Cognitive Behavioral Intervention Approach, Research Paper Example

Students who have emotional or behavioral problems present distinct challenges to the educators who are involved in their academic lives.  These students, also classified as EBD students, demonstrate patterns of behavior that are markedly different from that which is expected of them by those around them.  Because of the stigma attached to the label” emotional disturbance” that has been used in the past to characterize students who act out, more recently the term “behavioral disorders” has been employed because it has fewer negative connotations.  Many methods have been used to address the learning needs of the students in their school settings, and one of the most frequently used approaches is called “Cognitive-behavioral therapy.” This paper will examine various aspects of the cognitive behavioral approach, its strengths and its weaknesses, and how they affect the student’s emotions, thoughts, and behavior.

For the purposes of this paper, there needs to be a definition or description of the behaviors that result in categorizing a student as EBD.  The typical behavior of a student with EBD includes: an inability to build or maintain adequate interpersonal relationships with peers and or teachers; a lack of comprehension or ability to learn which is not caused or explained by intellectual, sensory or health factors; and chronic inappropriate behavior or feelings demonstrated in situations that are when normal and do not warrant such unusual or extreme behavior.

The basic idea supporting cognitive therapy is that a thought precedes a mood, and that both are interrelated with a person’s environment, physical reaction, and subsequent behavior.  Therefore, changes  that arise in a given situation will change mood, behavior, and physical reaction  (Stuart J.Rupke, 2006).

The Council For Exceptional Children describes “serious emotional disturbances” as a condition that exhibits one or more of the following characteristics over a long period of time and to  a significant degree, which negatively affects educational performance: the inability to learn, which cannot be explained by intellectual, sensory, or health factors; an inability to build or maintain adequate interpersonal relationships with peers and teachers ; inappropriate types of behaviors or feelings under normal circumstances; the  pervasive mood of unhappiness or depression; a tendency to develop physical symptoms or fears associated with personal or school problems. (Behavior Disorders Of The EBD Child, 2010). In addition, the Federal definition of emotional disturbance in children includes children who are diagnosed as schizophrenic, but does not include socially maladjusted children unless they are “seriously emotionally disturbed” (Behavior Disorders Of The EBD Child, 2010.)

Cognitive behavioral therapy, or CBT, is a short term mode of psychotherapy that is employed for both adults and children to treat depression.  It focuses on present issues and symptoms instead of the way traditional forms of therapy have always addressed past behavior and the patient’s history (Cognitive behavioral therapy, 2006).  Typically, the treatment with students involves both therapy sessions as well as daily activities that are aimed at helping the students practice skills learned in the CBT setting  and applying them to other environments, such as home, as well.

There are several components of CBT intervention: cognitive restructuring, or pinpointing and then correcting inaccurate thoughts pertaining to the student’s depressed feelings; behavioral activation, or helping the student to involve himself or herself in pleasant activities; and increasing as well as improving problem-solving skills ( (Cognitive behavioral therapy, 2006). Cognitive restructuring involves the educator or therapist collaborating to identify and then change characteristic mistaken thoughts or feelings that lend themselves to feeling depressed, such as “I am  ugly” or “I am stupid” or “I am worthless.” The teacher uses information from the student’s current environment, past experiences and future potential to offset these beliefs, by pointing out situations or evidence that disprove the student’s negative self concept.  The teacher also encourages the student to become involved in activities that are potentially enjoyable, also part of cognitive restructuring.

Behavioral activation, the second component of CBT, helps the student to increase in small steps their participation in activities that are potentially enjoyable or rewarding.  This can be accomplished by exploring what the student finds enjoyable and taking steps to help him engage in these activities on a regular basis.

The third component of CBT, which addresses problem-solving skills, can be accomplished  by dividing what appear to be tremendous obstacles and problems into small steps that seem more manageable and are more likely to bring the student a sense of success.  For example, if a student berates himself for having a messy room, resulting in conflicts with his parents and the reinforcement of low self confidence, the teacher or therapist might make a suggestion that the student begin each day by making his bed.  The following week, the teacher might suggest that he put away his clothes from the day before each night before going to bed.  In that way, the CBT method helps to overcome problems that appear to be insurmountable by breaking them down into more manageable tasks.

The interrelationship between thoughts, behaviors, and emotions involves significant interaction between all three.  The way a child or adult feels emotionally can have a distorting impact on his or her thoughts and behaviors.  As in the example cited above, if a child is depressed, his thoughts will be affected by having irrational extremes in beliefs, such as “I am worthless” or” no one cares about me.” These thoughts will have a direct impact on the behavior that follows, and can result in either self harm such as compulsive scratching or pulling one’s hair out, or aggressive behavior towards others including physical fighting, destroying things belonging to either the student or the people around him, or being verbally abusive because he is feeling emotionally sad, angry, or depressed.

