Cognitive-behavioral therapy intervention for Chaney Allen's depression and addiction

Cognitive-Behavioral Therapy Assessment - Developing Intervention

Cognitive-behavioral therapy assessment developing intervention

This intervention addresses the case of Chaney Allen as a subject and incorporates group CBT as well as journaling. Allen's case would have been helped by community CBT because in addition to needing help on a personal level, she also needed community support -- both to help in combating her depression and addiction and in order to have emotional resources for raising her children. This Treatment Plan incorporates writing into CBT, in order to help participants process the characteristics of their addiction, change their perceptions and visualize positive choices.

Develop an assessment according to DSM-IV-TR diagnosis. In the analysis, discuss any automatic thoughts and core beliefs that Chaney Allen, possibly could have had.

Treatment Plan:

Initial assessment:

Session 1: Introduction to CBT

During this session, CBT would be explained and an overview of the following sessions would be given. Emphasis would be placed on empowering individuals to make decisions to change their behavior. An analogy to culture shock could be used here in order to help patients understand the stages of recovery. Participants would first be asked to journal about a time when they moved to a new place or traveled somewhere and stayed there for a few weeks. They would be asked to describe first impressions of the experience, how they felt when they began to see the negative as well as the positive sides of the setting, and how they overcame culture shock. Then the facilitator would describe how recovering from addiction can follow the same stages: excitement about the decision to change, happiness about overcoming initial obstacles, frustration with new challenges, and dealing with disappointment as a result of relapse. Finally, just as with culture shock, a person optimally comes to terms with the situation, finds balance, and continues the journey.

It should be mentioned that some people give up when faced with culture shock and they return to their original place without having experienced the final stage. But people who experience culture shock are much more likely to succeed in acculturating and understanding the target culture if they have a community of travelers with them who understand their experiences and feelings.

This strategy would be well understood by Allen as she made major changes in her life when she decided to travel from Alabama to Ohio at a young age. These two places have significantly different cultures, and she would surely have experienced culture shock.

Session 3: crisis management

At the beginning of this session, participants would begin by drawing symbols or a sketch to illustrate a recent crisis that they have experienced recently. Around the perimeter of the illustration, participants would be asked to draw symbols to show what resources they need or wished they'd had at the time of the crisis, in order to avoid relapse. They then discuss their illustration with a partner to solidify the connections between crises and resources. Finally, participants would write in their journals about what they would do in the future if a similar crisis arose, being as specific as possible, and perhaps writing down the exact steps they would hope to take. This approach would appeal to Allen because it involves communication through illustration, which would appeal to her visual intelligence, as well as her interpersonal intelligence.

At the end of this session, participants would write down an instance when they were offered alcohol and wished they had refused it, and turn it in to the facilitator. This information will be used in session 4.

Session 4: strategies for refusing alcohol and problem solving:

During session four, the facilitator would hand out the scenarios written by participants, to pairs and ask them how they would cope in the different situations. These discussions would be followed by whole group discussion during which participants share how they would deal with the situation. Next, the facilitator would hand out the whole list of scenarios and pairs would role play how to refuse the alcohol in each situation. This approach would appeal to Allen because at her core she is a generous person who feels good about helping others. She would be motivated by the group processing and by group members helping each other solve problems.

Session 5: planning for emergencies and coping with relapse:

This session opens with a discussion about relapse, and then asks participants to work in groups to create two endings to a story that describes a situation in which someone is facing temptation -- one in which the character relapses, and the events that follow, and one in which the character does not relapse, and the events that follow. Facilitator then leads a discussion in which groups share their ideas and discuss which outcomes they thought were most realistic, strongest, etc. Finally, the group makes a collective list of what to do in an emergency. The list is copied by one of the facilitators and distributed to the group.

Session 6: maintaining changes in drinking behavior:

Chaney Allen described herself as being "joyfully sober." It is possible that a facilitator could have seen the potential for this joy after the first 6 stages. In order to maintain this joy, I would recommend journaling daily; then, on a weekly basis, reading through the journal and highlighting all the times when you felt joy. The next step would be to make a running list of all the things that make you feel joy. Anytime you feel the urge to drink, read the list, and if possible, do an activity that made you feel joyful. This process is helpful because it is easy to do, and keeps the subject aware of thoughts and feelings, but focuses on the positive ones.