Topic 4: Psychoeducation & Behavioral Activation {by 2/17}

[Psychoeducation] – Watch MDD-4: Psychoeducation – Therapy Expectations and the Cognitive model AND PDA-4: Psychoeducation – Diagnosis.  Answer the following: (1) How can you adjust psychoeducation of therapy expectations and the cognitive model based on a client’s distress and presenting problems?  That is, what can be said differently, and how can it be done differently?  (2) For psychoeducation of specific disorders, what are some ways you can “normalize” each clients’ experience without alienating them or coming off as lacking empathy?

 

[Behavioral Activation] – Watch MDD-5: Behavioral Activation – Psychoeducation & Introducing Weekly Activity Monitoring Log (WAML).  Answer the following: (1) Based upon what you know about this client so far (e.g., information from his assessment and this video vignette), what patterns of behavior do you think warrant follow-up in the next session while reviewing his WAML?  (2) How would monitoring this client’s accomplishment and pleasure be helpful for his treatment?

 

Your original post should be posted by the beginning of class 2/17.  Have your two replies posted no later than 2/19.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

 

*Videos can be found at R&L website or here: https://dradamvolungis.com/classes/psy-708/cbt-theory-into-practice-psy-708/videos-psy-708/

40 Comments (+add yours?)

  1. Emily Barefield
    Feb 14, 2022 @ 13:51:35

    When describing therapy expectations, the process will look different for each client, even for clients with the same disorder. Each client’s symptoms will vary and their experience with those symptoms will be unique. When explaining the relationship between thoughts, behaviors, and emotions it is helpful to use client specific examples. This can be done by first drawing out and explaining the basics of the cognitive model, and then selecting a specific situation in which the client experienced symptoms. Using this experience the client and the therapist can work together to identify the thoughts, emotions, and behaviors the client experienced in that situation. The therapist can then explain how those particular thoughts, emotions, and behaviors are interacting in the situation. When explaining the cognitive model, it is also important to do so in a way that the client can understand. For some clients, especially those with higher levels of education particularly in science-related fields, it would be appropriate to use formal CBT terms and describe collaborative empiricism in more detail. When working with kids, some adolescents, and some adults, this might be overwhelming and unhelpful and describing the relationship between thoughts, emotions, and behaviors would be best done using terms already in their vocabulary. The process of describing the cognitive model utilizing the client specific examples does address their distress, but it is beneficial to utilize the model in explaining how change can occur. This process can instill hope in the client.

    When providing psychoeducation for specific disorders, it can be helpful to provide information about prevalence in some cases, especially if the client expresses feeling alone in their struggles. It is beneficial to explain to the client the process of the development of the disorder. It can be helpful for clients to know that their experiences is a result of a normal process gone wrong and that mental disorders exists on a continuum that crosses over into “normal.”

    When reviewing Mark’s weekly activity monitoring log, I would review his withdrawal behavior, tasks during his workday, and time he spent being active with his girlfriend, dog, or his friends. I would want to have a discussion surrounding what preceded his withdrawal behavior and how that behavior impacted his mood. I would also want to discuss his workdays, specifically what went well and what he wants to change. Finally, I would want to talk about what motivated him to engage in more active behaviors and how those behaviors made him feel. Monitoring Mark’s accomplishment and pleasure will likely help him see which behaviors he wants to target for increase and which he wants to decrease. Because Mark is depressed, he is likely to evaluate the week more negatively. Highlighting activities where he did experience pleasure and accomplishment may show him that things are not always as bad as they seem and that there are things to look forward to.

    Reply

    • victoria cestodio
      Feb 14, 2022 @ 19:15:19

      Hi Emily!

      I love how you talked about when explaining the cognitive model. It is important for you to describe it in a way that the client understands. I also kind of said this in my post. Making sure the client is engaged and you are not just speaking all scientific to them is important. For the specific disorders I like how you mentioned the development of the disorder, this can really help the client understand their disorder better and why we may have anxieties (biological; fight or flight). I also had a similar answer to what we should focus on next time with Mark, his withdrawing behaviors seem to play a big role and it seems like work isn’t always the best.
      Awesome post!!
      Victoria

      Reply

    • Vanessa Nichols
      Feb 15, 2022 @ 14:52:41

      Hi Emily,
      Great post this week!
      I agree that language makes a substantial difference in explanation and understanding. The scientific gardon may be comforting for those with higher education or knowledge. However, for those in severe distress or lack of understanding, language can be extra confusing and make the client feel uncomfortable or disconnected from the therapy. I agree with you that each client will present differently even with the same disorder, and instead of trying to fit them in a box of where we think they should be, we have to meet the client where they are at. CBT is collaborative, so the client must understand what CBT is and what is being asked of them. It is also essential that the client has a say in their therapy and expectations are made for their needs.
      You made a great connection between his weekly activities and figuring out what is essential for him or what makes him feel good. Some depressed individuals can be preoccupied with what they think they need to be doing and not focus on what they want to be doing or activities that make them happy. Monitoring his behavior can allow us to figure out what works for him and what doesn’t. His accomplishment can lead him to be motivated for additional change.
      I think you did a great job this week!

      Reply

    • Tressa Novack
      Feb 15, 2022 @ 21:25:15

      Hi Emily,
      I like how you mention to use client specific examples during psychoeducation. This can be a great way to help them understand what we are trying to teach them. I also like how you pointed out that age and education level play a role in how we psychoeducation our clients. I really agree with this, because we do not want to use terms or examples that go beyond our clients’ understanding. You also did a really good job of putting into words what I was trying to say about teaching a client about their specific diagnosis. I think a normal process done wrong is a good way to explain it. Overall, great post.
      Tressa

      Reply

    • Moises Chauca
      Feb 20, 2022 @ 17:39:57

      Hello Emily,

      I enjoyed reading your post! I agree and found helpful some points you made in this post. First, I agree that introducing the client to the basics of CBT in a specific way that fits the client is important for a collaborative environment. The therapist has to adjust their explanation to the client’s language, experiences, and academic level. Second, I found agree with your point about the importance of psycho education and I found it helpful that you mentioned prevalence and development because this information can go a long way. Lastly, I agree with your way to go about the Mark activity monitoring tool. It is helpful for the client to go over Mark week and highlight the pleasurable activities and how we can change the negative ones in terms of their emotions and thoughts.

