Therapeutic Intervention

Therapeutic Intervention Author’s Name The Institutional Affiliation Course Number and Name Instructor Name Synopsis of Consumer and Rationale for Chosen Intervention Maria, a 34-year-old woman and single mother of two children, is serving in an organization as a full-time nurse. She presents comorbid alcohol misuse with depression and anxiety, dealing with panic attacks. Alongside, Maria reports experiencing persistent guilt, mainly for her failure to balance her parental responsibilities with work. Moreover, she has left her feeling lonely, pronouncing the problems related to the work-life collision. Moreover, a sense of being judged negatively impacts her ability to socialize, further contributing to her isolation. Considering her case closely reveals that she lacks a proper social support system. Understanding Maria’s case led me to apply Cognitive Behavioural Therapy (CBT) to the case of Maria as clinical guidelines by reputed healthcare institutes such as the National Institute for Health and Care Excellence (NICE) also support CBT’s implementation in scenarios characterized by the comorbid presentation of mental health conditions, as in Maria’s case (National Collaborating Centre for Mental Health, 2011). CBT’s focus on cognitive restructuring was considered helpful for the purpose of reframing her thoughts with anxiety, depression, and panic attacks. Similarly, behavioral activation was focused on addressing her social withdrawal and reducing her alcohol consumption by providing a healthier coping mechanism. Process of Engagement and Therapeutic Relationship I started with empathetic listening, which enabled me to look at Maria’s context through her own emotional lens and created a sense of interconnectedness in Maria. I encouraged her to share her experience and adopted a non-judgmental and receptive approach, which is crucial to effective rapport building (Bourke et al., 2021; Walker, 2019). During the interview, I kept interjecting questions where appropriate for deeper inquiry to guide a more targeted approach. After getting insights into her experience, I engaged with her for collaborative goal setting, an important aspect of a therapist’s commitment to the client’s autonomy (Walker, 2019). I considered her preferences and assured her of being given charge of the process, with my role being assistive instead of authoritative. Next, I took care to determine the therapeutic boundaries. I remained aware of and kept reminding myself to suspend my judgment rooted in my belief about parental responsibility (and subsequent bias) so I could look at Maria’s case through her own specific psychological and cultural lens. Gradually, I shifted from listening to adding my remarks, which involved appreciating Maria’s struggle and her commitment to her children. Acknowledging her role as a mother and worker was instrumental in inoculating mutual trust in our therapeutic bond and ensuring its durability throughout the course of the intervention. Over time, Maria became more active in initiating the goals and sharing her feelings, particularly those attributable to self-blaming and guilt, which indicated the development of trust and rapport. Application of CBT to my Practice and Critical Analysis Planning and Implementation I used case formulation while planning CBT and based my implementation on the 5-area model by Padesky & Mooney (1990), considering its relevance to Maria’s case. Two other alternatives, including Motivational Interviewing (MI) and Dialectical Behavioural Therapy (DBT), were also considered but ruled out. MI was considered suitable as it could help Maria take charge of her issues while motivating her to alter her perceptions (Magill & Hallgren, 2019). However, since MI primarily deals with ambivalence, it did not align with Maria’s deeply entrenched emotional experiences and thought patterns. Similarly, DBI was briefly considered for its suitability for cases involving emotional regulation, as also faced by Maria considering her self-blaming (Chen et al., 2021). However, emotional regulation was not central to Maria’s case, and there was a need for a more robust intervention that encompasses all key psychological and behavioral patterns intersecting to create her unique reality. Based on this model, the case for implementation was broken down into the following key elements: Triggers: Work-related stress and her inability to balance work with personal life. Thoughts: “I’m not a responsible mother”; “I deserve to be punished for not doing enough for my children.” Feeling: Her guilt as a mother for not sparing enough time to take care of her children Behavior: Alcohol misuse and social withdrawal. Physical: Fatigue and panic symptoms. Based on the 5-areas model, the goals for CBT were defined as below: * Enabling Maria to overcome negative automatic thoughts (NATs) * Promoting resilience in Maria * Helping Maria develop coping skills * Improving emotional regulation * Reducing alcohol use by Maria Within CBT’s framework, I applied the following techniques in line with the above goals: Behavioral Activation: Behavioural activation involves engaging a consumer in activities that they previously enjoyed as a tool to promote positive moods and mindsets (Walker, 2019). I discovered that Maria was interested in journaling and creative writing. I set short, playful writing tasks for her, giving her a choice among a range of writing prompts. I kept these tasks brief, considering she’s already frustrated for being overly burdened with her schedule. Cognitive Restructuring: Cognitive restructuring is the process of enabling the client to reconsider her thoughts by providing them with an alternative, generally positive version of their experience (Ciharova et al., 2021). In Maria’s case, her thought, “I’m an irresponsible mom,” was aimed to change to something like, “I am highly responsible since whatever I am doing is to serve my children.” The restructuring process focused on making Maria realize her potential and appreci...