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You most closely identify with Cognitive-Behavioral Theory (CBT) because it seems to be the most effective for a wide range of clients. CBT is also the theory you will be writing about in my theoretical orientation paper. The main reason You feel that CBT is the most obvious choice for me is due to its establishment in the Pragmatic school of psychotherapy. I believe that when we utilize tools in our lives that have practical applicability we can more often reap the benefits of the outcomes. Some of the other theories tend to be lofty in that they do not attack the core issues presented by the client and favor a more roundabout manner of therapy. I think this not only wastes time and money but also instills a safety blanket so-to-speak within the client and he or she may never see the end of their mental anguish. It is this practical applicability of the techniques of CBT such as skills training, relaxation, and behavioral contracting (Halbur & Halbur, 2015).

You like almost everything about CBT but if I could choose one thing to dislike it would be the inclusion of mindfulness in the therapeutic techniques of CBT. While I do not think mindfulness is a bad thing to introduce to clients, I feel it is not something that can be widely effective due to people having vastly different attention spans. Personally, my mind tends to wander after a brief amount of time if I am not interested in something and I feel that mindfulness would limit the therapeutic efficacy of the sessions in some cases.

Mrs. A presents with multiple struggles but as we narrow down the case note, we can select a few of the more salient concerns that may help us understand her primary needs. As a cognitive-behavioral therapist, I would assess Mrs. A's behavior and cognition using the BASIC ID. Behaviorally, she has gained weight, has underperformed in her job duties, and has distanced herself from her friends, family, and husband. Her affect shows that she is remorseful of the fact that she cannot become pregnant, attempting to manage too many stressful situations in her life while taking on even more, and feels empty and numb. The rest of the model delves into sensations, imagery, cognition, interpersonal relationships, and drug use. For the sake of brevity, as the CBT therapist working with Mrs. A, I would ask her targeted questions regarding these assessed ailments such as what she would like to change about her situation and what has she been doing in order to make those changes occur as well as work with her to establish a link between the feelings she expresses and how they are altered directly by what she does in her life (Corey, 2011).

To better assist Mrs. A from the standpoint of a CBT therapist, I think she could elaborate more upon why she has been performing poorly at her places of employment. I feel that by further assessing her career obligations we may open a deeper understanding into what may be the best therapy for her. Gathering more information concerning her relationships would also benefit the course of therapy because in doing so we can glean insight into how these relationships affect her cognition and possibly manage the conflict she has encountered within these relationships.

References

Corey, G. (2011). Theory and Practice of Counseling and Psychotherapy (9th ed.). Belmont, CA: Cengage Learning.
Halbur, D. A., & Halbur, K. V. (2015). Developing Your Theoretical Orientation in Counseling and Psychotherapy (3rd ed.). Hoboken, NJ: Pearson Education, Inc.

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