Question 1
Cognitive Behavioral Therapy (CBT) is a psychotherapy intervention, which uses a goal oriented and a systematic approach to address dysfunctional thoughts, behaviors and emotions (Epstein & McCrady, 2008). Inpatient and outpatient CBT interventions are some of the most effective and common types of psychotherapy used in the treatment of personality disorders (substance abuse, anxiety, mood and eating disorders) and mental illness.
Inpatient CBT interventions
The inpatient CBT intervention will be divided into four phases. The first phase will be all about establishing a working relationship with my client (Mary) and educating her about the CBT model of intervention (Epstein & McCrady, 2008). Together, will develop a problem list and start working on the most pressing issues on the list. During this introduction stage, most effort will be focused on helping Mary reduce the negative thoughts that are triggering her towards alcohol use, opiate use and Generalized Anxiety Disorder (GAD).
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The second and third phases will be individually tailored to target each problem on the list. Here, I will help Mary to recognize cognitive phenomena like negative thoughts and distortions. Also, the client will learn more rational thinking patterns. The fourth and final stage of inpatient treatment is all about preparing Mary for discharge. Some CBT activities will include discussion of Mary’s transition to outpatient treatment, cognitive rehearsal, role-playing of interactions and anticipatory problem-solving in areas, which may seem troublesome after discharge (Epstein & McCrady, 2008). It is recommended that Mary should undergo a minimum of six months of intensive outpatient CBT after discharge.
Outpatient CBT interventions
The majority of CBT interventions used often on an outpatient basis include pharmacotherapy, psychosocial intervention, and intensive outpatient treatment (. In pharmacotherapy, I will administer drugs for medicinal reasons (Epstein & McCrady, 2008). Mary may need medications to manage her alcohol use disorder, opiate use disorder and Generalized Anxiety Disorder (GAD). Normally, these medications are administered on an outpatient basis.
In a psychosocial intervention, Mary will verbally interact with other people to help her change her behavior (Epstein & McCrady, 2008). Formal group and individual therapies are common modalities used. Mary has just been discharged from an inpatient treatment program and so she needs further intensive treatment. Intensive outpatient treatment may offer intensive and focused therapy which should be administered at least weekly.
Question 2
There is no doubt that exercise, meditation, and yoga are some of the best coping strategies that help prevent relapse. Besides helping individuals achieve and maintain a healthy weight, regular exercise improves emotional well-being. Aerobics such as swimming, cycling, walking, and jogging can reduce symptoms of depression and anxiety, enhance self-esteem, and boost self-confidence (Giménez-Meseguer, Tortosa-Martínez, & de los Remedios, 2015). Meditation and Yoga can help reduce withdrawal symptoms. In this case, Mary is still in the early stages of recovery. Therefore, withdrawals may be uncomfortable and painful. Such an individual may have strong urges and cravings to use. In addition to regular exercises, yoga and meditation will help ease withdrawal symptoms which may cause cravings.
It is also important to have a support system. In this case, the family and the community can help and see that the patient succeeds in avoiding a relapse. Honesty is thus important and talking to this support system about how the patient feels can help the family and community keep the patient accountable (Giménez-Meseguer, Tortosa-Martínez, & de los Remedios, 2015).
References
Epstein, E. E., & McCrady, B. S. (2008). Overcoming alcohol abuse use problems: A cognitive-behavioral treatment program . New York: Oxford University Press.
Giménez-Meseguer, J., Tortosa-Martínez, J., & de los Remedios. F.-V. M. (2015). Benefits of exercise for the quality of life of drug-dependent patients. Journal of Psychoactive Drugs, 47 (5): 409-16. Doi: 10.1080/02791072.2015.1102991.
