Cognitive Interventions Essay Example for Free

Cognitive Interventions attemptIntroductionCognitive fashion therapy implicates umpteen types of therapy and can be applied in a renewing of circumstances. Dialectical expression therapy (DBT) is to the highest degree commonly known for use on clients with borderline personality disturb (BPD). However, DBT is becoming more popular and practically used when working with teens. Some adolescents participate in nonsuicidal self-injury (NSSI). Counselors divulge DBT is an effective therapy to help youth acquire the coping expertnesss lacked to stop NSSI. A review of DBT, and adolescents hurt with NSSI will better help angiotensin-converting enzyme to understand why this technique is beneficial. NonSuicidal Self-InjuryNSSI is defined as the lead and intentional destruction of ones own body tissue without an intent to die. Therefore, some(prenominal) form of self mutilation non intending to result in suicide qualifies as NSSI. The number of adolescents practicing NSSI i s alarming. Youth practicing NSSI include both sexes and e very(prenominal) racial and ethnic radical. This alarming behavior is not secluded to some(prenominal) particular type of adolescent. NSSI a good deal appears in the form of cutting with sharp objects, scratching, hitting, burning, and inserting objects under the skin. These behaviors typically come between the ages of 12-14, indicating that adolescent years ar particularly vulnerable to such practices.In addition to NSSI, these behaviors are often in conjunction with separate self-harming behaviors like eating disorders, substance abuse, and depression. Puberty can be an extremely difficult time for many people and adolescents cannot reason and rationalize as adults can therefore, youth often bring out self-harming issues because they lack fit coping skills. Last, NSSI particular(prenominal)ally refers to injuries not acquired bit attempting suicide however, 50-75% of those with a history of NSSI have also move su icide at least once. As one can put on, NSSI is an alarming behavior that needs attention (Choate, 2012).Addressing the IssueNSSI is a prevalent and serious issue that must be properly handled. Counselors and people working with NSSI youth must have an understanding of the complexity of this matter and be familiar with handling options. DBT is an minute method to attempt to help adolescents overcome NSSI behavior. The effectiveness of DBT has been shown in at least seven controlled trials conducted by four independent research teams. DBT shows the most improvement, when compared to prior therapy options, to treat NSSI (Choate, 2012). DBT uses a comprehensive multimodal 16-week interference approach shot for NSSI.The multimodal addresses skills for interpersonal effectiveness, self-regulation, and distress tolerance provides structure to motivate, reinforce, exclusiveize, and generalize these skills and identifies and cooks learned behavior patterns leading to NSSI. This thera py treatment includes individual therapy, family therapy, multifamily training groups, and telephone consultations for those affect in the process. Additionally, a support team for the advocates is a part of this process. commission NSSI adolescents is an extremely stressful position so it is important for advocators to have professional peers to share their thoughts. DBT therapy for NSSI adolescents can be practiced in many settings, including inpatient or outpatient treatment (Choate, 2012).Interventions and TechniquesIndividual TherapyA firsthand counselor is paired with the adolescent through the DBT process. The relationship between the primary counselor and the client is extremely important. The make goal for the counselor is to help the adolescent develop skills for coping with stressful thoughts, events, and perceptions. An important aspect in the client therapist relationship is for the counselor to convey acceptance, validity, and trust. The primary counselor needs to remain cool down and listen with interest up to now without showing much perception. A client must not see a counselor react to stories of self-harm in the way a parent or peer talent react. The goal for the counselor is to show an understanding of the self-harming behavior while conveying acceptance and validating the adolescents thoughts and actions (Choate, 2012).The counselor shows acceptance however, the goal is to create commute. Although the counselor equalisers acceptance and change, the counselor continually challenges the client to alter any negative behavior hindering ones aliveness quality. Ultimately the thought is that acceptance and validation will speed self-change while change will facilitate self-acceptance. If the adolescent is reluctant to change the insalubrious behavior, the counselor whitethorn spend more sessions building trust and showing validation before attempting change. Additionally, a client whitethorn find it difficult to trust the counsel or is the client believes the counselor will report NSSI episodes to the adolescents parents.A balance must be created between client trust, parental rights, and