      Reply

  2. Victoria Cestodio
    Feb 14, 2022 @ 15:53:40

    Obviously, no client will be the same, and you will not approach every client the same way when providing psychoeducation. For example with Mark, he definitely struggles with some negative automatic thoughts therefore going through a specific example he has recently dealt with can make understanding psychoeducation easier. If Dr. V started just describing what negative automatic thoughts were to Mark he probably wouldn’t have understood as well if you weren’t talking about a specific situation where his negative automatic thoughts come into play, because it is much more relatable to him and he actually realizes there’s a reason behind these emotions he feels. Therefore, I think bringing back to the clients direct experience makes psychoeducation less ‘boring’ for the client. It is making them understand why they are the way they are, which I think is much more powerful compared to sitting there just explaining the cognitive model.

    When providing psychoeducation for specific disorders there are certain things we can do as therapists to ‘normalize’ the clients experiences without coming off as cold. How we would do that is by talking about the features of the disorder, but showing them they may be biological for example. With the woman in the second video we see Dr. V does this, she suffers from panic disorder and Dr. V explained to her that anxiety is sometimes there to protect us but too much of it is not good. He talked about fight or flight and how anxiety is somewhat of a biological response to fear. This ‘normalizes’ it enough but also not lacking empathy, as you still validate their feelings and experiences because in the case of the woman validating these are real physiological symptoms and it can feel like a heart attack can validate her much more.

    I think the patterns of behavior that should really be reviewed is one, his withdrawal. Mark seems to do this a lot, therefore seeing how much time he spent withdrawing can help both Mark and Dr. V with developing a treatment plan. Also, I would review if he was more active with his girlfriend and maybe even his friends. However reviewing this will give us insight if he made any steps to get a little more active, even if there are no friends involved the first week, maybe hearing he did go out with his girlfriend more is a good start and will eventually lead him to go out with his friends more. It seems as though work can sometimes be difficult for Mark, so I think looking over some positive things that came from work that week and some negative things that impacted him from work. Monitoring this Marks accomplishment and pleasure can be helpful for his treatment because since Mark suffers with depression we would not always want to talk about the negative or the stuff that went wrong, one of our goals in treatment would be having Mark think or see the positive more therefore having him see what he has done positive each week will really reinforce him. When someone is struggling with depression it is sometimes hard to see what things went well, because focusing on the negative is usually how our brains conceptualize things when we are depressed.

    Reply

    • Vanessa Nichols
      Feb 15, 2022 @ 15:11:35

      Hi Victoria,
      Great post!
      I really like how you explained the process of learning about automatic thoughts through Mark’s perspective. I agree with you that relating the information to the client can help understand the material more in-depth and make it not so boring. An essential aspect of connecting the model to the client is that it also gives them the opportunity to ask questions about themselves, something they have experienced concerning CBT or therapy.
      I agree with you that normalizing can come off cold and phony sometimes. I think it’s important to do normalizing in a casual sense. I think it’s imperative not to over normalize because in away over normalizing may invalidate the clients’ feelings of distress. I also really liked how Dr.V explained the functional aspect of her disorder and related the symptoms she feels to their evolutionary function. I feel like this is crucial because it explains why the feelings occur in the first place; it also lets her know that these feelings occur in everyone at some point; she just experiences them a little more frequently or severely.

      Reply

    • Jeremy
      Feb 19, 2022 @ 20:49:50

      Hey victoria,
      I liked your response a lot, I think you hit the nail on the head for Marks’s review.
      I definitely agree, using recent examples from the client’s life is a good way to ensure that they can handle why automatic thoughts are important. It definitely can also be useful to have the client explain an example themselves as well afterward to ensure that they grasp the concept. If they do not give an example of an automatic thought it then gives a good point to correct his mistake before it goes too far.

      I defiantly liked how you pointed out the associated biological processes of panic attacks, explaining common mechanisms of a specific disorder can go a long way in indienfying and correcting negative trends especially when those models are tied back to the client’s situation. A lot of the time individuals don’t understand whats going on in a panic attack, learning the associated language and processes can demystify the situation.

      Reply

  3. Vanessa Nichols
    Feb 15, 2022 @ 14:27:12

    One of the most important things I have learned in this program so far is that you have to meet a client where they are, and I feel this heavily relates to the discussion of therapy expectations and the cognitive model. Every single client (even with the same disorder) experiences mental distress differently. As successful therapists, we must have the ability to read the room and adapt our approach to fit the client’s specific needs. For more distressed clients, you may want to minimize the scientific gardon, the goals may need to be smaller than those set for others, and you may limit the initial work between sessions. For those in extreme distress, too much homework between sessions at first can result in failure. This failure can hurt the therapeutic relationship, the client’s motivation, and belief in therapy. While explaining the CBT model for those in more distress, you may have to spend significant time breaking down the model and focusing on the immediate distress, and coming back to the fancy or technical stuff later when the client can handle it. How you describe the CBT model should match the client’s education level and understanding. Some of the scientific words can confuse the clients. The goal of CBT is to be collaborative, so it’s essential that the client fully understands how CBT works and what is expected of them.

    One of the things I noticed Dr. V do in the video was using the words understandable, normal, expected. I think this type of gardon portrays empathy and, at the same time, normalizes the disorder. I think the way Dr. V did it was great because it did not overdo it to the point where it seemed phony. I also really liked that Dr. V explained the practical use of her disorder. Like why it happens in the first place and the positives created due to the disorder. Once the functional use and normalization are completed, he explains where there’s goes a little wrong. This is great because it shows the client that the part of what they are experiencing is functional and something everyone experiences. I think providing statistics can be helpful, but I feel the statistics can come off disconnected and unempathetic, so maybe statistics and other information would be the best bet.

    For Mark, I would want to discuss his avoidant/withdrawal behavior and his sleep schedule. Mark mentioned in detail that it was vital for him to spend more time with his girlfriend and friends. A lot of Mark’s automatic thoughts and core beliefs occur while he is trying to do social activities. Following these behaviors, emotions, and thoughts is extremely important for Mark’s development throughout therapy. While monitoring mark’s behavior, Mark will be able to tell us what activities made him feel good, what activities gave him difficulties, and what thoughts occurred during those difficulties. Mark will also be able to tell us how he could get through those difficulties, what motivated him, or if he couldn’t complete them. Discussing mark accomplishments are important for multiple reasons accomplishments contribute to Mark’s self-efficacy, and talking about them can bring that more into his awareness. Accomplishments motivate individuals to strive for more. These accomplishments can also help Mark not negatively view the week or himself. They can also be used for contradictory evidence when talking about negative automatic thoughts and core beliefs.

