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Cognitive Behavioral Therapy: Comparing Group, Family, and Individual Settings

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Cognitive Behavioral Therapy: Comparing Group, Family, and Individual Settings

Cognitive-behavioral therapy (CBT) is a psychological intervention that aims to improve

mental health by helping people to learn how to identify and change destructive thought patterns

that negatively influence their emotions and behaviors(Whitfield, 2010). It focuses on

challenging and changing maladaptive thinking patterns, improving emotional regulation, and

developing coping strategies that target cognitive problems (Wheeler, 2020). Several studies

have identified CBT as one of the best psychological treatments for depression, anxiety

disorders, addiction problems, and severe mental illness. It improves the emotional well-being of

people with the problems above by teaching them coping strategies. This approach can be used

in individual, family, or group psychotherapy.

CBT with Groups vs. CBT with Family

CBT in a group setting focuses on providing therapy to many people experiencing

psychological problems to change their maladaptive thinking patterns into a more adaptive or

positive thinking pattern. It utilizes the interactions of group members as a remedy source to the

challenges faced by the group members (Psych Exam Review, 2019). Team members share their

problems with other members, who may be experiencing the same difficulties (Whitfield, 2010).

Other members present their knowledge of dealing with such problems, helping the group

achieve the solution to the challenge. As such, the group members provide support and morale to

each other.Yusop et al. (2020) presumed that group CBT is more dynamic than based on the

interactions of the group associates. During CBT, therapists educate self-motivated individuals,
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making the intervention readily acceptable to deal with group challenges by utilizing limited

time and collaborative skills (Yusop et al., 2020).

In contrast, family CBT involves sharing therapeutic information with the client together

with their family members. It focuses on supporting family members by seeking to address the

specific issues affecting the health or functioning of the family (Lan & Sher, 2019). It also seeks

to ensure family members think and act more adaptively, learn to make better decisions, and

develop a friendlier and calmer family atmosphere (Söylemez, 2017). In family CBT, therapists

perceive feelings, behaviors, and cognitions as mutually influencing all individuals involved. For

instance, in the YouTube video by Psych Exam Review, Michael Cora says that a case of mental

illness is likely to affect all family members even if only one person has the condition (8.35). As

such, family CBT enables family members to overcome the transition of psychiatric disorders

from one person to the entire family. It means that a family therapist must view the individual

problems in the context of the larger unit.

PMHNP Challenges

One of the challenges Psychiatric mental health nurse practitioners (PMHNPs) might

encounter when using CBT in the group setting is difficulty in restructuring the thinking patterns

of individual members simultaneously. Another problem is cooperation. According to Okamoto

et al. (2019), clients with persistent relational problems and personality disorders can experience

a major difficulty with collaboration. Some members fail to comply with the group principles of

freely sharing challenges affecting them due to fear of being exposed or judged. This makes it

hard for a PMHNP to identify and help solve the challenges.

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Recommendations to Overcome the Challenges

One of the problems identified is difficulty in restructuring the thinking patterns of

individual members of the group at the same time. Whereas a therapist may work with members

with similar psychological problems like depression and anxiety, they should note the causes of

these conditions may vary. For example, a person may experience depression caused by rape or

the loss of a loved one. Another person may have the same condition caused by the loss of a job

or drug abuse. The above causes are unrelated, which is why it may be difficult for a therapist to

restructure the thinking patterns of the group simultaneously.

To overcome this problem, the therapist should group the members based on the causes

of their psychological conditions and work with them at different intervals. Having people with

similar causes and conditions could help the therapist restructure the thinking patterns of these

individuals simultaneously. It also encourages the group members to share their feelings freely,

thus, boosting their cooperation. The therapist should also consider the clients’ beliefs to foster

their collaboration. As early as the first session, the clinician should inquire about the client's

thoughts about the therapist (Okamoto et al., 2019). If dysfunctional beliefs emerge, they should

assist the client in testing them or look for evidence to support or rebuke the thoughts (Okamoto

et al., 2019). Doing will encourage clients to cooperate.

Conclusion

CBT in a group setting is similar to CBT in the family setting because they both involve a

professional therapist who helps the clients cope with their psychological conditions. However,

CBT in the two settings differs in the sense that group CBT involves individuals from diverse
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families, whereas family CBT uses people of the same family. Each of the supporting sources

used in this work is considered scholarly because they are peer-reviewed. A peer-reviewed

source is written by an expert and reviewed by several other experts in the field to ensure its

quality before publishing. The selected sources focused on CBT in family and group, and they

established that CBT in these settings has similar agenda.

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References

Lan, J., & Sher, T. G. (2019). Cognitive-behavioral family therapy. Encyclopedia of Couple and

Family Therapy, 23 (8), 497-505.

https://www.researchgate.net/publication/329138631_Cognitive-

Behavioral_Family_Therapy

Okamoto, A., Dattilio, F. M., Dobson, K. S., & Kazantzis, N. (2019). The therapeutic

relationship in cognitive-behavioral therapy: Essential features and common challenges.

Practice Innovations, 4 (2), 112-121.

https://www.researchgate.net/publication/330941099_The_therapeutic_relationship_in_c

ognitive-behavioral_therapy_Essential_features_and_common_challenges

PsychExamReview. (2019, April 30). Cognitive therapy, CBT, & group approaches (intro psych

tutorial #241) [Video]. YouTube. https://www.youtube.com/watch?v=A2_NN1Q7Rfg

Söylemez, A. (2017). Cognitive Behavior Therapy with Couples and Family Relationships.

Journal of Family Counseling and Education, 2 (1), 72-76.

https://www.researchgate.net/publication/327908994_Cognitive_Behavior_Therapy_with

_Couples_and_Family_Relationships

Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide

for evidence-based practice . New York: Springer Publishing.

Whitfield, G. (2010). Group cognitive–behavioural therapy for anxiety and depression. Advances

in psychiatric Treatment, 16 (3), 219-227. https://www.cambridge.org/core/services/aop-

cambridge-
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/div-class-title-group-cognitive-behavioural-therapy-for-anxiety-and-depression-div.pdf

Yusop, Y. M., Rahman, N. A., Zainudin, Z. N., Ismail, A., Othman, W. N., & Sumari, M.

(2020). The Effectiveness of Cognitive Behavioral Therapy in Group Counselling.

International Journal of Academic Research in Business and Social Sciences, 10 (9),

359-378. https://hrmars.com/papers_submitted/7648/the-effectiveness-of-cognitive-

behavioral-therapy-in-group-counselling.pdf