance.
This model differentiates between the difficulties as having an “activating event,” “beliefs” by which the incidents are dealt with, and to conclude a “consequence”, which explains to be significant if beliefs are maladaptive. The intervention is based on the recognition and opposition of the person’s belief systems by the therapist. Beck’s position to these beliefs is similar, though the analysis of them is that they are often too unconditional, attempts made are therefore to increase or decrease their effects. Intervention includes depression and anxiety and confrontation healing.
Presenting Concerns Chris is struggling to be accepted by Mid-Western society. When Chris was in high school, he was suffering from depression and anxiety. He was raised by very strict parents who would often discourage him from playing with others and prevented him from participating in any after school activities. Moreover, he was not allowed to have friends who would come to his house, or go over to his friends’ house. His mother put a lot of pressure on him to perform well academically and to be the perfect son, while his sister recived all the family’s attention.
Chris and his sister spent a lot of time together playing with her toys, playing with her friends, and doing the things she enjoyed doing. Eventually, he acquired a feeling girls were “the best” according to his family and he wanted to be just like his sister. When he reached high school years, he came to realize he was not the same as his male peers. No one knew Chris’s feelings except him. At this time Chris began to experience a feeling he was unsure of, but informed himself he would get married later on in life and have a family.
He would not upset anyone and this feeling he had would go away because he would be suppressing his feelings. Chris did get married a few years later after graduating high school, but was completely unhappy with this lifestyle and his marriage ended years later. Chris wanted to be himself and live a homosexual lifestyle, but knew this was not going to be accepted by his family or the people in his environment, so he suppressed the feeling and began to have several problems within himself and in his life.
He finally told himself he needed help on what to do and how to feel towards those who had a problem accepting him and his lifestyle. Case Conceptualization Chris is a 27 year old Caucasian man who grew up in the Midwest with both parents. He and his family were very close. Having grown up in a close family from the Midwest, which is an area of the United States said to be conservative, Chris’s surroundings have had an impact in his beliefs. As a homosexual, he knows that particular a lifestyle is not always accepted.
Because Chris is greatly influenced by his environment and is able to perceive the wishes and feelings of people, it is quite likely that these circumstances have become factors to his uneasiness within his surroundings. Beck’s ideas of maladaptive cognitions may be brought to bear on Chris’s case, because it seems that his ability to figure out people’s implicit desires has repeatedly transformed into a want to complete them in order to form an approving environment.
In addition to this, Chris has had the chance to live the life he wanted to live and the life he feels that was forced upon him: he has been married, as well as, candidly homosexual. In each lifestyle he has found himself miserable. Considering the intense effect that his environment has on him, it is possible that his sexual wants have in both cases have clashed with his desire for an environment in which the feeling is one of approval. Two scenarios, activating events, have existed in Chris’s life. He has tried both repressing his feelings and coming out as a homosexual. In both cases has felt uncomfortable.
A probable reason for his discomfort in his marriage is that it failed to fulfill his sexual needs. One possible irrational belief he held was based on the fact that his marriage would have provided him and his family with a feeling of security within their conservative community—a feeling he desired to provide despite the fact that he felt little guilt as a homosexual. Another probable irrational belief is based on ideas behind Ellis’ Rational Emotive Behavior Therapy (REBT), which states that individuals have constructed belief systems founded on experiences of the past.
According to this, Chris’s only firsthand past experience had been within a nuclear family, and as a virgin he had had no experience with women or men. He therefore gravitated to the kind of heterosexual relationship with which he had had some experience. Yet this proved to be the result of an irrational belief that heterosexuality was appropriate for him because it had been for his parents and other elders in his community. Chris probably also felt that deviation from the norm would have proven disastrous.
These beliefs were proven to be irrational through his inability to find fulfillment in his marriage. Treatment Plan Goals for Counseling According to the REBT scheme, Chris might be made to think about the truest and most lucid effects of those actions, thereby resulting in a conflict of unreasonable beliefs. It would be essential for Chris to find out how to understand himself completely and not try to establish himself and his worth to others—which is practically unattainable. Interventions For whichever of the reasons described above, the nuclear family he created did prove itself unable satisfy him.
In light of this fact, Chris’s current discomfort with his “outed” lifestyle demonstrates a further maladaptive cognition or irrational belief that the general disapproval focused toward homosexuality should have an actual bearing on his life. Though his parents might not disapprove, the conditions under which they are viewed by other members of society creates a general atmosphere of strain which likely affects Chris’s ability to relax in his new situation. Chris’s cognitive therapy should therefore involve his deep consideration of the true effects of these conditions that he so fears.
Chris’s thought processes in his first activating event, decision to marry, appeared to be the following: “If I don’t get married and choose a homosexual lifestyle, my family and I will come under ridicule by the conservative members of the community. This will bring an inordinate amount of discomfort to our lives and make it impossible to have a normal life. ” Therefore, using the ABC’s of the REBT method, Chris would be asked the following questions: (1) What evidence exist that choosing homosexuality would incur the ridicule of the community? 2)If this ridicule should come, how can this make Chris and Chris’s family uncomfortable unless Chris choose to pay attention to it? (3) What evidence does Chris have that choosing a heterosexual lifestyle will make him less uncomfortable? (4)How does Chris most desire to live? Intervention would involve both one-on-one therapy with the cognitive therapy professional, but would go further to include his family and provide him with homework and group-work as a means of extending the scope of the therapy.