    Reply

    • Tressa Novack
      Feb 15, 2022 @ 21:20:43

      Hi Vanessa,
      You make a lot of really great points about meeting the client where they are at. Depending on the client’s diagnosis and distress, they may not be able to handle as large of goals or amount of homework as another client. They may not be capable of the same understanding of CBT and therapy expectations as another client. These are all important things to keep in mind when educating our clients on CBT and therapy. I also think that Dr. V. did a great job of normalizing while showing empathy for clients. I like how you pointed out the specific words that he used to do this. In terms of Mark, I also pointed out how his withdrawal behaviors and how logging activities can help him see what made him feel good and what did not. Great post!
      Tressa

      Reply

    • victoria cestodio
      Feb 17, 2022 @ 10:32:05

      Hi Vanessa!
      I like how you started your post with the most important point! Meeting the client where they are at is crucial and important to build rapport. “Reading the room” is something therapists need to have, we need to be able to pick up on cues that might not be too obvious. I also talked about in my post that we have to use language with our client that is more “normal” or broken down. Some clients we may have the ability to talk more scientifically with, like doctors for example, but others we need to break down the language to simpler forms. I also agree with you that for Mark we have to really target his negative automatic thoughts, as it seems to be affecting him greatly.

      Great post!
      Victoria

      Reply

    • Lauren Pereira
      Feb 17, 2022 @ 11:07:51

      Vanessa,

      I love all the examples you provided in your descriptions! I like how you mentioned that failure can damage the therapeutic relationship, and that is why it is so important to try your best to read your client and pay attention to their needs. The client should be able to understand the CBT model being used in sessions, so they feel more comfortable and motivated when trying to reach their goals. Having that communication skill with your client would be most beneficial when explaining information in terms that they understand.

      I also agree that Marks withdrawal and avoidant behaviors need to be focused on. It is also a good idea to point out his sleeping schedule to indicate whether he is getting enough rest. Sometimes not being able to sleep well can affect your day and how your emotions play out that day. Another importance if expressing some of his accomplishments to help reassure him of his rewards thus far and for him to feel more confident in himself. Great post!

      Lauren

      Reply

    • Pilar Betts
      Feb 17, 2022 @ 18:46:41

      Hey Vanessa,

      I really like the way you described it as “meeting the client where they are” this is so important because being aware of the clients place in their process and what they are able to handle or not handle in the moment is helpful so you don’t overwhelm them or damage the progress by thinking they are further ahead Tim the process then they actually are. I liked that you mentioned the difference in homework, whether you are assigning to much or too little for the particular client especially if they are in extreme distress.
      I totally agree with checking in on Mark’s sleep schedule he mentioned feeling rushed in the mornings and I think it would be good to follow up on his sleep habits and his ability to give him more time in the morning to eat. Also doing more social activities is a great follow up as well.

      Reply

  4. Tressa Novack
    Feb 15, 2022 @ 21:14:46

    Psychoeducation of therapy expectations and the cognitive model will have to differ for each client based on their diagnosis and their familiarity with the therapy process and CBT. Clients will have differing levels of motivation and understanding to engage in the therapy process based on their diagnosis. Some clients may come into therapy having learned some about CBT depending on previous therapy experience and schooling. These clients may enjoy hearing the technical terms of CBT and learning about the research that backs up CBT and the therapy process. Other clients may come in not knowing anything about CBT and may appreciate the use of simpler terms and more explanation of CBT and therapy expectations as they learn. Adolescent clients or clients of a college age may react negatively to the term homework, while this may not bother those of an older age who are better able to see the activities as work that will benefit them outside of therapy, showing how client factors can affect how they respond to therapy and CBT terms. Age, diagnosis, presenting symptoms, and other factors all affect the way in which a therapist psychoeducates their client. Some ways to normalize specific disorders without alienating the client or coming off as lacking empathy is to remind the client that the emotions that they are experiencing are normal emotions that everyone has, but they may be amplified in the client’s case. It is important to let the client know that it is not their fault that their emotions are amplified or more distressing.
    The patterns of behavior that I think warrant follow-up are Mark’s pattern of not completing chores such as washing clothes and dishes and withdrawing from others. These are important to follow-up on because they reinforce Mark’s negative patterns of thinking. Negative patterns of thinking can decrease Mark’s self-efficacy, motivation to get things done, and keep him stuck in the cycle of feeling negatively. Monitoring this client’s accomplishment and pleasure can be helpful for the client because it can allow him to see what he is getting done and in what areas of his life he is getting enjoyment and where he is not getting enjoyment. Looking at pleasure and accomplishment can allow the client to see during which activities he is not feeling well and what is he is thinking during those activities that may lead to low levels of pleasure and accomplishment. The monitoring can also be helpful in allowing Mark to see where he is and is not being productive, and where he can make changes to hopefully be more productive.

    Reply

    • Madelyn Haas
      Feb 16, 2022 @ 19:44:51

      Hi Tressa,
      I enjoyed reading your post. I think you pointed out a lot of good individual differences to consider when deciding how to tell a client about the cognitive model and CBT in general. Age, diagnosis, and symptoms are all important when discussing therapy expectations. Education and emotional intelligence are also important to consider as well. It is extremely important to also use personalized examples when explaining the ideas to clients. That way, it seems more individualized and easier to understand. I also think your explanation of normalizing but not downplaying their emotions is good to. Everyone does experience these negative emotions, so we shouldn’t make them feel bad for feeling them.

      I also think that you pointed out two important patterns of behaviors to discuss with Mark the following week. It is important to make sure he gets his chores done so that he can feel more accomplished and get himself in a cleaner living space. I also think it is important for us to discuss pleasurable activities, like his time outside with his girlfriend. If we get an idea about the level of pleasure he gets from these activities, we can help him schedule them. These activities can be incredibly rewarding and can help him improve his mood and, hopefully, ultimately stop being depressed. Great post!

      Reply

    • Pilar Betts
      Feb 17, 2022 @ 19:14:51

      Hello Tressa,
      I like that you mentioned possible age differences, and discussed how that could affect the amount of homework assigned. I agree that Mark’s negative patterns of thinking should be followed up on as well as his keeping up with chores because the continuation of him completing these tasks will be a good sign of progress in his therapeutic process. I also agree that following up on these tasks will allow Mark to see how productive he can be to help him see where he is for himself. The feeling of accomplishing his goals may lead him to want to do it more often.

