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Case Study for Assessment and Formulation Skills using CBT

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caroline long

on 6 March 2014

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Transcript of Case Study for Assessment and Formulation Skills using CBT

Assessment
Frequency.Intensity.Duration.Onset
FIDO
(Scale from 0-8)
Work: Recently Unemployed
Leisure: Rarely goes out alone
Home: Struggles for motivation
Client Information
Cindy
45 years old
Married
Three Children
Unemployed Housewife

Confidentiality is considered throughout this case
Formulation
Early Experience
Competitive Family Upbringing
Poor Attachments
Isolation
Core Beliefs
I am not who I want to be
Others are better than me
Rules/Assumptions
If I am myself people will think I am stupid, so I must not show my true self or emotions
If people know I am stupid they will not like me
Critical Incident/Trigger
Busy public places
Meeting new/old friends
Event
Woman points whilst saying clients name in busy town

Interventions
Cindy is now able to go for daily walks with her dog on her own, although safe routes are still used
Cindy still believes people will judge her although her inner strength and belief appears to be growing
Dual Relationships can be difficult when trying to remain congruent and empathetic
Interventions out of session could have been focused on more in session looking at the 'safe behaviours' exhibited and what they mean to the client
Reflections
Case Study for Assessment and Formulation Skills using CBT
Presenting Problem
Fear of people judging and afraid people will not like her
Can't go to busy public places due to anxiety i.e. Supermarkets, Town Centers
Sticks to 'safe routes' which are quiet
Woman points at client saying her name in middle of busy town
Event
Avoids going out alone
Sticks to 'safe routes'
Behaviour
Anxiety
Palpitations
Feeling Nauseous
Feelings
Appraisal
Avoids going out alone
Sticks to 'safe routes'

Behaviour
Appraisal
Behavioural
In Session:
Look at clients self-concept and how this affects them physically (Reappraisal)
Out of Session:
Gradually attempt to walk different routes with more opportunity for socialization i.e. road side
Daily Thought Records (DTR)
Feelings
In Session:
Discuss what looking stupid means to client in mental terms
Recognise patterns in behaviour understanding formulation (Reappraisal)
Out of Session:
Aim to give one opinion a day without being critical of it
References
Three System Analysis
FIDO Ratings
Anxiety
Palpitations
Feeling Nauseous
Feelings
Beck A. Rush J. Shaw B and Emery G. (1979) Cognitive Therapy of Depression, New York: The Guilford Press
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Beck A. Freeman A. Davis D. and Associates (2004) Cognitive Therapy of Personality Disorders, New York: The Guilford Press
Beck A. (2005) ‘The Current State of Cognitive Therapy’ Arch Gen Psychiatry, 62; 953-959
British Association for Counselling and Psychotherapy (2010) Providing a Good Standard of Practice and Care, http://www.bacp.co.uk/ethical_framework/good_standard.php (19/02/14)
Collins S. (2009) ‘Good Communication helps to build a therapeutic relationship’ Nursing Times, 1; 1- 4
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Kazantzis N. (2006) ‘Theory, Research, and Practice of Cognitive Behaviour Therapy in Aotearoa/ New Zealand: Introduction to Special Feature’ New Zealand Journal of Psychology, 35; 3,114-116
Mcleod S (2010) Kolb- Learning Styles, http://www.simplypsychology.org/learning-kolb.html (21/02/14)
McCoy Lynch M. (2012) ‘Factors Influencing Successful Psychotherapy Outcomes’ Master of Social Work Clinical Research Papers, 57; 1-50
Ministry of Justice (2010) Working with NOMS to manage the risk of Serious Harm, London: National Offender Management Service
National Institute for Clinical Excellence (2004) Self-Harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care, Leicester: The British Psychological Society
Neenan M. and Dryden W. (2010) Cognitive Therapy in a Nutshell, London: Sage Publications
Persons J. (2008) The Case Formulation Approach to Cognitive-Behavior Therapy, New York: The Guilford Press
Russ S. and Ollendick T. (1999) Cognitive Behavioural Therapy: Handbook of psychotherapies with Children and Families, Philadelphia: Department of Psychology
Sharpley C. Jeffrey A. and Mcmah T. (2006) ‘Counsellor facial expression and client-perceived rapport’ Counselling Psychology Quarterly, 19; 4, 343-356.
Stedmon J. and Dallos R. (2009) Reflective Practice in Psychotherapy and Counselling, Berkshire: Open University Press
Zayfert C. and Becker C. (2007) Cognitive-Behavioural Therapy for PTSD: A Case Formulisation Approach, New York: The Guilford Press
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