confidentiality. With a proper balance allowing the youth comfort, yet abiding by regulations, an adolescent will be able to build the relationship required to develop change (Choate, 2012). Assessments should be conducted during the initial interviews with the client. These initial evaluations are either conducted in officially with an interview or formally with a structured interview and self-report tool. The DBT model allows the counselor to integrate assessment results into four DBT target treatment areas. Specific behaviors and areas are written into a treatment plan with goals for the client (Choate, 2012). Target areasA) Decreasing monstrous behaviorsB) Decreasing behaviors that interfere with therapyC) Decreasing behaviors that interfere with life qualityD) Increasing behavioral skills(Choate, 2012).As the treatmen t begins, the goal is to help the client realise the events, thoughts, or feelings one has prior to the NSSI occurrence. If one can determine factors contributing to the negative behavior, one can start to alter circumstances leading to NSSI and ultimately change the behavior. Clients are asked to champion diary card game documenting behaviors and actions surrounding NSSI behavior. The diary cards address problem behaviors, fast prior events leading to problem behavior, vulnerability factors, entire chains of events prior to problem behavior, and consequences from the behavior. Upon review of the cards the counselor can help the client identify triggers of NSSI behavior and find alternative life choices or thoughts to screw better with given situations (Choate, 2012).Multifamily scientific disciplines Training GroupsThe individual session emphasizes focus on assessment, client trust, and identifying the problem. on with identifying problems, individual therapy does encourage b ehavior change. However, multifamily group therapy focuses on skill sets needed to facilitate change. To implement behavior changes and develop coping skills, the adolescents must be aware of thoughts, feelings, and actions tolerate the pain and stress associated with unpleasant life events, regulate emotions better, and become effective at communicating emotions. The DBT approach focuses on building four inbred skillsA) heedfulnessB) distress toleranceC) Emotion regulationD) Interpersonal effectivenessAdditionally, a fifth skill was added Walking the middle path (Choate, 2012).Skill SetsSkill Set One Core MindfulnessMindfulness is acknowledging ones emotions, thoughts, and personal experiences without trying to end them, numb them, or avoid them. Learning to observe, hound, and experience emotions without judgment and while in control of ones attention is the core of brainpowerfulness. As adolescents become more aware of emotions in the present, they develop a better understan ding of their own emotions and reactions (Choate, 2012). DBT uses a model with terce states of mind to apprise mindfulness. The three mind-states are reasonable mind, emotion mind, and wise mind. Reasonable mind is controlled primarily by logic. Emotion mind is regulated significantly by emotions.Wise mind synthesizes all the ways of intimate to develop knowing through intuition, using deep inner wisdom. oftentimes time groups sessions will use acting or charades to have participants learn to understand these types of mindfulness (Choate, 2012). Group members are taught to observe their thoughts by awareness. The clients are encourage not to multitask but rather to focus on one task at a time. The feat of focusing on one task at a time is referred to as one-mindfulness. Focusing on one aspect at a time allows the client to recognize and understand the emotions related to the specific task.Skill Set Two Emotion RegulationEmotion regulation helps group members learn to recognize , observe, and describe emotions. Additionally, this skill set memorisees one to regulate intense and painful emotions, regulate vulnerability to negative emotions, and accession positive emotions. The clients begin to realize they have control over their emotions and behaviors. When one learns to alter responses to emotions it is both empowering and liberating (Choate, 2012). slipway of teaching emotion recognition often include listening to music or watching a movie. The goal is to have the client react to something, recognize, and observe ones own emotion. As clients recognize emotions they are asked to prove the responses both mentally and physically connected with the emotional reactions. Group members are taught to respond to ones own emotions with self-compassion and acceptance.Often one may believe an emotional response is wrong, silly, or unjustified. Once one understands that every emotion is justified one can accept the emotion and find a healthy response to that emot ion (Choate, 2012). An opposite aspect of emotion regulation includes reducing vulnerability by maintaining better physical health. consume well, sleeping sufficiently, exercising regularly, and avoiding substance abuse will help one regulate emotions by maintaining physical health. Ones physical health can weaken ones mind-state, and the person