      Reply

  5. Lauren Pereira
    Feb 16, 2022 @ 17:42:33

    Even though clients may have similar forms of mental distress, it is still true that every individual has a different process and approach to situations. This relates to therapy expectations and the cognitive model, as every client has different types of distress. In order to be a successful therapist, it is important to fit all of your clients needs. It would be most helpful to express examples to your clients to have them best understand what you are describing. An example that Dr. V used was how he explained to the client how anxiety can be useful by protecting individuals, but having too much of it is not great. In doing this, he was able to start off with a positive example explaining anxiety and then lead into it. This benefits the way the client feels towards the situation. The client will be more at ease with their struggles if their thoughts, emotions, and behaviors are portrayed in a more positive outlook. Not only this, but it is important to explain information in a way that clients will best understand. Not only are examples a good tool, but it is also beneficial to try and use terms that you know your client will understand. In this way, you can still include important key information that will help them understand and remember the material better.
    In order to normalize each clients’ experience, it is important to provide them with psychoeducation for their specific disorder in a more positive manner. In doing so, the therapist should consider explaining the main factors of the disorder and provide symptoms that go along with it. Giving examples to your client to express that these disorders are not all negative aspects of them can show a lot of importance in a client because it will help create a more valid way of thinking. Clients will not necessarily being looking down on themselves and they will not think of their disorder as a weakness, but more as an obstacle that they can overcome.

    I find Mark’s withdrawal and avoidant behaviors to be a core pattern of behavior that should be followed up on. It may be beneficial to follow through with his actions and the activities he does throughout the week, while monitoring the types of emotions he is feeling in that period of time. This will help Mark be able to process what situations were more difficult than others and what they can try to focus on in sessions. Finding helpful strategies to use during those times of difficulties will help Mark accomplish his goals which will give him more confidence in this process. A goal is to stray away from those negative ways of thinking so he will become more motivated in all that he does. This is helpful throughout treatment because it will allow for Mark to be more productive with his time. He will also start to believe in himself more which will help him gain more confidence and self-efficacy.

    Reply

    • Madelyn Haas
      Feb 16, 2022 @ 19:22:03

      Hi Lauren,
      Great post! Everyone does process and understand things differently, so it is incredibly important to give specific, personalized examples for each client. In Dr. V’s video he related his explanation of CBT to Mark’s problem with his friend, so it helped Mark get a clearer understanding of the model. I think your example about focusing on the positive aspect of things is great too! People often view anxiety as 100% bad and maladaptive, but it really does serve a purpose, despite how uncomfortable of a feeling it is. Without anxiety, we likely wouldn’t get all our class work done, haha.

      I also think looking into his withdrawal and avoidant behaviors is great idea. On the flipside, it is also equally important to see the positive activities he does, like spending time with his girlfriend. If we can see how he likes and responds to activities, we can help him schedule activities that bring him joy and/or accomplishment.

      Reply

  6. Madelyn Haas
    Feb 16, 2022 @ 19:14:03

    Psychoeducation is an important part of CBT. Sometimes, even just learning about one’s diagnosis and negative automatic thoughts can significantly relieve their distress. It is important to explain the cognitive model, and all CBT concepts, in a way that each client can understand. You should adjust the explanation to the emotional intelligence and education level of each of your clients. One client may love to hear all the names and backgrounds of CBT concepts whereas another will tune you out and may not come back for another session if you speak too technically. It is also important to explain the model and expectations in relation to a client’s problem. In Dr. V’s video, he explained the cognitive model in relation to Mark’s situation with his friend. Personalizing the explanations makes the more engaging and easier to follow for the client. As mentioned earlier, teaching a client about their diagnosis is extremely important and can even relieve distress when they realize that their behaviors can be explained by a disorder. With that being said, it is important to find a balance between normalizing the disorder and coming off as uncaring or too mechanical. For that reason, you should educate the client on their disorder and give examples that relate to them in particular. Instead of saying “depressed people have difficulty sleeping.” You can say “Your difficulty sleeping can likely be explained by your depression.” It is important to not equate their disorder to who they are as a person. If you equate all their behaviors to their disorder, they may internalize that into their self-concept. You should specify that you have treated patients with their disorder in the past but that you also understand that they are an individual and that your treatment for them will reflect that. CBT is highly adaptive, so make sure to tell your client that you will individualize their treatment plan not for the disorder but for them. This should give them more confidence in your abilities while also make them feel understood.

    Based on what I know about this client, I would want to hear more about the time he spent with his girlfriend outside and time he spent at his job in the next session. Because he is depressed, it is very important for him to have rewarding activities in his life. Assuming he enjoys spending time with his girlfriend, this could be incredibly rewarding for him and could “energize” him. It would be important to see how he rates this time with his girlfriend. If he rates it highly, the following week I could help him schedule time to spend with his girlfriend out of the house each day. Although it is important for depressed clients to incorporate pleasurable activities into their schedule, it is also important for them to get their jobs and chores done. For this reason, I would also look at how he was feeling at his job. While his pleasure scores will likely be low, I would like to review his accomplishment scores for his work. If he is not feeling accomplished, it would be worth looking into and discussing in the next session. It would be incredibly important for this client to monitor his level of pleasure and accomplishment that he gets from each activity. He is depressed, so he has less energy and motivation to do things, even things that would likely bring him joy. Not only that, he avoids activities that could make him feel happy or accomplished. When he monitors his activities, we could see what is working for him (e.g., brings him pleasure and/or accomplishment) and schedule more of those activities in the future.

    Reply

    • Lauren Pereira
      Feb 17, 2022 @ 11:24:25

      Madelyn,

      You make some great points on why psychoeducation is an important part of CBT! It is important to explain models and symptoms throughout the clients level of education and how they may best understand this information. This will allow them to be more open and comfortable in sessions. I like that you brought up where Dr. V had explained the cognitive model in relation to Marks situation with his friend.

      It is a good idea to bring up the positive activities seen when spending time with his girlfriend. Finding more activities that he enjoys can help us come up with more positive things for him to do throughout the week. Helping him see the good in situations will help him stay more positive and it will keep his mood up. This can help a significant amount within depressive clients and having the guidance from a therapist will be more helpful to get yourself to follow through with the activities. Great post!

