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Discuss the relationship between culture and psychopathology
Essays on cross cultural mental health
Underlying theories of cognitive behavioral therapy
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Internalizing disorders such as anxiety and depression as well as personality disorders can occur when change does not accurately follow the developmental timeline (Beck, 1976). Over-distortion and one-sided patterns of speculation cause maladaptive development. These negative patterns of the cognitive system are; arbitrary inference, selective abstraction, overgeneralization, magnification and minification, personalization, and dichotomous thinking (Wenzel, et al., 2006). Arbitrary inference is drawing conclusions without supporting evidence or proof. Selective abstraction is conceptualizing a circumstance based on a single detail of an event while disregarding other information. Overgeneralization is applying extreme beliefs, which are …show more content…
based on a single event, to every situation. Magnification and minification are identifying situations in a greater or lesser light than they truly are. Personalization is ascribing outside events to oneself without proof supporting a causal association. Dichotomous thinking is classifying events in all or nothing terms; something is either all good or all bad. All of these negative patterns cause maladaptation in the formation of self and can lead to personality disorders, anxiety, and depression. These faulty errors in information processing are used to support the validity of automatic thoughts and core beliefs of the individual even though there may be proof indicating differently. (Beck, 1976) Cultural and contextual variables. When working with all clients, regardless of culture, it is important to keep in mind these cultural and contextual variables; age, developmental and physical factors, cognitive, sensory and psychiatric disabilities, religion and spiritual orientation, ethnicity and racial identity, socioeconomic status, sexual orientation, and gender (Nelson, et al., 2014). Techniques in CBT that are found to be helpful across cultures and may hold universal value are; goal setting, problem-solving, identifying negative thoughts, connecting thoughts to emotions, behavioral experiments, changing negative thoughts to those that are positive (Nelson, et al., 2014). Another aspect of CBT that works well for a broad range of cultures is the idea of setting personal goals and finding own ways to correct problems. This may, however, pose an issue for individuals who come from collectivist cultures. Cognitive-behavioral therapy has the potential for practical application for a diverse range of client populations. With that said, the approach does not seem to hold the same clinical potential for overly intellectualized clients, who may possess schemas that are relatively impervious to this approach (Weinrach, 1988). Instead, CBT is more effective for clients who are of a lower socioeconomic status or those who are less educated; their approach to life is based on street smarts that allow them to better grasp a more practical type of therapy (Weinrach, 1988). When incorporating CBT into clinical treatment, some adaptations may be needed when providing therapy to clients from different cultures. Some cultures may view looking at worst-case scenarios as offensive or insensitive. In cases like this, the therapist may need to adapt the approach to the situation and ask if the client is comfortable pressing further into specific topics. Another cultural consideration of cognitive behavioral therapy is the concentration and the amount of time spent in the here and now (Nelson, et al., 2014).
This concept is typically viewed as one of the positive aspects of cognitive behavioral therapy because this approach to therapy focuses on the client’s immediate problems and by staying in the present moment rather than having the client recollect past experiences. However, to some cultures, it can feel that by staying in the present there is an abandonment of cultural influences significant to the client if the therapist does not take the time to explore and reflect the client’s past (Nelson, et al., 2014). By spending large amounts of time in the present the therapist can neglect to learn about the history of their clients by not examining where the client came from and other important cultural factors that would be found by looking at the clients past and obtaining a full history of the …show more content…
client. Cognitive behavioral therapy is also culturally limited because of the importance of individuality as opposed to other cultures that are more collectivist and emphasis the importance of the family and the group as a whole (Nelson, et al., 2014). CBT encourages individuals to use assertive communication styles where other cultures may use a more restrained means of communicating. In CBT talking is crucial to the therapeutic process, however, in other cultures non-verbal communication such as listening, and silence may be viewed as equally if not more important and helpful for clients. Lastly, cognitive behavioral therapy uses a linear style of therapy and is highly structured whereas other cultures use non-linear forms of communication such as storytelling. All of these factors should be considered in order to provide culturally sensitive therapy. Adaptations and adjustments may need to be made throughout therapy in order for this to happen. (Nelson, et al., 2014) The therapist can correct these cultural errors in therapy by becoming culturally responsive and aware by educating themselves about the client’s culture on their own time. A therapist who is sensitive to culture searches for cultural information about a client then uses this to better appreciate and understand the client’s experience from a particular cultural lens. It is very important for therapists to recognize and be aware of own cultural biases’, attitudes, and beliefs that may affect working with clients who come from cultures different than their own. One way a therapist could gather cultural information about clients in the therapy room is to have clients create a genogram or family map in order to better understand the client’s cultural roots and background. Because it is unrealistic and essentially impossible for a therapist to understand every culture, cultural learning is a process that should be done throughout the entire career of a therapist. Cultural competency is a skill that is never complete or ever truly mastered. (Nelson, et al., 2014) Goals of Counseling Cognitive behavioral therapy emphasizes the importance of strategies for guided discovery in order to help the client recognize' and test their own beliefs through individual awareness and evaluation (Ellis, 2005). The goal of counseling in CBT is to gain awareness and change maladaptive thinking and dysfunctional behavior with the intention of alleviating internalizing problems and to teach the client how to become their own therapist (Johnson, & Friborg, 2015). The aim is to restore the overall functioning of the client by reducing the effects of the symptoms; or present problems (Mennin, et al., 2013). The efficacy of CBT is based on both client and therapist factors. Important factors that are distinct to the client are; personality traits, temperament, the motivation for treatment, and important life events that happen to the client throughout the time spent in the therapy process. The significant factors distinct to the therapist are; gender, age, education and training, personal style, competency, the ability to build rapport, and use of therapeutic techniques (Johnson, & Friborg, 2015). Cognitive behavioral therapy is problem-based therapy and the goal of treatment is to alleviate problems in cognition or thinking. There are three types of problems that Aaron Beck recognized; the first is a long-standing problem that led to the creation of the internalizing disorder and still exists, the second is a problem that is caused by the internalized disorder itself and impacts the person’s ability to function, and the third type of problem is the internalized disorder itself; which creates distorted thinking and inhibits the development of the person (Mennin, et al.
