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Cognitive Behavioral Therapy

Nursing practice today has expanded to more prominent healthcare service fronts than

ever before. The nursing practice now offers their services in physiological, psychological and

acute healthcare services with state of the art technology and advanced healthcare phenomenon.

In this sense, cognitive behavioral therapy has become one of the most critical psychological

treatments that are being provided to patients around the world. Significance of this treatment is

understood as many people are suffering from cognitive difficulties and antipsychotic

medications are highly addictive, so the importance of Cognitive Behavioral Therapy simply

cannot be ignored as it is beneficial in patients who suffer from anxiety, depression, and post-

traumatic stress disorders and also for the patients who suffer from dyslexia. We can say that

Cognitive Behavioral Therapy can be given to people who need support while dealing with

negative feelings and or emotional reactions (Chapman, and Dehle).

Sometimes, we have experiences that make us learn harmful or painful emotional

reactions. For example, if a person suffers a traffic accident and although he or she is not injured

but is very scared, the next time they get into a car, they can feel very anxious, with great fear.

Such people have developed a phobia to drive or learned to be afraid to drive. Other times the

learning process is slower. For example, if a person is educated at home and school, their
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psychological aspects will be different. The importance of failing from others or teaching them

that they are a priority or that what they think about themselves is crucial, that person may

develop pathological shyness or social phobia which is anxiety when imagining that does not

meet expectations. In short, Cognitive-Behavioral therapy is a form of psychological treatment of

practical orientation, based on scientific knowledge and a broad spectrum of application. Its main

objective is to alleviate human suffering by using procedures validated by science (Glenn).

Psychology is a young science with much ahead, to discover and improve. The different

currents have focused on different ways to approach the person and alleviate their discomfort.

From this arise visions that clash in the idea of whether the scientific method is necessary to help

solve the suffering of the person. Cognitive-behavioral therapy is clear and committed to

objectivity versus the intuitive, making it one of its strengths. However, it is not exempt from

criticism. Then, it can be seen that its advantages and disadvantages are present, in order to have

a broader vision, which is useful at the time of nursing practice or training in order to deal with

the different cases that come to consultation, knowing whether the treatment will adjust to the

individual who tries to fix his problem. This therapy is a model of mental treatment, just as being

a lot of systems dependent on a reasonable model. This model is shaped through the association

of subjective and conducts brain research. Henceforth it is recognized by impartially assessing

the psychological procedures that happen in treatment, following up on conduct and intellectual

schemes (Hambrick et al.).

Cognitive therapy consists essentially of identifying those irrational thoughts that makes

the patient suffer, and identifying what is irrational in them. This is done through a process of

self-analysis by the patient, which the doctor must promote and supervise. It should be noted that

this effort of observation and criticism that the patient makes of their automatic negative
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thoughts should not be confused with the tendency known as positive thinking, which only

promotes indoctrination through positive or optimistic phrases like ‘I deserve to be happy’, ‘I am

smart, strong and capable, etc.’, because this therapy uses critical thinking to achieve change in

its patients and relies on facts and thoughts adjusted to reality. It is not a dogmatic imposition of

predetermined thoughts (Glenn).

There are two basic ideas on which the whole therapeutic process is based. The first is

that all thoughts can be changed. Because thoughts are the result of learning and lived

experiences and, therefore, can also be unlearned and changed by more adaptive ones. Changing

thoughts means changing only that which causes us discomfort, and not changing the way of

being. A high level of belief in thought does not make it true. The force with which we believe in

thought has nothing to do with its authenticity or the reality it describes. Two aids to identify

automatic negative thoughts are that negative thoughts are always value judgments;

interpretations, evaluations, and assessments of the facts. There is no clear causal connection. If

the patient were in that situation, would he or she think the same way? These are some aspects

that combine to prepare the nurses while they deal with psychological issues (Roitblat, and

Meyer)?

In order to change the negative thoughts that cause the patient discomfort, the nursing

practice of this therapy focuses on discussing the issues and carries out to verify its authenticity.

