Therapy Modalities

Therapy Modality Focus Points

Week X

 

 

Therapy Modality: Cognitive Behavioral Therapy

 

Creator: Aaron Beck

Therapy used for what DSM5 Diagnoses: Cognitive Behavioral Therapy (CBT) is an effective treatment for many of the mental health diagnoses listed in the DSM-5, including anxiety, depression, post-traumatic stress disorder, bipolar disorder, eating disorders, obsessive-compulsive disorder, and substance use disorders (Reddy et al., 2020). CBT helps individuals identify and modify distorted or negative thought patterns, manage stress, increase self-esteem, and develop healthier coping skills. It is an active therapy, and the techniques used can be tailored to meet the needs and goals of each individual.

Emphasis of Therapy Modality: CBT is a kind of psychotherapy that aims to assist patients in recognizing and controlling their thoughts and actions. CBT emphasizes the role of thinking in how we feel and what we do. It teaches individuals to recognize, challenge, and restructure their thoughts and behaviors to improve their emotional state and manage their lives better. CBT is a goal-oriented therapy, and it is focused on the present (Külz et al., 2018). It works to identify and change the unhelpful thoughts and behaviors that are causing distress or preventing the individual from reaching their goals. CBT is an effective therapy for various mental health conditions, such as depression, anxiety, post-traumatic stress disorder, and substance abuse. It can also help improve relationships, increase self-esteem, and reduce stress. CBT is an evidence-based approach that effectively reduces symptoms of mental health conditions and improves the overall quality of life.

Goals of Therapy Modality: The main goals of CBT are to help individuals identify and modify any cognitive distortions, develop healthy coping strategies, and gain insight into their behavior and thought patterns. CBT also focuses on developing problem-solving skills, increasing self-awareness and understanding of one’s emotions, and building self-confidence. The goal is to help the individual gain insight into their behavior, recognize how their thinking and behavior impact their daily life and learn how to make changes to improve the quality of their life (Külz et al., 2018). Additionally, CBT helps individuals develop better coping skills to deal with stress, anxiety, and depression. CBT is also used to help individuals with substance abuse, eating disorders, and other mental health issues. The goal is to identify triggers and underlying causes for the behavior and to develop healthier coping skills and behaviors.

Notes: The primary purpose of Cognitive Behavioral Therapy (CBT) is to help individuals identify and modify any cognitive distortions, develop healthy coping strategies, and gain insight into their behavior and thought patterns. The goal is to reduce the negative emotions they experience and help them individually develop more adaptive ways of thinking and behaving. CBT is a collaborative approach between the therapist and the individual, focusing on the present. Through CBT, individuals can learn new skills such as problem-solving, relaxation, and communication. It is an evidence-based approach that effectively reduces symptoms of mental health conditions and improves the overall quality of life.

 

 

 

 

References

Külz, A. K., Landmann, S., Cludius, B., Rose, N., Heidenreich, T., Jelinek, L., Alsleben, H., Wahl, K., Philipsen, A., Voderholzer, U., Maier, J. G., & Moritz, S. (2018). Mindfulness-based cognitive therapy (MBCT) in patients with obsessive–compulsive disorder (OCD) and residual symptoms after cognitive behavioral therapy (CBT): a randomized controlled trial. European Archives of Psychiatry and Clinical Neuroscience, 269(2), 223–233. https://doi.org/10.1007/s00406-018-0957-4

Reddy, Y. Cj., Sudhir, P., Manjula, M., Arumugham, S., & Narayanaswamy, J. (2020). Clinical Practice Guidelines for Cognitive-Behavioral Therapies in Anxiety Disorders and Obsessive-Compulsive and Related Disorders. Indian Journal of Psychiatry, 62(8), 230. https://doi.org/10.4103/psychiatry.indianjpsychiatry_773_19

Directions:  Please select one case scenario topic and post your own opinions. You will find a link to my PowerPoint on NASW Code of Ethics and a link to the actual code of ethics. You will use the actual NASW Code of Ethics to address your questions by identifying the code by its assigned, such as 1.01 Commitment to the Client and/or the Ethical Principles that apply. I recommend you carefully read all the Code of Ethics before answering the questions. Your post should be a minimum of 4 paragraphs (5-7 full sentences) and you may use first person to address your topic. You may want to begin your post by identifying which group you are in.

Scenario 1

You are a supervisor (MSW) in a mental health program which has a strict policy against transporting clients. As you are driving to work you see a woman who you know is one of your counselor’s clients, walking down the road. You assume she is walking to your office as she has at least 3 appointments a week and you have seen her at your office. It has begun to rain hard and the office is at least a mile away.

• Is it illegal to stop and provide a ride to this client?
• Identify any NASW Code that would support or challenge you providing this client a ride
• Is this an ethical dilemma? Why or why not?
• As the supervisor what would you do?

Use your lecture materials to determine what CPT E&M Code and ICD-10 diagnosis code to utilize for this “new patient” encounter using the medical decision-making (complexity) approach.

Provide justification for the code you assigned by including the following information in your discussion:

This patient presents to a local health center. As the provider, you must conduct a full physical on the patient as well as a psychiatric intake.