      Lauren

      Reply

  7. jeremy
    Feb 17, 2022 @ 13:31:20

    Psychoeducation is a daunting part of the job of a CBT clinical mental health counselor. Attempting to take advanced psychological models and apply it to a particular individual’s case is already a challenge, communicating how their unique situation is affected by their thoughts, behaviors, and environment can also be a difficult task. When attempting to psychoeducation a client it is important to remember that each client may have a different level of understanding in psychology, some may know nothing and need very simplified terms, others may be mental health professionals themselves. Tailoring the language you use can be greatly beneficial, You may not want to throw around words like behavioral activation and collaborative empiricism with an 8-year-old client. Additionally, if someone is struggling to understand the concept, It is beneficial to cut out large swaths of the theory that may not be relevant to the client, parceling out psychoeducation is a good way to promote mastery of the material by providing it a little at a time. It is always beneficial to include examples from the client’s life, allowing them to connect an abstract theory to their lived experience and better apply it,
    When considering discussing the client’s specific disorders, it can be validated to explain common symptoms, thought patterns, or experiences in order to help the client understand that they are not alone. Normalization can include the validation of emotions and valid thoughts. Empathizing with the difficulty and pain they experience. IT may also be helpful to remind clients that the development o the disorder may have been used to protect them from a hostile environment.
    Based on my limited knowledge, it seems that Mark struggled with household tasks (Sepfifclay an hour of dishes) and withdrawing. One is a pattern of behavior that he allows a build-up in the Sink, likely distressing him each time that he tries to cook. Another issue that he identified was withdrawal, this has been a significant issue for Mark over his videos, so seeing what progress he made will be beneficial, even if the progress was no progress. Another thing I would be interested in seeing is what things he rated as highly satisfying, seeing where he finds joy may help find new ways to engage him in areas that he especially enjoys.

    Reply

    • Lexi
      Feb 19, 2022 @ 13:26:23

      Hey Jeremy!
      I like what you had to say about normalizing the diagnosis for clients, I think reducing the stigma and making it clear to the client that what they are experiencing is common is so important to treatment. Clients should know that other individuals have overcome the same struggles. I also think that providing the client with reassurances about the success that CBT has specifically can be helpful in giving clients the sense that yes this thing I am feeling has a name, it is not just me, and yes there is a process that can help me change it with proven results. Kind of weaving these two concepts together you can see how important and powerful psychoeducation can be in the context of cognitive behavioral therapy.

      Reply

    • Monika
      Feb 19, 2022 @ 20:02:08

      Hi Jeremy,
      I agree with you that every client comes to therapy with different levels of understanding and so it’s important to consider this and accordingly decide what points to explain to clients in detail and which ones to cover briefly. I see how this can be a challenge, especially with younger clients or clients who come to therapy for the first time with no knowledge or background of any kind of therapy. I like how you mentioned giving examples to clients so they can better understand the more difficult terms like behavioral activation or self-efficacy etc. Validating clients’ emotions and thoughts can also help them feel more comfortable and can help establish a good rapport. Good job!

      Reply

  8. Lexi
    Feb 17, 2022 @ 14:28:01

    Setting expectations is hugely important to the flow and success of therapy in my opinion. Expectations will vary from client to client, and the therapist must also form realistic expectations for each client in order to create success. Psychoeducation is a tool that I think therapists should have and use as needed to enrich the outcomes of therapy as well. Clients should have a solid understanding of the expectations for therapy as well as a basic understanding of the tenants of CBT / the cognitive model and how these things can work to help them create less distressing lives. I think it is important to use psychoeducation to communicate with clients how the CBT triangle works, what beliefs and evidence support the application of the model, and how the model looks in action specific to types of disorders and interventions.

    Clients should understand that they are active participants in this type of therapy and that they are going to need to work harder than the therapist at times to make real gains happen. Clients’ symptoms will be different and they may suffer from a variety of disorders but if they understand how CBT is supposed to work and they understand what the expectations are for them in therapy it leads to a greater sense of control for the client and better outcomes for therapy. I think pictures / models/ graphics or even examples can be helpful. Therapists should be careful to match their client’s academic abilities / level of understanding so that they aren’t talking down to them or confusing them. I also think self-disclosure can be helpful in getting a client to understand how CBT works if the therapist is able to share a story of monitoring and changing a thought pattern as an example. It is important not to alienate clients or make them feel as if they are being labeled by a diagnosis, I think this can be done with empathetic approaches and reassurances in the therapeutic relationship. I think providing an understanding of what the disorder is and how it can present differently is helpful, I also believe it’s important to share with clients the evidence of success in respect to CBT. For example the research shows if we do XYZ with a depressed client we have a wonderful chance of making positive changes (without making promises), I think the data at least for me would be instrumental in accepting psychoeducation relevant to a diagnosis.

    Mark seems very positive and highly engaged in his therapy which is great, you can tell from videos of sessions that he is proud of successful moments and taking control of his healing journey. Monitoring his social activities / level of interpersonal distress with the girlfriend and friends seems really important to me, and to him. Any avoidant or withdrawal behaviors that could be damaging to his sense of accomplishment should be looked at, along with dysfunctional thinking. This can include dysfunctional automatic thoughts and core beliefs, or certain common styles of thinking like minimizing and black and white thinking / catastrophizing. Factors pertaining to his professional life also and of course continuing to monitor his level of distress / depressive symptoms is also important more generally speaking. Mark seems to have some habits that are limiting to him such as social withdrawal / loss of interest. Instances of minimizing or catastrophizing should be monitored, I think… It is always helpful with depressed clients to get them to look at the positives and place emphasis on those moments – Dr. V says in one video that Mark seems to maximize / focus on the bad and trends to minimize the good so monitoring his accomplishments and high moments would definitely be helpful in starting to shift those ways of thinking and of course boost efficacy and confidence.

    Reply

    • Will Roche
      Feb 17, 2022 @ 20:38:00

      Hey Lexi,

      I think it was important that you noted that while the client should have expectations for therapy, that the therapist should have some expectations as well. However perhaps the therapist should base their expectations off of the expectations of the client. I’m not exactly sure how that should happen but it would be a good question to bring up (what expectations should a therapist have and does it vary client to client?). Like you said, it is important that clients get a solid understanding of psychoeducation because it will help put labels to the things they feel and behave, and they will have a better understanding of what to expect in the future (ex: a person have panic attacks will understand the flight or fight symptoms they feel and realize that they will not die as a result of these feelings). Great job!