The cognitive discussion consists of evaluating, using a scientific approach, the thoughts. The

nursing practice uses objectivity and reason to see if thoughts are estimates or judgments of

reality as accurate as the patients have believed for years. The discussion lies in questioning

through concrete questions the truth of the thoughts. There are four types of questions. When the

thought that is evaluated does not meet any of these highlighted criteria, it will be a maladaptive
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thought for the patient. The first criterion evaluates the objectivity of thought, for example, what

evidence do they have to think like this or can it be used to think about it (Sookman, and

Steketee).

Adaptive thoughts are objective; they can be supported by evidence. While non-adaptive

thoughts are not objective, but are based on philosophical beliefs, and not detached from reality.

For example, now it is a day. What tests does one have to prove this like there is light, sun,

people on the street, cars do not switch on lights, and psychologists also have accumulated

evidence of the past that tells them that information being provided is based on facts or not. The

second criterion evaluates the intensity and/or duration of the emotion that generates thought, for

example, how this thought makes them feel and does it overflow them. Since adaptive beliefs

produce moderate emotions allow pleasant or unpleasant feelings, but under control. Moreover,

maladaptive beliefs produce emotions of very high intensity or very long duration, creating

disturbance and lack of control (Roitblat, and Meyer).

Example: A person loses a loved one, and thinks life is horrible; he cannot live without

her. This person will feel very sad and hopeless; but if he thinks he is going to have a bad time,

being sad, he will have to adapt, he will face the event with less discomfort, therefore, and he

will face the duel better. The third criterion evaluates the utility that this thought has for the

person. For example, what is the use of thinking like that? Is it useful now, tomorrow and in the

future? Because adaptive thoughts serve in the short term to feel healthy emotions, they help us

to act more effectively, in the medium term they help us achieve the set goals (at work, social,

etc.) and in the long term, we manage to be happy. While short-term negative thoughts make us

feel painful emotions and act inappropriately, in the medium term, we boycott these goals, and in
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the long term produce unhappiness. Example: I am a failure; I do not have to try to find a job

because I'm not going to get it (Wheatley, and Hackmann).

The fourth criterion evaluates the form of thought, for example, what kind of words is the

patient using and do the words appear as a useless, failure, disaster among others because

rational beliefs are expressed in a language of desires, preferences, using continuous, in a

probabilistic language like maybe and or like. Moreover, irrational beliefs are expressed in a

language of demands, needs, obligations, language absolutist, dichotomous and catastrophic like

never, always, sure, everything, ever, horrible, should, I cannot stand. Example: I am (sure,

always) useless. This is a typical negative thought in people with low self-esteem. These types of

thoughts have a great influence on their lives and their relationship with others (Wheatley, and

Hackmann).

By means of this type of questions the nursing practice in the Cognitive Behavioral

Theory provides a framework to heal the patients, the analysis of the patients' thoughts is guided,

so that they arrive at the conclusion that the way in which they think does not benefit them, and

would make them happier to change their type of thoughts to more adaptive ones, which they

generate with greater welfare. If after the discussion one concludes that the analyzed thought is

negative for the person and, therefore, does not make them happy, psychologists will look for

another thought, objective, that replaces it and explains the situation from another point of view.

This one interpretation according to the facts is either rational or alternative. To favor the change

of cognitive style practice this new way of thinking in everyday life, with rational thoughts that

do not move intense negative emotions is very beneficial (Leahy, and Dowd).
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Behavioral treatment is wise over pharmacological treatment when the emotional well-

being issue introduced by the patient is confounded by other ailments, for example, liquor or

medication misuse, or constant physical medical issues, just as on account of children, young

people and pregnant females, because of the high hazard to wellbeing that the utilization of

psychotropic medications involves in these type of people. Just in extreme cases is the utilization

of medicine prescribed, yet dependable in the mix with subjective social treatment, and

educating the patient about the helpful ends, the length of pharmacological treatment, the

conceivable reactions and the dangers associated with an unexpected interference of treatment

are educated to them (Chapman, and Dehle).

