Assignment 1 – David Case Study

Introduction

David came for personal counseling with me and being trained and comfortable in

Cognitive Behavioral Therapy, following is the approach that was taken. All the responses in this

assignment are framed around the questions provided in the said assignment.

Summary of David’s Case

In Summary, David is a 26 years old divorced male has been instructed by a judge to seek

professional help as David is found guilty of driving under the influence of alcohol. David is

currently employed in the construction industry but has the ambition to become a counselor.

Currently David is living alone and not in a relationship. David is the third of four children in his

family, and throughout his childhood days, David felt unloved and unwanted in the family

because his parents used to make a comparison between him and his older siblings who are

academically brilliant whereas his younger brother was pampered. Despite being married before,

David admits that he is afraid of strong attractive women. David claims that his mother

dominated his father and treated him similarly to how she treated his father. David stated that his

marriage was brief and that his wife had left him because of his sexual impotence issues.

Philosophical Assumptions

As discussed in the introduction, the approach utilized in personal counseling for David is

Cognitive Behavior Therapy. The philosophical assumption underlying this approach is that the

cognitions are key to understanding and applying therapeutic interventions for clients.

The theoretical background of the therapy is based on the idea that the learning processes

determine behavior and consolidation of beliefs and view of the world. CBT assumes linkage

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Assignment 1 – David Case Study

between the client’s thoughts about self, the future, the world, and their emotions, behavior, and

physiology. The client’s work in between therapy sessions consists of observation of their

thoughts, behaviors, and emotions, and the introduction of changes within the scope of their

thoughts and behaviors.

Cognitive Behavioral Perspective therapy incorporated into David’s counseling sessions

will be beneficial and helpful to find meaning and purpose in his life as this approach emphasizes

the role of social interest in determining psychological health. The basic hypothesis from this

approach is that our emotions stem mainly from our belief, evaluations, interpretations, and

reactions to our life situations. Through the cognitive behavioral therapy, clients acquire the skill

that gives them tools to identify and debate irrational beliefs that have been self-constructed

within and learn how to replace such ineffective ways of thinking with effective and rational

cognition and as a result, they change their emotional reactions to situations.

Basic Assumptions of CBT where Human Nature is concerned

CBT discusses that human beings are largely “cognitive” beings. The cognitions form the

base of what it means to be human as per Cognitive Behavior Therapy. Hence in summary CBT

is conveying that human beings operates largely through their world of thinking, remembering,

perceiving, memory and all other mental processes.

Regarding human nature, no one theory can totally explain the linkage between CBT and

human nature, but human’s psychological nature is influenced by individual beliefs, values, and

experiences, and it solely depends on the individual belief from the power of the mind to either

empower or hold back. In my experience, the past is crucially important in shaping who we are

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Assignment 1 – David Case Study

today but not necessarily the only factor. Hence, in our daily lives, as humans, we can change

and adapt to situations.

Therapeutic Goals for the CBT Approach

CBT main goals is moving towards better thinking in the therapeutic alliance between

counselor and client with CBT Approach. Hence client heal better, faster and think better when

client moves away from cognitive distortions.

The first few sessions would be spent building rapport with David as well as gathering

information on his experiences. During the sessions, David must identify the areas that he wants

to work on so specific attention would be paid to these areas and his past experiences that may

have contributed to his current behavior. David would be educated on the importance of

examining his automatic self-talk as well as assisted in discovering some basic cognition that

influence his self-talk, feelings, and actions. Once David is able to identify his automatic self-

talk and understand its effect on him, we would move onto helping him monitor and evaluate

how he keeps telling himself these thoughts.

Role play and assertiveness training can be used to assist David to overcome his fear of

women. The change in his self-talk would help David to improve his self-confidence. Role play

when used could help to view how David interacts with women and at the same time provide

David the opportunity to practice identifying and changing any negative thoughts and anxiety

attached during their interactions.

As a counselor my goal is to assist David to meet the challenges of contributing to society

by letting him know of his desire to become a counselor is a good option. This would be done by

assisting David to develop insight into how these faulty assumptions affect his behavior and

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assist him to develop alternate ways of thinking, feeling, behaving and then translate these into

action that can change his life.

David would also be challenged to view his mistakes as learning experiences that could

assist him in becoming a better counselor particularly in assisting persons with similar

experiences. David would be challenged to make a list of positives in his life and a list of ten

things that he likes about himself. This would be aimed at helping him focus on the positives

about his life so that he would start to have a different frame of reference to view his life.

Positive aspects of his life that could be highlighted includes his ability to leave some of his past

behind, he was in college, the support of his youth camp supervisor and his job.

Along with the changes in David’s cognition, it’s important to share with David on how

he was balancing between his work and study, as it could affect his ability to do well in school

and cause a setback in progress. With this, David would be encouraged to see that although there

were many challenges that he encountered but he could easily overcome by not moving into the

negative part and move purposefully towards his goals.

Functions and Role of the CBT Counselor

CBT counselor functions as a helper who is using psycho-education to teach the client to

utilize more empowering thinking to bring about healing or growth in their lives. The counselor

is seen as an expert in CBT technique, someone who actively coaches the client about automatic

thoughts, core beliefs, and ways to restructure thinking, as well as someone who gives

homework. The CBT counselor style is transparent where both client and counselor work

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Assignment 1 – David Case Study

together to decide goals for the sessions and develop a plan to address the problems that client

decides to solve.

The relationship between counselor and client is non-judgemental and equal in CBT

approach as the client is actively involved in the sessions and this help client be more open and

communicate about things that are difficult or personal to the client. The counselor would assist

to seek client views and reactions based on their experiences to move towards the way therapy

should be conducted.

Expectations the Counselor has of the client and how the relationship is viewed

CBT requires a collaborative therapeutic relationship between the counselors and the

client. As a CBT counselor, my expectations are that the client would complete their homework

during the sessions. In a CBT approach, the relationship is viewed not merely as a helper-client

aspect but more in a teacher-student focused relationship. Through this relationship, the client’s

maladaptive thoughts or beliefs, faulty assumptions, and mistaken goals are identified.

The identification of the thought brings awareness of the thought process and the

outcome based on the impact of behavior. These thoughts are then challenged with the aim of

having the client restructure their thought process so that the client has a positive view of life.

Furthermore, when the client reveals the lack of mastering the basic life tasks and improper way

of developing superiority, hence the client is educated and coached to develop self-confidence

and understand the purpose of their behavior and a new cognition.