will be more vulnerable to NSSI and other self-harming episodes (Choate, 2012).Skill Set Three Interpersonal EffectivenessThe goal of interpersonal effectiveness is for one to maintain personal values and beliefs while improving relationships. An example of teachings in this module is that group members are often asked to remember the acronym DEAR MAN to help remember the key components of this skill set. The components Describe, Express, Assert, Reinforce, stay Mindful, Appear confident, and Negotiate. The crush method for learning this skill set is role play. Often the facilitator will pair up group members and role play a variety of sit uations using DEAR MAN (Choate, 2012).Skill Set iv Distress ToleranceStress tolerance relates to ones ability to effectively accept emotional pain, in any given situation, that cannot be changed at the time. Once one can tolerate and accept unpleasant situations, one can more effectively cope. Further skills would help the client to self-soothe and distract from emotionally painful situations (Choate, 2012). Distress tolerance skills have two categories. The first category is skills for accepting reality, and the second is skills for crisis survival. Skills for accepting reality teach clients how to accept everyday life even when it is unpleasant. Deep-breathing is a common practice for this skill. Skills for crisis survival follows more of a distraction method. The goal may be for the client to find an alternative task, practice self-soothing, or receive a break. Whatever the activity change is, the goal is to distract one from the crisis and prevent self-harming behavior (Choate , 2012).Skill Set Five Walking the Middle PathThis particular skill set works with the adolescent and family members to help those involved alter polarized mentation and live a more balanced lifestyle. The first clapperclaw is to encourage participants to abandon black and white thinking and recognize the gray area. People often need to realize that any given situation can be viewed in multiple ways, and often everyone would arrive at from viewing incidents through multiple perspectives (Choate, 2012). Common issues between adolescents and parents include strict or lenient parenting thinking lightly of serious matters, or judging harshly common adolescent behavior and pushing away, or holding too tightly.Adolescents and parents are asked to determine where they believe themselves and others to be regarding these topics, and try to come to an agreement regarding how to alter behavior and meet in the gray area (Choate, 2012). Communication and listening are key factors involved in developing this skill set. Positive reinforcement is taught to be used whenever possible as parents often think to punish negative behavior rather than reward the positive actions. Reconciling family differences can be a key component when attempting to help an adolescent stop NSSI behavior (Choate, 2012).Effectiveness of DBT for NSSIThe treatment for NSSI that has the most positive support is DBT. DBT is the high standard of therapy for reducing suicide and self-destructive behavior among clients with BPD. The effectiveness of DBT has been shown in many trial studies. Not as many studies have been conducted regarding DBT and NSSI with adolescents however, a DBT model has been created for adolescents and shows very brilliant results. DBT is the highest regarded method for at risk youth. Certainly, much can always be learned regarding human constitution and therapy, and not all people will respond to the same treatment therefore, this method is certainly not effective every time, b ut it does seem very beneficial (Choate, 2012).SummaryNonsuicidal Self-injury is a serious issue. As one can see, action needs to be taken to save youth from such harmful behavior patterns. Cognitive behavior therapy, specifically dialectical behavior therapy, has many excellent interventions and strategies to help adolescents approach NSSI (Choate, 2012). DBT uses individual therapy, group therapy, and family therapy to help adolescents with NSSI. Individual sessions focus on trust with the counselor, and identifying and acknowledging negative emotions, and behavior patterns. Additionally, the primary therapist will help the client find healthy ways to change behavior patterns and cope with life stressors (Choate, 2012).Group therapy focuses on building the skills needed to accomplish the desired changes. The five core skills sets include core mindfulness, emotional regulation, interpersonal effectiveness, distress tolerance, and walking the middle path. Many methods are used to t each and practice these techniques (Choate, 2012). Studies continue to determine the effectiveness of DBT with adolescents involved in NSSI. However, DBT is the standard therapy for adults facing similar issues with BPD. Additionally, DBT seems very promising as an effective method for treating NSSI adolescents.ReferencesChoate, L. H. (2012, January). Counseling adolescents who engage in nonsuicidal self-injury A dialectical behavior therapy approach.. Journal of Mental Health Counseling, 34(1), 56-71. EBSCOhost.