This procedure has just been effectively executed in the US, which has consolidated

numerous therapists in Primary Care administrations to offer proof based treatment and fulfill the

need for consideration required by the issues of uneasiness and despondency in anti-psychotic

medicines. The reports distributed demonstrate the achievement of this methodology of activity

against the conventional pharmacological methodology, just as the positive fulfillment

communicated by the clients of the wellbeing administrations of the US. In any case, despite the

logical help supporting psychological conduct treatment, in the nation. The consideration model

that wins in emotional well-being is the behavior-based therapy, instead of the medications that

do not provide wholesome care and long term healing to the illness (Leahy, and Dowd).

In the framework of the Congress on anxiety and comorbid disorders mentioned above,

medical professionals expressed their inclination to treat these problems with new drugs called

dual drugs, other new antidepressants and, even, anticonvulsants, given that Psychological

therapy is an article of luxury, and it does not seem that our health model follows the path of

incorporating, as recommended by international organizations. This insistence on anchoring in

an intervention model of the pharmacological one that has proven not to be the best treatment

available, seriously questions the quality of care offered to citizens. Clinical decisions should be

directed, not necessarily towards medicalization, but towards the therapeutic response that, based

on empirical evidence, has shown greater efficacy and efficiency (Hambrick et al.).

The tendency to prescribe drugs abusively despite its side effects, its doubtful efficacy for

the treatment of some ailments and the high economic cost involved, has serious repercussions

that transcend the personal or social spheres. In this regard, researchers has recently published a

series of journals, in which different researchers reflect on the true efficacy of antidepressants,

the harmful effects of the long-term administration of psychotropic drugs, the dubious validity of

the theory that reduces the explanation from mental disorders to simple biochemical imbalances

and over economic interests of the pharmaceutical industry in perpetuating these behavioral

models in mental health. It is for this reason that significance of the Cognitive Behavioral

Therapy cannot be ignored and why it is important for the nursing practice to include this

framework in their healthcare services (Sookman, and Steketee).

Work Cited

Chapman, Alexander L., and Crystal Dehle. "Bridging Theory And Practice: A Comparative

Analysis Of Integrative Behavioral Couple Therapy And Cognitive Behavioral Couple

Therapy". Cognitive And Behavioral Practice, vol 9, no. 2, 2002, pp. 150-163. Elsevier

BV, doi:10.1016/s1077-7229(02)80008-6.

Glenn, Cynthia Wheatley. "Cognitive Free Will Learning Theory". Procedia - Social And

Behavioral Sciences, vol 97, 2013, pp. 292-298. Elsevier BV,

doi:10.1016/j.sbspro.2013.10.236.

Hambrick, James P. et al. "From Theory To Practice: Facing Ethical Challenges As A Clinical

Intern". Cognitive And Behavioral Practice, vol 16, no. 2, 2009, pp. 191-204. Elsevier

BV, doi:10.1016/j.cbpra.2008.09.009.

Leahy, Robert L, and E. Thomas Dowd. Clinical Advances In Cognitive Psychotherapy.

Springer Pub. Co., 2002.

Roitblat, H. L, and Jean-Arcady Meyer. Comparative Approaches To Cognitive Science. MIT

Press, 1995.

Sookman, Debbie, and Gail Steketee. "Directions In Specialized Cognitive Behavior Therapy

For Resistant Obsessive-Compulsive Disorder: Theory And Practice Of Two

Approaches". Cognitive And Behavioral Practice, vol 14, no. 1, 2007, pp. 1-17. Elsevier

BV, doi:10.1016/j.cbpra.2006.09.002.
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Wheatley, Jon, and Ann Hackmann. "Using Imagery Rescripting To Treat Major Depression:

Theory And Practice". Cognitive And Behavioral Practice, vol 18, no. 4, 2011, pp. 444-

453. Elsevier BV, doi:10.1016/j.cbpra.2010.06.004.