Counselling Theories and the Application of Counselling

Understanding current Cognitive Behaviour Therapy (CBT)

The 18-year-old student from Illinois State High School, Kevin was referred to the student counselling service by his football coach. The concerns were that Kevin was having difficulties focusing and playing well, with generalised issues about low mood. Additionally, Kevin has a diagnosis of major depressive disorder where feelings of inadequacy and a perception of worthlessness are the presenting themes.

According to Maj and Satorius (2002) there is a likeness between normal sadness and a depressed mood, but often depressed people do not seek help on their own until the condition deteriorates. This is also true for Kevin, who would probably not have self-initiated therapy, if his coach had not referred him.

Some typical symptoms of a depressive episode include loss of interest or pleasure in activities that are usually enjoyed, loss of confidence and self-esteem, complaints or evidence of diminished focus or concentration, and bleak or pessimistic views of the future (WHO, 1992; Maj & Satorius, 2002). Two additional aspects to consider are age and cognitive functioning, as a young person’s capacity differs from the cognitive function of an adult, and their ability to distinguish between rational and irrational thoughts and feelings should be taken into consideration during therapy (Braswell, 2001).

Kevin believes that he is inadequate and weak, because he has not been playing football as well as he could – and has in the past. Moore and Garland (2003) highlight that such perceptions fall into clusters of unconditional beliefs, such as weakness and unacceptability, the two main themes that are prevalent in Kevin’s case. Kevin, who is struggling to come to terms with...

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...sues surface and are explored under a new lens (Nichols, 2009).

Assuredly though, Kevin’s family is supportive of him, and this is a valuable basis for an on-going alliance. Furthermore, the learned problem-solving and communication strategies equip each individual to navigate through potential future conflicts, reducing the need for repeat-therapy. Lastly, though it is unknown whether Kevin is medicated for his depressive disorder, young people have an improved outcome with a combined treatment approach of pharmacotherapy and either CBT or systemic family therapy (A. Hall, personal communication, 17 April 2014; March, 2006; The Werry Centre, 2010; Nayar, 2012). All safety and appropriateness considered, this approach would improve Kevin’s mood and ability to engage in therapy and as a consequence, also improve his other social relationships (Nayar, 2012).