Cognitive Behavioral Therapy Family versus Individual Settings

CBT in Families vs. CBT in Individual Settings
It should be noted, from the onset, that as Lee and Edget (2012) observe, at first instance, CBT in families and CBT in individual settings could appear contradictory. However, according to the authors, although the said approaches differ in some ways, they also happen to have a lot in common. To begin with, the author observes that both approaches are short-term in nature. This is to say that they typically last for a couple of months. Further, the authors also observe that both approaches are behavioral-based. Thus, in essence, in both settings, “individuals learn to recognize the mistakes in their thinking that impacts behavior, then make modifications to change that behavior” (Lee and Edget, 2012, p. 137).
It should, however, be noted that the central focus of both approaches could differ. CBT in individual settings happens to largely focused on the individual person following diagnosis. For instance, in my practice, I have found that in the treatment of persons with alcohol use disorder, the overall goals of treatment happen to be the achievement and maintenance of sobriety, as well as recovery from the addiction damage that was caused. On the other hand, however, the main focus of CBT in families happens to be the institution of productive changes that aim to promote not only the engagements, but also the communication in the familial realm. In this case, therefore, there is expanded focus. Indeed, according to Gobbard (2009), “when applied to families, the cognitive–behavioral therapeutic approach examines the interactional dynamics of family members and how they contribute to family functioning and dysfunction” (p. 87).
It would be prudent to note that in comparison to CBT in individual settings, family-focused cognitive behavioral interventions have also been shown to be more effective in some scenarios. This is more so the case when it comes to the treatment of children with anxiety disorders. Indeed, in the words of Groot, Cobham, Leong, and McDermott (2007), studies conducted in the past have suggested that “children with anxiety disorders appear to improve following a family-focused cognitive behavioral intervention” (p. 994). This is something I have witnessed in my own practice – most specifically following my interaction with an 11-year-old girl diagnosed with generalized anxiety disorder (GAD). The child had been through individual therapy and only started to show signs of improvement once the family was roped-in to the therapeutic process.
Possible Challenges in the Use of CBT in Family Settings
There are a number of challenges that counselors could face in their utilization of CBT in family settings. To begin with, garnering the cooperation as well as commitment of all those involved could be a huge challenge. According to Gobbard (2009), CBT for families involves a wide range of activities including thought recording and journaling. For some families, this could be deemed too much homework. Further, in the words of the authors, in this particular case, “each individual must commit to being open and examining their own behavior” (Gobbard, 2009, p. 212). Obtaining the cooperation of all those involved could be an uphill task. Given that family involvement is a key aspect of the approach, lack of commitment and perseverance on the part of all those involved could work against recovery. Secondly, there is also the concern about the emergence of conflicts that make it difficult to focus on the relevant coping mechanisms (Gobbard, 2009). In individual settings, such conflict could be easy to handle as the engagement in this case is largely between the therapist and the client. In family CBT, however, the inclusion of additional members from the family could in some instances give rise to additional concerns and conflicts that frustrate the attainment of certain therapeutic objectives.
References
Gobbard, G.O. (2009). Textbook of Psychotherapeutic Treatments. American Psychiatric Pub.
Groot, J., Cobham, V., Leong, J. & McDermott, B. (2007). Individual versus group family-focused cognitive-behavior therapy for childhood anxiety: pilot randomized controlled trial. Aust N Z J Psychiatry, 41(12), 990-997.
Lee, S.A. & Edget, D.M. (2012). Cognitive Behavioral Therapy: Applications, Methods and Outcomes. Nova Science Publisher's.