In addition, behavior can affect feelings and emotions; for example, if a child does something that he knows is not acceptable, such as taking money from a parent’s wallet, he may feel extremely anxious about being discovered, guilty about having done something wrong, and depressed about feeling like he is a bad person.  It is virtually impossible to separate out the way behavior, thoughts, and emotion influence each other.

Regarding the effectiveness of cognitive behavioral therapy, there are a number of studies that are persuasive in demonstrating that CB T is an effective treatment for patients who are depressed.  Other studies have shown that CBT is superior to either no treatment at all or to receiving a placebo.  Two other analyses indicated that CBT is as successful as interpersonal or brief psychodynamic therapy, and also demonstrated that CBT is as effective and even possibly more effective than the pharmacological therapy in managing depression in adults or children (Stuart J.Rupke, 2006).  Although measuring the effects of psychotherapy or other helping methods is difficult if not impossible, there is evidence to support the fact that CBT is a legitimate alternative to  psychotropic medications for students with mood disorders.  It is a method that also has the benefit of being relatively easy for both the teacher and the student to comprehend: the idea of using positive reinforcement to improve self concept.  If a child says, “everyone hates me” the teacher might respond by reminding the child that he was playing with other children at recess, or that he had been invited to a birthday party the week before, or that his parents took him away a on a vacation for his birthday.  By providing tangible information and examples that contradict the student’s distortion and thinking, CBT can be an extremely effective method to help both children and adults with low self esteem.

CBT is not considered to be an appropriate or helpful method for everyone; in order for it to be successful, both the student and the teacher must be determined and consistent in addressing the

The issues involved. The method includes homework assignments that may be difficult for the student to complete or work on on a regular basis, assignments which may also be extremely challenging.  These tasks which are to be done both in school and at home may cause additional anxiety or stress.  In addition, the child’s parents must be committed to addressing the problems in the same ways in which the teacher is handling them, and their ability to do so may depend on a variety of factors, many of which may not be conducive to acting as a “therapist at home”   where they may have many other things going on in their lives and their other family relationships.

Teaching social skills is a vital aspect of CBT.  The goal is to help students communicate with others in a way that will cause them to feel comfortable with others, rather than fearing that other people will do them harm.  The method places a strong emphasis on connecting with people who are positive thinkers, and to avoid people who are negative thinkers or who are engaging in negative behaviors such as people who are using chemicals to medicate themselves.  CB T encourages the students to note what are the qualities that they are attracted to  in other people and that will increase their self esteem by association, as well as to become aware of qualities in people that they should avoid. (Cognitive behavioral therapy online, 2010). The method offers concrete advice to students about how to make and keep friends, such as not imposing oneself on others but rather, waiting for signs that the person welcomes contact with them.  The CBT method also recommends not becoming involved in intimate relationships until the person is healthy enough to maintain a relationship.

The CBT method encourages people to develop a knowledge of who they are before engaging inother relationships by asking them three questions: what makes that person unique; where that person fits in with others, that is who are the people that he is most comfortable being around, and how well that person is functioning.  Building social skills includes overcoming the resistance to change that characterizes many EBD students.

When designing the curriculum fort EBD students, it is important to individualize  the plan for each student, taking into account their strengths and weaknesses, learning needs, and possibly most importantly, their support system at home.  It is vital that how they are being educated in school is followed through at home, in the form of homework help from their caretakers, who need to be familiar with and comfortable with CBT methods.  This continuity will help the student to have a more successful outcome regarding their individual objectives in school.

References

Behavior disorders of the EBD child. (2010, September 25). Retrieved September 26, 2010, from Council for exceptional children: .http://www.cec.sped.org/AM/Template.cfm?Section=Behavior_Disorders_Emotional_Disturbance

Cognitive behavioral therapy. (2006, February 2). Retrieved September 26, 2010, from University of Michigan depression center: http://www.med.umich.edu/depression/cbt.htm

Cognitive behavioral therapy online. (2010, February 25). Retrieved September 26, 2010, from Online therapy: http://www.online-therapy.com/building-social-skills-cbt-borderline-personality-disorder-bpd-a-71.html

Cognitive-behavioural therapy (CBT). (2007, Mayi 1). Retrieved September 26, 2010, from Patient UK: http://www.patient.co.uk/health/Cognitive-Behaviour-Therapy-%28CBT%29.htm

Stuart J.Rupke, D. B. (2006, January 1). Cognitive therapy for depression. Retrieved September 26, 2010, from American academy of Family Physicians: http://www.aafp.org/afp/2006/0101/p83.html