Liam is a 22 year-old who reports to you that he feels depressed and is experiencing a significant amount of stress about school, noting that he’ll “probably flunk out.” He spends much of his day in his dorm room playing video games and has a hard time identifying what, if anything, is enjoyable on a typical day. He states once he leaves the room he begins sweating and feels as if he has heart palpitations. He rarely attends class and has avoided reaching out to his professors to try to salvage his grades this semester. Liam has always been a self-described shy person and has had a very small and cohesive group of friends from elementary through high school. Notably, his level of stress significantly amplified when he began college. You learn that when meeting new people, he has a hard time concentrating on the interaction because he is busy worrying about what they will think of him – he assumes they will find him “dumb,” “boring,” or a “loser.” When he loses his concentration, he stutters, is at a loss for words, and starts to sweat, which only serves to make him feel more uneasy. After the interaction, he replays the conversation over and over again, focusing on the “stupid” things he said. Similarly, he has a long-standing history of being uncomfortable with authority figures and has had a hard time raising his hand in class and approaching teachers. Since starting college, he has been isolating more, turning down invitations from his roommate to go eat or hang out, ignoring his cell phone when it rings, and habitually skipping class. His concerns about how others view him are what drive him to engage in these avoidance behaviors. After conducting your assessment, you give the patient feedback that you believe he has social anxiety disorder, which should be the primary treatment target. You explain that you see his fear of negative evaluation, and his thoughts and behaviors surrounding social situations, as driving his increasing sense of hopelessness, isolation, and worthlessness.

Significant Symptoms:

· Anxiety

· Depression

· Ruminations

· Social Anxiety

· Physical symptoms; sweating, heart palpitations

Vitals:

· 127/80

· 98

· 18

· 60

· 90%

· BMI 30

· 225 lbs.

· 72”

Physical exam:

· General: Well appearing, well nourished, in no distress. Oriented x 3, normal mood and affect. Ambulating without difficulty.

· Skin: Good turgor, no rash, unusual bruising or prominent lesions.

· Hair: Normal texture and distribution.

· Nails: Normal color, no deformities.

· HEENT: Head: Normocephalic, atraumatic, no visible or palpable masses, depressions, or scaring. Eyes: Visual acuity intact, conjunctiva clear, sclera non-icteric, EOM intact, PERRL, fundi have normal optic discs and vessels, no exudates or hemorrhages.

· Ears: EACs clear, TMs translucent & mobile, ossicles nl appearance, hearing intact.

· Nose: No external lesions, mucosa non-inflamed, septum and turbinates normal.

· Mouth: Mucous membranes moist, no mucosal lesions.

· Teeth/Gums: No obvious caries or periodontal disease. No gingival inflammation or significant resorption. Pharynx: Mucosa non-inflamed, no tonsillar hypertrophy or exudate.

· Neck: Supple, without lesions, bruits, or adenopathy, thyroid non-enlarged and non-tender.

· Heart: No cardiomegaly or thrills; regular rate and rhythm, no murmur or gallop.

· Lungs: Clear to auscultation and percussion.

· Abdomen: Bowel sounds normal, no tenderness, organomegaly, masses, or hernia.

· Back: Spine normal without deformity or tenderness, no CVA tenderness.

· Rectal: Normal sphincter tone, no hemorrhoids or masses palpable.

· Extremities: No amputations or deformities, cyanosis, edema or varicosities, peripheral pulses intact.

· Musculoskeletal: Normal gait and station. No misalignment, asymmetry, crepitation, defects, tenderness, masses, effusions, decreased range of motion, instability, atrophy or abnormal strength or tone in the head, neck, spine, ribs, pelvis or extremities.

· Neurologic: CN 2-12 normal. Sensation to pain, touch, and proprioception normal. DTRs are normal in upper and lower extremities. No pathologic reflexes.

· Psychiatric: Oriented X3, intact recent and remote memory, judgment and insight, anxious mood and affect.

· Breast: No nipple abnormality, dominant masses, tenderness to palpation, axillary or supraclavicular adenopathy.

· G/U: Penis circumcised without lesions, urethral meatus normal location without discharge, testes and epididymides normal size without masses, scrotum without lesions.

The level of medical complexity encompassed by including the number of points for the diagnoses/management options and the amount/complexity of data reviewed; then identify the level of risk for complications, morbidity, mortality

In the discussion, explore how the ICD-10 Codes that you assigned impact third party payor reimbursement for this visit.

Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

Please review the rubric to ensure that your response meets the criteria.

Selecting 1 of the 5 topics, you will be required to submit a 300-word minimum main topic posting. Your initial posting should be analytical, persuasive, or reflective in nature.

 

Topic 2: Suicide Exposure in Law Enforcement Officers

Cerel, J., Jones, B., Brown, M., Weisenhorn, D. A., & Patel, K. (2019). Suicide exposure in law enforcement officers. Suicide and Life-Threatening Behavior, 49(5), 1281–1289. https://doi.org/10.1111/sltb.12516

\/* Selecting one of the four topics, you will be required to submit a 300-word minimum main topic posting. Your initial posting should be analytical, persuasive, or reflective in nature. Please add your references to the main topic posting (required). You are encouraged to do research on the topic from other resources. Each classmate’s response should be a minimum of 100 words per response. Your option is to respond to postings that concern your main topic selection, or you may respond to postings from classmates that have to do with one of the other two topics.

Topic 1: Courting Compliance: The Role of Case Managers in Mental Health Courts

Castellano, U. (2011). Courting compliance: Case managers as “double agents’” in the mental health court. Law and Social Inquiry, 36(2), 484–451. http://www.jstor.org/stable/23011900