Case/Theory

Presentation

Jocelyn Chadwick
Brief Case Presentation
 Family/Personal History

 The client is an 19 year old African American female

 First generation college student
 Her only social support is her best friend on campus
 Father died in a car accident ( reportedly due to being under the influence of
drugs)
 Mother not present reportedly due to alcoholism and drug use
 Client was placed in foster care at age one and then adopted by her grandmother
where she grew up with her four other siblings
 The client reports that her grandmother and siblings where verbally and
emotionally abusive
 She identifies as Christian
 Presenting Concerns

 Client T presents having difficulty adjusting to college. She has been

feeling depressed and alone.
 The client has difficulty trusting others and gets anxious and irritable
when she's alone
 She has many insecurities that stem from internalized emotional and
verbal abuse and constantly battles with negative automatic thoughts
 Her goals include working on her irritability and developing coping
mechanisms to manage her anxious and depressive symptoms
 Multicultural Differences

 There are many differences between the client and I. She was raised
in a completely different environment than me and has different
values and experiences.
 Therapeutic alliance was built using the strengths perspective,
intersectionality theory and having unconditional positive regard.
Client T’s Baseline Findings &
Symptoms

 During intake the clinical assessment tool (CCAP’s) showed numbers in the
80’s( out of 100) or above for every section ( depression, generalized and
social anxiety, academic and overall distress and hostility)
 Symptoms include ( insecurities, hostility, irritability, difficulty trusting
others, depressed or unhappy and anxious much of the time, fleeting
thoughts feelings of hopelessness and worthlessness )
Intervention Theory
&
Practice Approach
 Diagnosis
&
Theoretical Approach
 I diagnosed the client with an adjustment disorder with mixed anxiety
and depressed mood.
 The client would benefit from reframing her core beliefs and gently
challenging her negative automatic thoughts about her self and the world
around her
( insecurities, hostility, irritability, difficulty trusting others, depression and
anxiety)
 After assessing I believed that Cognitive Behavioral Therapy would be
the best approach to helping client T
 Proven to be effective for mental health issues like depression, anxiety,
eating disorders, personality disorders, trauma etc..
 Cognitive Behavioral Therapy
Background & Empirical data

 CBT was pioneered by Aaron Beck in the 1960’s

 “Dr. Beck began helping patients identify and evaluate these automatic
thoughts. He found that by doing so, patients were able to think more
realistically. As a result, they felt better emotionally and were able to
behave more functionally. When patients changed their underlying beliefs
about themselves, their world and other people, therapy resulted in long-
lasting change. ( Beck Institute)
 “CBT dominates the international guidelines for psychosocial treatments,
making it a first-line treatment for many disorders, as noted by the
National Institute for Health and Care Excellence’s guidelines and
American Psychological Association” (David, D., Cristea, I., & Hofmann, S.
G. , 2018)
 “CBT is the most researched form of psychotherapy. No other form of
psychotherapy has been shown to be systematically superior to CBT”(David,
D., Cristea, I., & Hofmann, S. G. , 2018)
Specific CBT Interventions

 Cognitive restructuring/ reframing - gently

challenging negative thoughts
 Investigative thoughts
 Cognitive pie charts*
 Mindfulness meditation
 Journaling/ recording thoughts and experiences
 Acceptance and Commitment techniques
 Building communication skills
 Psychoeducation on negative thinking styles
 Client T’s Response to CBT
&
Treatment Progression to Date
 Currently after the first personal session the client’s number drastically decreased
to the yellow and white areas no area had a number over 45
 The client has made friends, identified unhealthy thinking styles and changed
them herself, using mindfulness medication and is working on her communication
 The client mentioned last week that she thought she had MDD but she realized
she just needed to talk to someone and learn coping skills.
 Modified slightly by using a lot of reassurance and strength based language/
empathy
 Findings show that CBT is working AEB clinical interview and self report of the
client
 Will continue with supportive therapy and building upon coping mechanisms
Reflection

 Eye opening experience( finding connection through our differences)

 My first time using CBT- nervous to apply it but it became very
natural because I was able to see a different perspective than the
client.
 Good at gently challenging
 I wish I would have incorporated more homework an activities but I
will do that moving forward.
 Transformative Question- How important is homework in the
therapeutic process specifically in regards to CBT?
Scholarly Sources

 History of Cognitive Behavior Therapy - CBT: Beck Institute. (n.d.).

Retrieved from https://beckinstitute.org/about-beck/team/our-
history/history-of-cognitive-therapy/.
 David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive
Behavioral Therapy Is the Current Gold Standard of Psychotherapy.
Frontiers in psychiatry, 9, 4. doi:10.3389/fpsyt.2018.00004