Cognitive Therapy Psyc 5834 -- Essay Final Exam

An “A” essay:

Answers the specific central question that was asked Incorporates pertinent and detailed information from class discussion, homeworks, and

assigned readings (whenever applicable), providing needed evidence. Maintains focus/avoids being sidetracked by tangents Presents all information clearly and concisely and in an organized manner Does much more than merely restate the question and offer a brief response Very few distracting grammar/spelling/etc. problems

Writing Guidelines for Essay ExamsContent:

This is where you should demonstrate the degree/extent to which you understood the material. This is accomplished by demonstrating that you have identified the main points of the reading by using examples and incorporating the themes into the broader context of the material addressed in the class. It is not enough to merely summarize the material.

Organization Topic sentences (e.g. Every paragraph needs a topic sentence.

The topic sentence is usually the first sentence of the paragraph and gives the reader an idea of what the paragraph is going to be about, e.g. “My perspective was not changed by this article given that…”)

Paragraph structure (e.g. After a topic sentence provide several sentences to support the topic sentence. Last, provide a conclusion sentence, which ties the body sentences to the topic sentence).

Integration of information (e.g. how well you use information to support your topic/thesis sentence in responding to a question)

Style/Tone Sentence variety (don’t start every sentence the same way.. “I

thought…” “I thought…” “I thought…”… You get the idea…) Appropriate word choice (precise language, e.g. Major

depressive disorder, depression vs. “crazy,” “down in the dumps”)

Conciseness, lack of redundancy Clarity of expression (don’t use unnecessarily complicated or

confusing sentence structure, e.g. “the paper which I was to write was to be due on Thursday” vs. “I am writing a paper that is due on Thursday.”)

Absence of clichés and colloquial expressions (e.g. “when it rains it pours”)

Appropriate use of quotations and paraphrases (e.g. don’t misquote or misrepresent what the author was saying. All direct quotes go in quotations. Remember not to plagiarize!)

Mechanics Punctuation Grammar (Note: You can use the first person “I”)

a) Subject-verb agreement (e.g. “Some of the author’s conclusions were misleading” or “Genuine feeling is missing from the author’s narrative”

b) Correct use of pronouns (e.g. agreement with antecedent, no ambiguity. For example, in the sentences: “Depression is considered a mental disorder by the DSM-IV. It has a high incidence rate in the U.S.” In the first sentence, Depression is the antecedent and “it” is the pronoun in the 2nd sentence that refers back to it) If you have questions about what pronoun-antecedent agreement see e.g. http://leo.stcloudstate.edu/grammar/pronante.html

Sentence structure (e.g. use complete sentences) Correct spelling

1. Components of CBT are similar across treatments developed for different issues, conditions, and disorders, including faith-based applications, anger problems, suicide/risk prevention, stuttering, couples problems, MDD, bipolar disorder, panic, GAD, social anxiety, OCD, PTSD, schizophrenia, eating disorders, borderline personality disorder, and alcohol and drug use problems.

**Integrative of both halves of semesters

Provide an overview of the general approaches taken in CBT across these approaches, and then provide a rationale for adaptations made to CBT in 2 of the approaches.

Address whether or not these adaptations have any empirical support as well as aspects of the approach that may not be well-supported or is in need of research.

Be sure to support your answer with relevant data and information (including readings from the Barlow book and outside readings selected by classmates). You may use material not used in class to illustrate points made in your answer.

2. Imagine you have a client with the following DSM-IV-TR diagnoses:

I: Major Depressive Disorder, Recurrent, Moderate without Psychotic FeaturesRule out: Bipolar I Disorder

II: Borderline Personality Disorder (provisional)III. Diabetes mellitus, Type IIV. Few social supportsV. 60

**Overlap with various symptoms**Consider CBT approaches but you can recommend meds

Discuss particular challenges you might have in applying CBT with this client. -Lack of information known; GAF score high for my interpretation of diagnoses.

How would you decide what to focus on first (what seems the most pressing)? -Borderline Personality Disorder, since it is provisional

What information do you need to know? -Length of times with Axis I and II

Who would you consult with?

Describe a sequence of therapy stages and CBT approaches you could use with this client.

Consider in your answer that there will likely be some symptom overlap between MDD, Bipolar I Disorder, Borderline, and Diabetes which could complicate the treatment. -Look at DSM.

Also consider: how might your therapy approach change if this client were 13 years old vs. if they were 30?

3. Chris is a 28 year old Asian American female who is uncertain about her sexual orientation. She comes to therapy with mood and anxiety symptoms subsequent to a motor vehicle accident which left her with a prosthetic limb. The accident occurred approximately 10 years ago while her (then) boyfriend was driving. She had screamed out when she saw that they were going to hit a car that was crossing over the median on a high-trafficked road, but he had not heard her and they crashed. She does not recall struggling with symptoms of anxiety or depression prior to this time. She hasn’t sought help for the symptoms over the years, because she has been functioning “fine.” She graduated from high school after the accident and took a year off to complete rehabilitation and learn how to use her prosthetic limb. She was an A student in high school and was predicted to be “most successful” by her senior year class. When she discusses high school she describes it as “another life,” and that she has not been as successful in life as she had dreamed. She has worked various clerical jobs as a secretary employed by temporary agencies over the past 10 years. She describes the work as “boring” but “it pays the bills.” She has only dated a few times since the accident, citing her prosthetic limb as a major problem in feeling attractive to potential dating partners. She described one incident when she was 26 in which a good same-sex friend was attracted to her. Chris indicated that this experience was confusing as she had conflicting feelings and thoughts about the situation.

When asked about more specifics regarding mood and anxiety, Chris said one of her biggest problems is that she has trouble sleeping. She also occasionally (about

1-2 times a month) wakes up in the middle of the night in a cold sweat, having just dreamt about her accident, screaming to try and prevent it from happening. She describes chronic feelings of worthlessness, sadness, and feeling unattractive. She indicates that she was extremely good at math in school, but has not taken the time to pursue a degree which would use this talent, “I am not as smart as I used to be.” “I probably wouldn’t be successful anyway,” and “Too much time has gone by.”**Significant: mood and anxiety issues**Give Axis 1, 2, 3 if you want, give all 5**With this information, when assuming things, give a GAF and support it**Think of critical issues

What are your initial diagnostic impressions? -Look at DSM

Describe what missing information you would like to gather to help clarify your diagnostic impressions.

What cultural factors would you consider? -The implications of Asian influence; the social factor and portrayal of herself from others.

Describe an initial case conceptualization and an overall treatment plan for Chris, using an integrative CBT approach (that is, you need not limit yourself to one adaptation of CBT, you should consider which adaptations could work best for this client and why).

In providing an overall treatment plan, describe some of the specific CBT strategies that you would like to try with this client.