Cognitive Behavioral Therapy

Introduction

Cognitive Behavior Therapy (CBT) is one of the evidence-based and widely used interventions in clinical social work practice. Aaron Beck developed CBT, focusing on the interconnection between cognitions, emotions, and behavioral factors. It believes that a dysfunctional thinking style is subject to favorable modification to improve mood and functioning (Beck, 2021). The approach involves a combination of environment- and evidence-based evaluation, along with strength-based social work, to promote mental and emotional health. Clinical social work is also directed towards diagnosing and treating mental, emotional, and behavioral disorders using references to social, cultural, and structural factors in the life of the client. CBT aligns with the exact definition, as it encourages collaboration, self-awareness, and behavioral change within the client's environment (Turner, 2020).

Client Description and Presenting Problem

Mr. Larry Bethea is an African American male patient aged 73 years, and he is diagnosed with unspecified dementia, moderate (F03.B). He also has a good history of poly substances, including cocaine, heroin, cannabis, and alcohol, which have been claimed to be in remission. His daughter referred Beteta to the behavioral health clinic because she was worried that her father was progressively experiencing issues with memorizing, feeling disoriented, and performing activities of his day-to-day living. His actions involve a failure to place and time, forgetting familiar people, a lack of purpose in where to go, and a withdrawn nature. He has also been reported to be happy, but his display does not seem genuine in relation to his reported emotion.

Theory-based Problems Statement and Assessment

According to CBT, the characteristic of the symptomatic problems that Mr. Bethei has can be described as the interplay between his emotional pattern and his cognitive distortions, along with behavioral patterns. Maladaptive thought patterns, as proposed by Beck in his cognitive theory, influence emotional and maladaptive behavior (Beck, 2021). Although dementia is a disease that implicates organic neurocognitive impairment, the history of substance abuse, unstable housing, and social isolation by the clients was a probable factor in the aggravation of the negative automatic thoughts and helplessness. Critical thinking skills and impaired thinking could have been among the developmental stressors due to long-term stress and substance exposure. CBT emphasizes that, despite the challenges presented when neurological issues are present, it can be used to help individuals develop compensatory mechanisms with the assistance of structured interventions to change behavior and apply positive reinforcement (Cuijpers et al., 2020).

Appropriateness of the Theory

CBT is suitable for the case of Mr. Bethea because it can be used with older adults with mild to moderate cognitive impairment. Easy types of CBT, such as behavioral activation, reality orientation, and emotion regulation training, have been proven effective for elderly individuals with mental impairments due to dementia (Baiyewu et al., 2023). CBT is interdependent and organized; therefore, it is associated with the model of clinical social work that is based on strengths and focuses on holism. The practice also promotes the involvement of influential caregivers, who will assist in ensuring the entrenchment of behavioral patterns, monitor development, and provide environmental reinforcement to the patient.

Potential for Change and Intervention Plan

This cannot be helped through cognitive recovery since, in this case, dementia is a chronic illness. However, CBT offers the opportunity for emotional control and improved functional everyday lives through systematic behavioral change. The treatment strategies will be based on the feelings of direction and regularity, emotional equilibrium, and drug abstinence. The interventions will involve behavioral activation, setting the frame of daily life, reality orientation through reminders and cues, and relaxation training to reduce irritability levels. Psychoeducation will be administered to his daughter, and this will boost her energy in favoring and confirming therapeutic plans.