Cognitive Behavioral Therapy: A Case Study On Successful Counseling Sessions For A Patient With Depression Due To Obesity

Overview of the Patient and Counseling Sessions

A counseling session was arranged in four episodes during the time of my placement. I got the scope of interacting with a patient with severe depression due to his obese body shape and applied the cognitive behavioral therapy with him. I had conducted four counseling sessions with him for four weeks and the outcomes of the counseling sessions were found to be successful. This assignment would be mainly focusing on the different aspects of the counseling sessions with the areas that went well and the areas that still require improvement.

The patient was 25 years old and having the BMI of 38.5. He had huge body weight that impeded his daily activities and often interfered with his emotional and mental health condition. He is bullied severely at his organization where he works and this adds to his further frustrations in his life. Moreover, he is recently facing issues during sleep where he is having breathing problems. He had visited the primary healthcare centre but the advices provided by the healthcare professionals there had not helped him to tackle his issues sufficiently. He had started to maintain diet but he is unable to manage the diet charts due to his heavy workload at office. His partner had left him because of his lack of motivation to care for himself and lead a healthy and safe life. All these had continued to affect him for long number of days that had affected his happiness and satisfaction in life. He had isolated himself and he does not want to come out of his home or attend social gatherings. His brother had requested him to attend a counseling sessions in order to help him overcome his difficulties and lead a happy and healthy life.

The counseling session that was developed were mainly based on four important arenas. These four arenas made the foundation basics of each of the four episodes of counseling sessions designed by me.  The first episode is planned in order to identify the troubling situations or the conditions present in the lives of the patients. Cognitive behavioral therapy mainly focuses on effective identification of the root causes of suffering of the patients and then helping the patients to acknowledge the causes of suffering to make them motivated to work on them (Paul et al. 2015). Studies advise professionals to spend more time with the patient in this phase in order to decide the problems and goals that the patient should focus on. I tried to develop good rapport with the patient by communicating with him in an empathetic and compassionate manner. It is important for the professionals to develop a therapeutic relationship with patient so that the patient can rely in the professionals and reveal his concerns and grief (Ratcliffe and Ellison 2015). I tried my level best to make the patient comfortable and helped him to feel at ease and trust me properly.

Four Episodes of Counseling Sessions

The second step is planned to make patients become aware of their thoughts, emotions as well as the beliefs about their problems. The duty of the professionals is to identify the different problems that the patient should work on and accordingly they would be encouraging the patient to share their thoughts and opinions about the problems (Gade et al. 2015).  The client who was suffering from severe depression due to his obesity issues was continuously encouraged to speak out about his different experiences, his interpretation of the meaning of the situation and the beliefs about himself, other people and events. It was advised to him to maintain a journal of thoughts so that he can identify his thinking procedures and engage in a technique of “self-talk”. This is one of the most important aspect of CBT. Studies have shown that more the individuals are able to identify their own thinking procedures and the causes of their sadness and grief; they would be able to modify such thinking procedures successfully. Therefore, the patient was continuously encouraged to reveal all his deeper thoughts and emotions. This helps the professionals in identifying the negative thinking patterns of the patients and thereby helps in developing intervention and motivation techniques to help patients overcome such negative thinking patterns (Palavras et al. 2015).

The third step is effective identification of the negative as well as inaccurate thinking procedures of clients. In this step, the professionals mainly help the clients to recognize their patterns of thinking and behaviors that are contributing to the problems. Accordingly, professionals ask the patients to pay attention to their physical, emotional and the behavioral responses in the different situations (Gu et al. 2015). In this step, the client was helped in a way by which he himself successfully identified his behavioral, emotional and physical responses in different critical situations. The client was motivated to be confident about his own will power and accordingly bring changes to his life that would help him to overcome all bullying behaviors of other people towards him. Moreover, he was also found to identify the unhealthy habits that make him gain calories. He voluntarily declared to modify the poor health habits to maintain a safe and healthy life. During the counseling sessions, active listening skills were ensured. Researchers like Andersson et al. (2014) are of the opinion that active listening skills help the patients to reveal their information completely allowing the professionals to understand their feelings and grievances completely. Impatient listening skills makes the clients feel irritated and upset making them feel that the professionals are not maintaining their dignity and autonomy and that they are not concerned about the feelings of the patients. This creates barriers in effective relationship development and hence affects trusts and reliance (Hallgren et al. 2016). Moreover, interrupted conversations can also prevent revealing of minute information by patient that could be useful to the professionals in intervention development.

How CBT Helped the Patient in Overcoming Depression

The fourth steps involve proper reshaping of the negative or inaccurate thinking and thereby helping clients to develop a positive thinking frame. This frame would be based on motivation, strengths and will power of successful change towards leading better quality lives. In this step, the therapist are seen to communicate with the clients  asking them whether they view their situations based on fact or on inaccurate perception about the aspects of their lives. Studies have suggested that this is the most difficult part of the counseling sessions as clients might have long-standing ways of thinking about themselves and their lives. However, they have also accepted that with practice, helpful thinking and behavior patterns would become a habit of the clients and would not take much effort (Jellalian et al. 2016). By the fourth week, mutual respect and trust had been inculcated in the relationship between the patient and me. Therefore, the patient successfully participated in the planning of the interventions and hence he was found to be motivated to modify his lifestyle and thinking procedures and start his life afresh. Proper diet management, physical activity sessions every day, avoiding fast foods, participating in social gathering, being motivated and many others were included in the discussion sessions.

The application of the cognitive behavioral therapy helped me to identify a number of aspects of the therapy that are helpful for the patient to overcome mental and emotional problems. Firstly, this therapy helps in identification of the problems of the patients more clearly and developing of the awareness of the automatic thoughts (Forman et al. 2016). As in the case study, the patient was seen to be highly affected by his thoughts of the body image that made him suffer from depression and social exclusion. The application of this therapy helped in developing positive thought patterns and motivation in the obese patient. Secondly, the therapy helps in challenging the underlying assumptions that are wrong and helps in distinguishing between real facts and irrational thoughts (Manzoni et al. 2016). Third, it helps in understanding how experiences can affect the present feelings and beliefs and help individuals to stop fearing about the worst. Fourth, it helps clients to see a different situation from a different perspective and better understand the actions and motivations of the other people. Fifth, the therapy helps patients in developing a more positive ways of thinking and seeing different situations and thereby become aware of their own moods. Sixth, the therapy helps in establishing goals and avoids any form of generalizations and all-or-nothing thinking (Karyotaki et al. 2017). Seventh, it helps to modify the thinking procedures of clients in ways by which they stop taking the blaming for everything and focus on the ways the things are rather than focusing how the things should be (Gade et al. 2014). Eighth, it gives the clients the scope to face their fears rather than avoiding them. It also enables the clients in describing, accepting as well as understanding rather than judging themselves or the others.

Conclusion

Conclusion:

From the above discussion, it becomes clear that the people may face from severe mental and emotional disorders. Cognitive behavioral therapy can help in managing such disorders successfully. It can be explained as the short-term therapy technique that can help people in finding various new ways to behave by modifying the thought patterns of the individuals successfully. Huge number of positive outcomes is associated with this therapy and this helps to ensure that the affected clients can overcome their symptoms and leaf quality lives. However, effective communication skills are extremely important as this can from the main foundation basis on which rapport development and relationship making might be based. This would help the client to align and communicate with professionals successfully multiplying the chances of success by many folds.

References:

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