Cognitive Behavioral Therapy Case Analysis

Cognitive

Case Analysis: Cognitive Behavioral Therapy

Alcoholism is a disease that many individuals face, with many suffering in silence. There are a number of persons diagnosed with alcoholism who find it very difficult to accept their condition. Chaney Allen was one of those individuals. She vacillated between acceptance and denial and had become powerless to her addiction. Chaney found out first hand that withdrawal from alcohol abuse has very dire consequences that may cause death if not appropriately treated. Not only is physical treatment required for many alcoholics, mental health intervention to address the psychological and emotional issues related to the addiction must also be addressed if there is to be real sobriety.

Background of Diagnosis

Chaney Allen is an African-American woman who was born in a strict CME family; the only daughter of a minister. She was one of 6 living children, with 5 other pregnancies resulting in miscarriage. According to Ms. Allen, she came from a high discipline, strict moral upbringing. Because of the familial family code, Chaney was forced to marry young, which did not last. She began to engage in a lifestyle that was not reflective of her upbringing, drinking heavily and partying (Allen & Mayfield, 1976). Chaney's drinking worsened when she entered the military. Her ability to hold her liquor was the mark of a great soldier. It was a symbol of one's ability in handling weapons. Chaney, just like other soldiers, used alcohol to deal with the traumas associated with stress from battle. Chaney was diagnosed with a variety of mental health disorders including alcohol dependent, alcohol intoxication, and posttraumatic stress disorder according to the DSM IV-R. Chaney was able to seek recovery and maintain her sobriety after years of intervention. She needed decorum and dignity for faster recovery. (Smith & Schuckit, 2008). Chaney Allen has reportedly been sober since 1968.

Current Research on Cognitive Behavioral Theories with this Diagnosis

Post-traumatic stress disorder is a disabling and chronic condition that is more prevalent in populations considered high risk which includes combat veterans and is exacerbated by alcoholism (McCarthy & Petrakis, 2010). Veterans, especially those who have combat experience, are one of the high-risk groups for developing post-traumatic stress disorder and increased alcohol use (Kilgore et al. 2008). Studies have established a high rate of co-morbidity of PTSD and alcohol use disorders (Stewart, 1996). This higher co-morbidity rate is indicative of higher rates of relapse, psychosocial and medical problems than are found in non-co-morbid individuals (Hoge, Castro & Messer, 2004).

There have been a number of cognitive behavioral therapies developed to address the treatment needs of individuals with PTSD and co-morbid alcohol dependence. One of the most well researched and frequently used is Seeking Safety; a present focused therapy with a goal of abstinence and a reduction in PTSD symptomology (Najavits, 2002). Although initially developed for women, men have now been able to benefit from the intervention.

Current Research on Cognitive Behavioral Assessment Issues and Methods used with this Diagnosis

Addiction is not just physiological but a multidimensional action in individuals; more than just being synonymous with tolerance, rehabilitation and withdrawal (Gifford & Humphreys, 2007). Using a functional model of assessment has proven to be effective with alcoholism. Functional models characterize individual and environmental interactions and provide a pragmatic means of changing behavior by way of environmental factors (Moos, 2006). Utilizing a functional assessment to modeling behavior change reportedly directly targets the individuals behaviors that lead to better long-term outcomes and serves as a point of integration for interdisciplinary research efforts. Having focused scientific efforts on processes of change may also be implicated in recovery in mutual help organizations.

Literature Review

According to recent research conducted by Kelly, Magill and Stout, empirical reviews that were rigorously conducted reveal that Alcoholics Anonymous (AA) and related 12 step treatment program participation is as effective as other approaches to intervention (AA, 2008, Humphrey's, 2004). AA is the most frequently sought source of intervention in the United States, for those suffering with alcohol related problems (Room & Greenfield, 1993). Intervention provided via AA is reportedly helpful for diverse individuals at various stages of recovery from alcohol dependence (Kelly & Yeterian, 2008; Ferri et al., 2006).

AA participation was compared with a variety of intervention techniques including cognitive behavioral therapy in reducing the frequency and quantity of alcohol use post treatment at intervals of 1 and 3 years follow up (Project MATCH Research Group. According to results, the rate of abstinence was 36% as compared to 24% in CBT (Cooney et al., 2003). What serves to make AA so successful is the fact that it is widely available, free, and in almost every community on any day of the week. This is particularly important for those at high risk for relapse when professional services are frequently unavailable (White, 2008).