Cognitive-behavioral therapy (CBT) is a psychotherapeutic method that alters one’s thought processes to achieve the desired outcomes. It is founded on the scientific reality that people’s thoughts rather than external factors such as situations or events influence their moods and behaviors. CBT is currently recommended as the first-line remedy for mental health disorders, including anxiety, depression, and personality disorders (Blackwell & Heidenreich, 2021). Notably, CBT may be used in group, individual, and family settings, with each setting having a distinct framework and features. This discussion explains how CBT in a group compares to use in an individual setting. It also highlights challenges psychiatric mental health nurse practitioners (PMHNPs) might experience when using CBT in the individual setting.
CBT in a group setting is highly structured, and interactive, focusing on helping several individuals recognize their depressive or anxious thought patterns and behaviors. Therefore, a psychiatrist can reach a more significant number of patients, making it less expensive than in an individual setting. CBT in a group setting plays a significant role in helping individuals understand that their thoughts can impact their behaviors (Hauksson et al., 2017). It also creates an opportunity for positive peer modeling, social support, normalization, reinforcement, and exposure to social dynamics. Importantly, CBT in a group setting regards the members’ interactions as the mechanism for transformation (Hauksson et al., 2017). Group members can share personal problems and experiences and receive feedback from the group. Therefore, this setting offers a unique sense of support and accountability that might not be available in the individual setting.
On the other hand, CBT in an individual setting helps the individual clients recognize inaccurate or negative thinking to view challenging circumstances more clearly and respond to them in a more operative approach. In this setting, the psychiatrist works alone with the client to identify issues and work through them. A study by Hauksson et al. (2017) showed that individual therapy is more effective in the treatment of major depression compared to group therapy. In the individual setting, clients are more likely to develop a therapeutic relationship with the therapist and become more comfortable sharing information than in a group setting.
When dealing with children, CBT in the individual setting gives the therapist more time to engage with the child and their families, unlike in a group setting where the therapist has less time to develop treatment plans specifically suited to the child. This treatment flexibility allows the child to have a more personalized experience with larger reported effect sizes. Moreover, since treatment in an individual setting is tailored to the individual needs, the therapist and the child might form a bond in which the youngster feels comfortable disclosing specifics about their fear (Guo et al., 2021). As a result, the therapist can sufficiently address the child’s personal and emotional requirements.
In an individual setting, PMHNPs may encounter a variety of patient behaviors that can obstruct CBT. It may be difficult to work with patients who have been labeled as difficult, unmotivated, or resistant (Heidenreich et al., 2021). Also, the client could have trouble recognizing emotions and thoughts. Clients often experience emotions before recognizing their previous thought (Heidenreich et al., 2021). This problem can challenge the determination of the very thought that caused the emotional response. Also, if the individual is linked to another person, like a spouse or family, the PMHNP can only control the particular individual’s behavior leaving out the other parties (Heidenreich et al., 2021). A case example from the Beck Institute for Cognitive Behavior Therapy (2018) video is where the counselor handles a spouse without their partner.
A client might also agree with the principles but be unable to change their minds. Clients sometimes report an intellectual cognizant of cognitive therapy principles but are unable to implement that understanding in a way that leads to real change. Finally, the client’s motive for change may be limited. Therefore, PMHNPs must establish motivating factors for clients who are not attending therapy of their own volition in the early stages.
The sources used are prepared by professionals with the aim of contributing to knowledge expansion in the field of nursing through analysis of current knowledge and research to post new findings. The information in the sources is evidence-based with clear referencing. Also, the authors are well indicated with their respective institutional affiliations.
References
Beck Institute for Cognitive Behavior Therapy. (2018, June 7). CBT for couples [Video]. YouTube. https://www.youtube.com/watch?v=JZH196rOGsc
Blackwell, S. E., & Heidenreich, T. (2021). Cognitive Behavior Therapy at the Crossroads. International journal of cognitive therapy, 14(1), 1–22. https://doi.org/10.1007/s41811-021-00104-y
Guo, T., Su, J., Hu, J., Aalberg, M., Zhu, Y., Teng, T., & Zhou, X. (2021). Individual vs. Group Cognitive Behavior Therapy for Anxiety Disorder in Children and Adolescents: A Meta-Analysis of Randomized Controlled Trials. Frontiers in psychiatry, 12, 674267. https://doi.org/10.3389/fpsyt.2021.674267
Hauksson, P., Ingibergsdóttir, S., Gunnarsdóttir, T., & Jónsdóttir, I. H. (2017). Effectiveness of cognitive behavior therapy for treatment-resistant depression with psychiatric comorbidity: comparison of individual versus group CBT in an interdisciplinary rehabilitation setting. Nordic journal of psychiatry, 71(6), 465-472. https://doi.org/10.1080/08039488.2017.1331263
Heidenreich, T., Noyon, A., Worrell, M., & Menzies, R. (2021). Existential Approaches and Cognitive Behavior Therapy: Challenges and Potential. International journal of cognitive therapy, 14(1), 209–234. https://doi.org/10.1007/s41811-020-00096-1
write