In dealing with Chris’s current discomfort with his homosexual life, a cognitive therapy (CT) treatment would involve the administration of the Beck’s Anxiety and Depression Inventories. This would be used at different intervals throughout the treatment in order to gauge his state at baseline and compare it with future states as the treatment progresses. He would be presented with challenging questions such as (1) What evidence exists that people frown on his lifestyle? (2) How can we view the situation differently? (3) How would Chris’s life be different if he conformed to what others would approve of? 4) When Chris did conform to “societal beliefs” or his own irrational beliefs, didn’t it prove detrimental to his happiness? The treatment would also involve educating him about how the arrangement of the ideas and beliefs learnt in the past can have a bearing on how he processes ideas in the present. When aware of the importance of schema in his decision making and though processes, he is expected to be induced to alter the processes by asking himself the hard questions that challenge maladaptive cognitions and irrational beliefs. Establishing the relationship
With the idea that I, as the counselor, and Chris, as the patient, work together to attain a trusting relationship and agree which problems or issues need to come first in the course of the therapy. For me as the Cognitive Behaviorist Therapist and the immediate and presenting problem, his homosexuality, Chris is suffering and complaining which takes precedence and must be addressed and focused in the treatment. There is instant support from the indicators, and may be persuaded or urged on to engage in in-depth treatment and lessening of the complaint where achievable.
The relief from the symptoms from the primary problem or issue, Chris’s homosexual life, will have him imagining or thinking that change is not impossible after all. In this model, problems are dealt immediately in a realistic way. In the cognitive methodology, I recognize that Chris comes into the healing relationship to alter or adjust his confused or error-filled thought patterns. These patterns may consist of wishful views, impractical expectations, frequently reliving and living in the past or even further than the present and into the future, and over generalizing.
These behaviors lead to uncertainty, aggravation and ultimate continuous dissatisfaction for Chris. This therapeutic method emphasizes or draws attention to the realistic, reasonable and/or optimistic worldview: a worldview that considers Chris as the problem-solver, allowing him to have options in life and having him believing he is always left with many choices. It also looks at the fact that Chris does have options and there are many issues he has to eal with, such as, being someone who has had and made some bad choices in the past, but now Chris can look positively into his future. Whereas in insight therapies the focus or emphasis is on the patient’s ability in understanding Chris issues based on his inner conflicts, motives, and fears. Coaching Chris on the step by step procedure of CBT is a basic and fundamental ingredient. Here Chris is informed of the patterns of his thinking and the mistakes of these thoughts which have caused the infractions in his attitudes and behavior.
His ideas and values have connections with his behavior and for that reason must be “reorganized”. When corrected at this level, the behavior follows automatically (Rubinstein et al. , 2007). Insight Albert Ellis developed his Rational-Emotive Therapy which understands human behavior distinctly as the person’s thinking process not as separate aspects but rather insists that many of a person’s thoughts, ideas or intentions actually overlap. Its perspective understands that rarely if ever that the thoughts of an individual occur alone.
When Chris weighs things or situations around him, he will oftentimes have inaccurate formations of the assumptions or “answers” concerning situations that are occurring. Irrational patterns of thinking then may impact and cause disturbances and instability to him, hence the consequent bearing on Chris develops mental illness and/or emotional difficulties. In other words, when Chris starts to have very high and impractical beliefs, Chris will bring about problems, which will be difficult to handle later on in his life.
Low-tolerance, overgeneralizations, and people’s criticism places Chris in a very dark world. When Chris is in treatment, he is guided by a counselor who will confront those irrational thoughts by questioning and or disputing them against the ideas that paralyze or develop false beliefs or deception (Ellis, p. 57, 2001). Conclusion The Beck’s Cognitive therapy is one of the most accepted and generally studied therapies in the counseling world today and is preferred by the counselors.
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Its comes down to understanding the results of biology, emotions, and surroundings of the person and pursues changes in those areas (Padesky and Mooney, 1990). There are a variety of versions and/or modifications of the approach today and continues to be top of the list in mental institutions. References Beck, J. S. (1995). Cognitive therapy basics and beyond. New York [u. a. ] Guilford Press. Corey, Gerald, 2004. Theory and practice of counseling and psychotherapy. Thomson Learning, USA. Corey, Gerald. 2001. The Art of Integrative Counseling.
Article 29: “Designing an Integrative Approach to Counseling Practice” Retrieved September 28, 2011, http://counselingoutfitters. com Ellis, Albert 2001. Overcoming destructive beliefs, feelings, and behaviors: new directions for rational emotive behavior therapy. Prometheus Books Padesky, C. A. , & Mooney, K. A. Presenting the cognitive model to clients, International Cognitive Therapy Newsletter, 6, 13-14, 1990. Rubinstein, Noah et al. , 2007. Good Therapy. Retrieved September 27, 2011, http://www. goodtherapy. org