2013). In order to correct or repair the problems, three things must happen. The first is to promote context engagement by utilizing new experiences to counteract old habits of maladaptive connections that have been reinforced. The second is changing attention by encouraging the client to refocus attention in various settings. Lastly, there must be a cognitive change in so that the client can adapt perception of various events in order to change the assigned meanings. (Mennin, et al.
2013). Process and Techniques Cognitive behavioral therapy is highly structured and has a very specific process of how a cognitive behavioral therapist should approach and conduct therapy. CBT helps improve the influences thoughts have on emotions and behavior through a variety of techniques. Cognitive behavioral therapy aims to complete three tasks throughout therapy; behavior modification, challenging automatic thoughts, and evaluating and changing core beliefs (Lorenzo-Luaces et al., 2016). Different cognitive and behavioral techniques are implemented into therapy to help clients in the process of restoring blind spots, distorted perceptions, and deceptions about themselves, others and the world (Beck, 1976). There are specific factors that are commonly used in every cognitive behavioral therapy session. When using cognitive behavioral therapy the therapist should keep these factors in mind. The first is that the formulation of the problem or conceptualization of the case is constantly changing and adapting throughout the entire therapeutic process. The therapist begins to conceptualize the problem by looking at the client’s current patterns of thinking and how these patterns perpetuate the emotional disturbance. The therapist then examines the precipitating factors that influenced the client’s perceptions when the client began to feel the emotional dysregulation. Next, the therapist begins to make a hypothesis about important developmental
It proposes that the capacity for reasoning develops in four sequential and interconnecting stages throughout infancy to adulthood. Some main pieces of the theory are schema, assimilation, and accommodation. Hutchison (2015) describes the schema as “an internalized representation of the world or an ingrained and systematic pattern of thought, action, and problem solving (p. 119). Dan has developed a certain schema throughout his life, which includes his beliefs that people should reach for high-success, respect and obey authority, and men are responsible for the women. Assimilation occurs when an individual reacts to an experience based on prevailing schemata (Hutchison, 2015). Accommodation happens when a person adjusts his or her schemata to a new situation in which the old schemata could not relate. After observing Dan’s case, I can see that he is assimilating to every situation and struggles with accommodating to a new situation that does not fit his existing schemata. When Dan’s friends and family present ideas that oppose his schemata, he seems to become frustrated, anxious, and sad. Dan’s lack of accommodation is creating conflict in his
During the initial interview with the client a new format is used called the Cultural Case Formulation. This takes into account the cultural identity of the person, their cultural definitions of distress, and cultural stressors. Psychosocial stressors are included which can be unique to each culture and the level that a person identifies with their culture can be taken into account when treatment planning. By assessing a client's cultural identity this may allow the clinician to identify barriers or commonalities between themselves and the
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Hays, P. A. (2008). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy (2nd ed.). Washington, DC: American Psychological Association.