      Reply

  9. Will Roche
    Feb 17, 2022 @ 15:22:09

    Psychoeducation is a very important aspect to CBT. The therapist needs to educate their clients on a variety of matters, but particularly the matters personal to each client. Seeing that each client is different, the psychoeducation should be appropriately adjusted to each individual. I think that adjusting psychoeducation to each client is important because of the feedback the therapist might get from this individual. Simplifying certain psychological terms like Dr. V did in the video with Mark might dispel some intimidation for large psychological terms and make it more real and personal (homework, guess instead of hypothesis, etc.) One who has automatic thought issues would benefit from getting a better understanding of the cognitive model, whereas a person with panic attacks would love to hear someone else know and describe exactly what they are going through. Hearing a therapist describe everything that the person is feeling and being able to justify why these things are happening to the client is very important. Therefore, it’s important to individualize psychoeducation to each client.
    In order to normalize psychoeducation. It is important to help personalize these terms and models so the client understands the education better. Dr. V using the cognitive model within Mark’s story of his friend George on the phone is a perfect way to clarify any issues Mark might have with translating the cognitive model to real life situations. Similarly, Dr. V was able to describe how panic attacks were feeling and how similar these feelings were to the woman in the video. By personalizing psychoeducation, it definitely will help the client see the psychoeducational terms and apply it in their life more accurately. In order to appear empathetic about a person’s mental illness issues it is important to include that their response is normal to the disorder and to assure them they are not the only ones who experience the same exact symptoms and that these symptoms can be improved upon.

    Based on the assessment and video vignette, there are a few things I would want to follow up with. The first being his feelings of withdrawal. I would want to monitor see if he’s been doing that more or less, and when these feelings of withdrawal occur. Secondly, I would like to assess how well he is doing when he’s with his girlfriend. Mark mentions that he would like to be more present with his girlfriend, so it would be important to see if he is backing those wishes up with actions. Lastly, I would like to monitor how Mark feels during his workday. Beyond work being a large portion of someone’s day, Mark emphasizes that his feelings can fluctuate especially at work. Therefore, this would definitely be an environment I would want to take a closer look at in the monitoring log.

    Reply

    • Emily Barefield
      Feb 19, 2022 @ 14:26:30

      Hi Will,

      I like how you emphasized personalizing the description of the cognitive model to the client. This not only makes it easier for them to understand, but also shows that you understand and care about their situation. I agree that hearing when a person is able to hear what they are going through described, it can be a very validating experience. It can demonstrate that they are not alone in the problems they are facing. It is also important and validating to discuss the aspects of the clients situation that make it unique.

      Withdrawal is a very common symptom of depression and is one that Mark has explicitly expressed concerns about. Because his relationship with his girlfriend is so important to him, it is important to pay attention to it. However, he is not currently experiencing issues with his girlfriend and does not have trouble experiencing pleasure when he is with her, so this might not be at the top of my list. I do think that monitoring his work day is very important. His feelings can fluctuate significantly during the workday. It does seem that his mood is very tied to how productive and successful he is at work and that this carries over into other areas of his life. Great post!

      Reply

    • Sandra Karic
      Feb 20, 2022 @ 13:21:58

      Hi Will,
      I agree that therapists should particularly emphasize matters that are relevant to their client in psychoeducation. I agree that individualizing psychoeducation is very important and like that you talked about receiving feedback from clients. I also really liked the example of Mark’s phone call with his friend being used to explain the model, it was relevant, made sense, but was not threatening. I think monitoring his relationship with his girlfriend and his feelings at work is a great thought. You’re right that work is a large portion of his day and seeing how/why his moods fluctuate in that environment could be very useful in understanding his behaviors in other environments as well. Good job!

      Reply

  10. Sergio Rodriguez Pineda
    Feb 17, 2022 @ 15:47:50

    Psychoeducation
    (1)
    It is important for the therapist to be clear about the expectations for the session with the purpose of generating a confortable environment. During the psychoeducation process, the therapist must adapt to the patient’s needs using visual, written, or kinesthetic resources, which facilitate understanding the elements that constitute therapy. For example, the client must participate in the formulation of the clinical case. The therapist should explain it to the patient so that patients can collaborate and give their opinion. Work with the patient and give them the opportunity to give feedback to the patient. Clarify each phase of therapy, sometimes the patient may feel anxious, like anyone else the day of his first therapeutic session, however it is possible that the patient has anxiety problems and the therapist at the beginning of the session can provide a clear structure that facilitates the way in which the sessions will develop so that the patient from the first moment can know what he is facing. Likewise, many times the patient may arrive at the therapy also consists of the therapist confronting the patient, clarifying that this is part of the process and that this can generate increased stress or symptoms that generate difficulty. This is especially helpful for patients who feel a lot of discomfort when confronted or who may feel insecure or attacked by the therapist’s appraisals. Explain that there may be a great deal of support at the beginning of therapy but that at some point the patient is expected to be able to be autonomous and learn skills that will enable him/her to respond to the difficulties he/she is facing, without the need to turn to the therapist. I believe that an essential element in therapy is not to take anything for granted. The patient must be able to provide feedback and clearly paraphrase what the therapist explains and intends.

    (2)
    Regarding the presentation of specific disorders, there are several ways to approach the patient in order to validate his or her experiences without coming across as unempathetic. The first, and most essential, is to get to know the patient. This will make the patient feel more comfortable and better able to understand the implications of the explanation of the symptoms he/she may be presenting with a disorder. The second element consists of presenting the general conditions of the disorder, its symptoms and characteristics, but at the same time being able to point out cases from the patient’s life in which he/she can see how personal situations fall within the diagnostic category for which psychoeducation is being carried out. Third but not least, to be able to ask the client his doubts about it. It is common that many clients do not ask questions out of fear, but the therapist can generate that atmosphere of trust to clarify all doubts and present hypothetical cases in which the patient may have doubts but does not know how to ask. Another strategy is to identify the disorder or problem. Give it a name, identify its sensations in the body, the reasons why it occurs, its functionalities, its positive side and why not give it a name in order to feel it as something more normalized, without it being something foreign or difficult for the person.

    Behavioral Activation:
    (1)
    I think one of the most important elements that I would follow up on is the morning routine and follow up a little more closely on what are the elements that make it difficult for him to finish his routines on time and start the day in a way that allows him time to accomplish the rest of his routine for the rest of the day.

    (2)
    I would also emphasize the difference between pleasure vs accomplishment which implies that many activities that are planned for the day may have a low level of pleasure but a high degree of accomplishment. On many occasions this is the main difficulty for patients with depression to stop doing the tasks of their daily life. In this order of ideas, help the patient to internalize the idea that many tasks that are planned, even if they are not pleasurable, can be of great accomplishment by the fact of accomplishing something that was planned. Also identify the context of many behaviors that were not completed even though there was pleasure involved.

