Cognitive Behavioral Therapy (CBT): Group Settings Versus Family Settings

CBT
From the onset, it would be prudent to note that CBT has been shown to be an effective therapy technique – especially in attempts to adapt the behaviors of persons as well as alter their patters of thought. Indeed, as the American Psychological Association – APA (2017) points out, some of the concerns that CBT has been effective in addressing (as indicated by various research studies) include, but they are not limited to, “depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders and severe mental illness.” In this text, I assess the utilization of CBT in family settings in comparison to its utilization in group settings. Further, I highlight some of the challenges that counselors could come across in their deployment of CBT in group settings.
To begin with, it is important to note that when CBT is applied to families, the focus happens to be largely on what Bieling, McCabe, and Anthony (2013) refer to as “the interactional dynamics of family members and how they contribute to family functioning and dysfunction” (p. 109). It is considered a short-term approach to treatment. The overall focus on this front still happens to be the modification of behavior and the alteration or adjustment of interactional patterns in the familial realm. As a consequence, in my own practicum experiences, I have found that family CBT often results in improved communication which often has a positive impact on family units – especially in the treatment of mental health issues. Thus, the various principles that could be deployed on this front are inclusive of; negotiation and contingency contracting strategies. Further, as Graham and Reynods (2013) point out, CBT on this front is also tailored to restructure attitudes and beliefs that appear distorted and that could come by as a consequence of interactions that are largely faulty. There is also need to observe that according to O’Hare (2020), family CBT further has a deep or significant focus on core beliefs (also referred to as schema). This, according to the author happens to be the case “in an attempt to evaluate how these impinge on the emotions and behaviors of family members’ interaction” (O’Hare, 2020, p. 213).
Like is the case with family CBT, group CBT has significant empirical support. Further, in addition to being deemed, collaborative, it is also considered structured (Graham and Reynods). Like family CBT, it also happens to be a short-term treatment approach and is also concerned with attempts to alter behavior as well as thinking patters that could be deemed harmful or unhelpful. However, unlike is the case in family CBT, group CBT could bring onboard participants from diverse backgrounds who possess no common or close links. This is unlike family therapy whereby participants are largely drawn from a family unit. Further, unlike is the case in family CBT where the focus is mainly the modification of familial interactional patterns, group CBT is modeled on the delivery of psychological interventions in a manner that seeks to provide access to social support. In my own practicum experiences, I have found out that in providing social support access, group therapy results in the lessening of suffering (rooted in isolation) that is associated with obsessive compulsive disorder.
There are a number of challenges that counsellors could encounter in their deployment of CBT in group settings. The first challenge relates to the risk of some patients dropping out of treatment. This is more so the case given that in a recent study, it was found that there is often a significant dropout rate in group CBT (Thimm and Antonsen, 2014). There is need to examine predictors of dropout so as to maximize the effectiveness of group CBT. Next, a counselor would have to contend with issues relating to confidentiality. This is more so the case given that as O’Hare (2020) points out, information is in this case revealed to both the counselor and other participants in the group. According to the author, “there is no guarantee that other group members will maintain confidentiality” (O’Hare, 2020, p. 177). The counselor could minimize confidentiality breaches by discussing with the group the relevance of confidentiality, as well as the most appropriate approaches towards the maintenance of confidentiality.
References
American Psychological Association – APA (2017). What Is Cognitive Behavioral Therapy? https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
Bieling, P.J., McCabe, R.E. & Anthony, M.M. (2013). Cognitive-Behavioral Therapy in Groups. Guilford Press.
Graham, P. & Reynods, S. (2013). Cognitive Behavior Therapy for Children and Families. Cambridge University Press.
O’Hare, T. (2020). Evidence-Based Practices for Social Workers: An Interdisciplinary Approach. Oxford University Press.
Thimm, J.C. & Antonsen, L. (2014). Effectiveness of cognitive behavioral group therapy for depression in routine practice. BMC Psychiatry, 14(292), 43-51.