Cognitive Behavioral Therapy (CBT) emphasizes the modification of thoughts that will invoke change in behavior (Nichols, 2014). There are two derivation causes for a distorted cognition: a structured schema, or map in the brain, that is too complex to handle the situation, and cognitive distortions of reality (Pajares, 2002). Schemas are materialized from life experiences, and the environment from birth, and direct how the brain translates these events (Bandura, 1989). The individual’s interpretation or
While CBT has many advantages, it alone does not encompass all of the concepts I believe are necessary to tackle a client’s needs. Therefore, I draw upon concepts from various theories to assist clients in achieving their goals. Pulling from Reality therapy, a key concept I utilize is focusing on what the client is doing and how to get them to evaluate whether they’re present actions are working for them. CBT does use some form of this in the sense that one must examine and establish their cognitive misconceptions; however, I prefer to extract this concept from Reality therapy because CBT tends to do so by focusing on the past. I am a firm believer that while the past can shape who you are, it does little good to remain focused on it. Focusing on overt behavior, precision in specifying the goals of treatment, development of specific treatment plans, and objective evaluation of therapy outcomes all come from Behavior therapy (Corey, 2013, p. 474). Behavior therapy is highly structured much like that of CBT. By utilizing this aspect of Behavior therapy, I am better able to closely observe where a client is currently and where they are headed. Lastly, I pull from Person-Centered therapy as the final key concept of my counseling approach. PCT focuses on the fact that client’s have the potential to become aware of their problems and resolve them (Corey, 2013). This Person-Centered therapy concept has overlap with CBT as
Torgersen, S. (2009). The nature (and nurture) of personality disorders. Scandinavian Journal of Psychology, 50(6), 624-632. doi:10.1111/j.1467-9450.2009.00788.x
Culture can be defined as behaviors exhibited by certain racial, religious, social or ethnic groups. Some factors in which culture may vary include: family structure, education, and socioeconomic status (Kodjo, 2009). Some may think cultural competence is something that has an end point, however, when the big picture is seen, it is a learning process and journey. From the writer’s perspective, the client-therapist relationship can be challenging. Culturally competent therapists must realize that behaviors are shaped by an individual’s culture. Many changes are taking place within the United States cultural makeup. Therapists and healthcare professionals are being challenged to provide effective and sensitive care for patients and their families. This type of culturally sensitive care requires the professional to be open and seek understanding in the patients diverse belief systems (Kodjo, 2009).
In a biological outlook on depression, abnormal genetic or biochemical processes incline some individuals to depression. Conversely, in a cognitive perspective, the way people understand events in their lives has a very important effect on their weakness to depression. One example of a cognitive perspective is the hopelessness theory in which people believe that negative events in their lives are stable and global in that it will last “forever” and will affect everything he or she does causing a maladaptive cognitive (Alloy, Abramson, Francis, 1999). This article proposes that negatively biased negative self description provides the foundation for a cognitive vulnerability to depression. That is, a person whose mind set is negatively biased when processing information about one’s self may be particularly vulnerable to depression. For instance, when confronted with an unfamiliar situation, a vuln...
The biological approach is useful in regards to treatment. This approach has led to many forms of treatments. The cognitive approach is also useful and has made important contributions to the field of psychology, particularly that for the treatment of depression. The cognitive approach has been applied successfully in therapy. One of the core expectations of the cognitive approach is that mental processes influence our behavior. A further similarity between the two approaches is that both are seen as deterministic approaches. The biological approach believes that behavior is determined by functions of neurons and the structure and functions of the brain. It aims to ‘predetermine’ our behavior so therapy can be developed to aid abnormal behavior. The cognitive approach outlines the importance of schemas and stereotypes. Schemas are seen to be important in an individual’s behavior. We acquire schemas through direct experiences. Another way we acquire schemas is through social interaction. Through interactions we also learn stereotypes. These schemas and stereotypes determine the way we interpret a situation. Furthermore, both the biological and cognitive approaches use scientific methods. Both approaches believe that behaviour should be tested and measured in a systematic
Smith, T. B., Rodríguez, M. D., & Bernal, G. (2011). Culture. In J. C. Norcross (Ed.), Psychotherapy relationships that work (2nd ed.). New York: Oxford University Press.
An example of this would be if someone were to break their ankle, they would not being able to walk as well as they used to without receiving some form of treatment, but if the same person were also depressed, their parents may believe that only the ankle injury is important. They believe this because they have not read up on depression and severity of mental illness. People usually come to these types of assumptions due to a lack of education on mental health.
There are four main approaches to understanding mental health problems (Psychodynamic, Behaviourist, Cognitive and Biological). The psychodynamic approach sees human functioning and behaviour as driven by unconscious forces between different structures of the personality. It considers the importance of psychosexual development during childhood; the three elements of the personality: the id, ego and superego and the conscious, preconscious and unconscious mind. The cognitive approach focusses on the role of thought processes and how humans process information. A person’s negative beliefs and emotional reactions to events are thought to have consequences that could result in mental health problems. The biological approach considers mental
Individuals with mental illnesses have been successfully treated in the past through different methods including psychotherapy and medication. However, an ethical dilemma presents itself when individuals with severe mental illness refuse to receive treatment for their disorders. In recent decades, the use of forced medication has emerged as “one of the most controversial issues in mental health policy in recent decades” (Swartz, Swanson, & Hannon, 2003, p. 406). The medical community is torn between whether it is appropriate to grant these patients’ wishes or if it’s best to continue on with the treatment they recommend. Despite frequently being faced with this ethical dilemma, society still has not reached an agreement regarding how to proceed.
In addition, some clients may want to explore their multiple identities and how they position themselves in a world that is highly influenced by culture. Nonetheless, as I read this question, I realized that there is no right or wrong answer. Similarly, there is no right or wrong reason to come to therapy. Therapy is for the individuals who want help regardless of a reason or problem. It is possible that some clients may not have a problem but that is not for the therapist to judge. Instead, the therapist must remain curious and explore the client’s perception of the problem or problems in order to identify unique outcomes and help build preferred