    Reply

    • Will Roche
      Feb 17, 2022 @ 19:47:31

      Hey Sergio,

      I like how you noted how important that expectations are for each client. Each client is going to have different expectations of therapy so it is important to get a strong understanding of what that is within the first few sessions. I also like how you said it is important for the client to participate in the psychoeducation process of the therapist and make sure they would be able to apply these concepts in their daily life. Simply being able to put a name to the feeling or emotion the client is experiencing is very important in the psychoeducation stage of therapy. Lastly, it was great to note that a therapist must explain to the client that the end of therapy should mean that the client does no longer need the therapist, which should ultimately be the goal. The collaborative effort to reach this goal is of utmost importance. Great job.

      Reply

    • Lexi
      Feb 19, 2022 @ 13:46:43

      Hello Sergio
      I agree that setting expectations is an important piece of creating a comfortable environment in therapy, most people prefer predictability or routine and so I think having expectations about session structure, about course of treatment and about outcomes is really key. Client participation is also so much more possible when the understanding of the process is there, and when they have realistic expectations. Using empathy when giving a diagnosis in combination with psychoeducation too I think promotes better collaboration and outcomes. Lastly, I like what you had to say about discussing and making the distinction between pleasure and accomplishment for Mark, and clients in general. The monitoring activities we have done thus far in class have been so helpful in understanding the effects of engaging in activities in both categories.

      Reply

  11. Pilar Betts
    Feb 17, 2022 @ 18:38:04

    Adjusting how you utilize psychoeducation is important because not every client is the same, everyone has their own way of learning and understanding concepts and the way they liked to be addressed or talked to is super important. If you are working with a client who is in a medical or science field they may want you to use that kind of language when psychoeducating, and other people may in those same fields may want you to not use that language because they don’t want to think about their work or careers in session. Psychoeducation is helpful for the client because having a better understanding of what they are going through could bring them a sense of relief or comfort even when talking about the concept of automatic thoughts it can be helpful to reassure the client that what they are feeling especially if they have a psychological disorder that this is a common way of thinking or feeling. As mentioned in the Beck chapter when trying to elicit an automatic thought, not every client may respond to the question “what was going through your mind?” so you may have to reform the questions or engage in other ways to get the client to elicit their automatic thoughts. People are way more aware of the emotions that are experiencing because of the thought than the thought. The thoughts that cause these emotions will be different depending on the client. I really liked the examples and descriptions of the types of automatic thoughts that were provided in the text because they will be helpful when I have to use psychoeducation regarding automatic thoughts in the future. When using psychoeducation, rather than using manufactured examples it is better to use examples personalized to the client for example in the video with Dr. V and Mark, Dr. V brought up the scenario Mark had with his friend to demonstrate how his automatic thoughts were affecting his thoughts and behaviors and to see patterns of these thoughts in future situations. I think it also was really helpful to provide a visual of how thoughts, behaviors, and emotions have a reciprocal relationship and Dr. V does this with the whiteboard by making a diagram. It may even be helpful for the client to create a diagram like this to help them to start to identify their own automatic thoughts and the effect on their emotions and behaviors. Lastly, when psychoeducating It is important to also make sure you aren’t making the client feel like the disorder or issue is who they are by normalizing what they are feeling or thinking and also validating the emotions they are feeling. When using psychoeducation with clients who are experiencing specific disorders some ways to normalize their experience in a way that is empathetic is to let them know some of the common symptoms, so they aren’t feeling alone in what they are going through. Also if they explain a scenario and how it made them feel, showing your understanding of that emotion can be comforting, you could say “I can understand why that would upset you I would be upset too” Showing understanding can help to normalize the experience but it shouldn’t be used if you don’t actually understand why they may have been feeling that way.

    Based on what I know about Mark as a client, after the review of his weekly activity log I would want to follow up on his behaviors of withdrawal as well as his feelings of being rushed in the morning and how he’s better managing his mornings and feeling and since he mentioned wanting o spend more time with his girlfriend and dog in the follow up I would want to know if he was able to fit in more activities that were pleasurable. Monitoring the client’s accomplishments and pleasure is helpful for his treatment because its important to note even the smaller tasks that brought pleasure, for example, Mark is depressed so focusing on the positives will help him to look more at those positives and actively seek more activities that bring him happiness and pleasure. For clients focusing on accomplishment is important because you want to pay attention to their progress and validate them for it.

    Reply

    • Monika
      Feb 19, 2022 @ 20:12:55

      Hi Pilar,
      I really liked your post this week! A client who is going through a serious mental illness is more likely to feel very strongly about the negative patterns of thinking they might have, and so it becomes even more so important to educate them about their symptoms, thoughts, and emotion so they decide to follow through therapy and be comfortable and optimistic about their treatment plan. I agree with you that self-disclosure can be a good idea than sharing some random examples to explain symptomatology but I also feel we need to be a little cautious while doing so. Providing visuals is a great idea, I didn’t think of this before so thank you, I am definitely going to use more images, especially with younger clients to better explain technical terms.

      Reply

  12. Monika
    Feb 17, 2022 @ 19:09:13

    Psychoeducation at the start of therapy is a more formal procedure in which basic expectations for therapy, as well as information about the clients’ diagnoses and issues, are addressed. Every client is unique and they come to therapy with different expectations, levels of motivation, and commitment. Providing psychoeducation for the cognitive model will change depending on the diagnosis a client has. So even though basic information about the cognitive model stays the same how it’s applicable to the client will change depending on their diagnosis and associated problems interfering with their daily functioning. For example, psychoeducation based on the CBT model will vary for a client who is diagnosed with depression and another client who is diagnosed with substance use disorder. Both these clients will need specific skills to manage their distress in the present and the future.
    A client with depression will need brief information provided about their illness and its management. They will also need to be provided with the symptoms, causes, treatment options, need for adherence, and overall course of outcome of the disorder. While a client with substance use disorder will need to be provided with different phases of treatment from detoxification to relapse prevention, the role of various triggering factors and avoiding them, finding alternate sources of pleasure, etc. Firstly, by drawing on the cognitive model we can make the experience of distress understandable. For example, we can say to a client with compulsive washing with something like, “so you believed you had poison on your hands and that you would be responsible for killing your children, well no wonder you felt anxious and wanted to wash your hands”. We can also help clients see that they are not alone in experiencing certain feelings or thoughts, and this can enhance feelings of self-esteem, improve coping and reduce stigma. Sometimes personal disclosure can also be helpful in normalizing the client’s experiences, for example, the therapist can describe how they had a phobia of public speaking and how they overcame this.

    While reviewing Mark’s weekly activity monitoring blog, I think it will be a good idea to review his routine activities like walking the dog, him having dinner, and spending time with his girlfriend and given that he is depressed I would also review his sleeping patterns just to get an idea how his sleeping schedule looks like. Also, I would review his daily chores, like doing the dishes, which he was saying isn’t pleasurable for him and his social engagement with his friends and family. Doing this activity where he realizes his accomplishments and actively thinks about them can really motivate him for the next day or week. This motivation in turn can really help him get focused at work or spend more time with his friends and help him minimize his negative automatic thoughts. Plus this activity can help him realize what activities he finds pleasurable and do those more often. Even doing more of little things which give him pleasure can be a big step in helping him deal with his depression.

    Reply

    • Jeremy
      Feb 19, 2022 @ 21:00:47

      Hi Monika,
      I really liked your discussion post. AN liked how you noted that the skills associated with each diagnosis vary wildly, to the experiences the skills we are teaching one client may directly conflict with the skills we are teaching another. Psychoeducation is a very important early-stage therapy skill helping you develop a shared language in order to make more therapeutic change.

      I liked your discussion of Mark’s follow-up, seeing what he has accomplished is very important, It is also important to remember what Mark doesn’t do, see what he avoids, to put more focus on those sections next week.

      Reply

    • Sandra Karic
      Feb 20, 2022 @ 13:14:59

      Hi Monika,
      I like that you highlighted how psychoeducation looks different for different disorders and the importance of using specific examples. I also really liked your examples, especially the one about validating a client’s anxiety. You did a great job illustrating validating a client’s emotion but not the thought. I agree that tracking accomplishment and pleasure can be motivating and that even seemingly little things can help combat depression. Great post!

      Reply

  13. Moises Chauca
    Feb 18, 2022 @ 01:08:18

    In therapy, every client has different experiences, thought, emotions, and behaviors. When working with clients, the therapist needs to meet them by adjusting the sessions to the client fit of their problems. For psycho education and the cognitive model, the therapist can adjust the explanation of the model by using the client experience when explaining the model, so the client can comprehend the model better. Finally, the therapist can adjust the language and terms that they normally use, so it fits more to the client, and they can understand better.
    Furthermore, for the psychoeducational of specific disorders, the way to normalize the client experience is to validate their emotions and to help the client understand that some of their experiences are normal and okay. Validation goes a long way as the client feels less lonely and misunderstood. Also, the client understanding that they have normal experiences at times can help them get more motivated and comfortable
    From the videos, Mark seems to struggle with avoidance and withdrawal. Patterns of behaviors that need to be tracked are social interactions and times that he goes out with friends. Finally, monitoring Mark accomplishments and pleasure is crucial because these say praises influence mark self-efficacy and motivation.

    Reply

    • Emily Barefield
      Feb 19, 2022 @ 14:35:44

      Hi Moises,

      I agree, using client examples is one of the best ways to provide personalization and increase client understanding of the cognitive model. Adjusting the language to the client is also important to ensure they understand what you are communicating to them. I like how you emphasized the importance of validation. Feeling validated can go a long way in helping build the therapeutic relationship.

      I like your suggestions for monitoring Mark’s avoidance and withdrawal. Increasing social interactions for Mark will likely improve his overall mood. Good post!

      Reply

  14. Sandra Karic
    Feb 20, 2022 @ 13:10:04

    I think therapists should modify their language and energy level with the needs of different clients. For instance, certain clients may really like the use of scientific terminology and references to evidence based practice. However, other clients may find this language intimidating, overwhelming, or even just annoying. I think explaining the cognitive model with examples from a client’s life is generally good, but should be done in a gentle manner initially. Many of the behaviors depressed individuals exhibit can maintain or worsen their depression, but you definitely don’t want to make it sound like the depression is their fault. So while it is important to use language that is appropriate to each client and examples that are relevant, it is equally important that this is done respectfully. I think it is also important to pay attention to how the client appears to be receiving this information and to ask for feedback e.g. “Does that make sense?” If a client seems overwhelmed, one should slow down and prompt the client for feedback. Alternatively, if a client appears bored or uninterested, this may be a sign that the therapist needs to relate this information to the client’s own life. Energy level is also important, in that you don’t want to be so high energy that you scare or overwhelm a client, but you also don’t want to bore clients with a really low energy approach.
    As far as normalizing, I think focusing on the meaning that clients attribute to symptoms and disorders may be a good approach. Some clients may assume that their symptoms mean they are crazy, a bad person, or will ruin their chances at forming healthy relationships. I think it could be helpful to investigate what, if any, inaccurate meanings the client has attached to their symptoms/disorder rather than assume a meaning and try to normalize in response to that assumption. I think that normalizing requires a careful balance of validating a client’s distress and assuring them that they are not alone and that there is hope. However, this optimism of course needs to be balanced with realism.
    I think the two biggest things that stuck out to me with Mark were his withdrawal behaviors and his lack of personal time, especially in the mornings. While it is great that he has a strong relationship with his girlfriend, one person is not able to fill the entirety of someone’s interpersonal needs. I think increasing his social activity would be a slow process, but have some really strong benefits in terms of improving his mood and self-esteem. More positive experiences with people may also help combat some of his worries about his friends not liking him/not wanting to be friends. I also think that improving Mark’s morning routine could have some positive effects on the rest of his day. If he can start his day with the satisfaction of making and eating a breakfast, without stressing about time, it’s possible that this could boost his mood and lead to greater self-efficacy with other tasks throughout the day. At bare minimum, a good breakfast can at least help his energy level. I’d be curious to see what the results of monitoring his sense of pleasure and accomplishment are. I imagine that he would get more pleasure and accomplishment out of some tasks than he might think he does or even remember getting if he didn’t assess these things till the end of the week. Additionally, monitoring his accomplishment and pleasure can serve as a guide when trying to gauge which activities it may be beneficial to increase or decrease.

    Reply

    • Moises Chauca
      Feb 20, 2022 @ 19:05:30

      Hello Sandra,
      Your post was awesome! I enjoyed it! You provide some good and helpful points. Your description and explanation of the CBT model to the client were helpful. Your point about using the client’s life examples to explain the CBT model is really important because it helps the client understand the model better and the importance of feedback is crucial as the therapist wants to know if the client understood or needs help. Second, I agree with your point about the balance between the client’s distress and validating because you do not want to minimize their emotions too. Third, I agree with the steps you set for Mark, it is significant to increase his social circle and improve his morning routine. Lastly, These behaviors will increase his positive experiences and accomplishments.

      Reply

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Adam M. Volungis, PhD, LMHC

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