Sometimes, faulty thought and behavior patterns cause psychological problems. To uncover the cause of the problems, some psychologists use cognitive and behavioral assessments. We'll look closer at those types of assessments and how they are used.
Cognitive Behavioral Therapy
Vincent has a problem. His wife recently left him for another man. He's feeling angry and depressed and isn't sure what to do about it. At his best friend's urging, he's gone to see a therapist.
Imagine that you are Vincent's psychologist. How should you treat Vincent? How do you help him move beyond the pain and anger of his wife's desertion?
There are many ways to approach mental health problems. One approach is cognitive behavioral therapy, or CBT for short, which says that by changing a person's thoughts and behaviors, you can change their feelings as well.
At the heart of CBT is the belief that many psychological disorders are caused by unhealthy thoughts and behavior patterns. For example, perhaps Vincent is having a hard time moving on because he keeps coming back to destructive thoughts, like, 'I was a bad husband,' and 'I'll never find another woman as good as her.' If you can get Vincent to stop thinking these things, you could help him move on.
But, before you can treat Vincent's thoughts and behaviors, you have to know what his thoughts and behaviors are. Cognitive behavioral assessments seek to understand what problems plague a patient and what underlying thoughts or behaviors might be causing or worsening the problems.
Often, cognitive behavioral assessments are done in a combination of forms. Worksheets that ask clients to rate their thoughts, feelings, and behaviors are often the first step of a cognitive behavioral assessment. Afterwards, the mental health professional might ask the patient questions to help them get a larger picture of their behaviors and thought patterns.
The Five Areas Model
It seems pretty simple. Vincent's wife left him; he thinks it's his fault; and he's depressed. That's a pretty straightforward view of Vincent's problems. But, in real life, there are many different elements that go into a person's problems, and people are often very complicated.
In order to assess and treat patients' problems, cognitive behavioral therapists often look at five areas of a person's situation. The five areas are:
1. Life situation. This includes the patient's relationships and practical problems. For example, Vincent's wife has left him for another man. That is his life situation.
2. Altered thinking. How has the life situation changed the way the patient thinks? Vincent's thoughts about it being his fault and never finding another woman are thoughts that have been informed by his life situation. If his wife hadn't left him, he wouldn't be having those thoughts.
3. Altered emotions. How has the life situation changed the way the patient feels? Vincent is feeling depressed and angry. Again, these are a product of the life situation (the fact that his wife has left him).
4. Altered physical symptoms. How has the life situation changed the way the patient physically feels? For example, is Vincent feeling more tired than he used to? Is he sleeping for many more hours every night? Or, is the opposite true? Is he having trouble sleeping? These are physical symptoms that can be traced back to the life situation of his wife's desertion.
5. Altered behaviors. How has the situation changed the way the person acts? Maybe because he is having trouble sleeping, Vincent begins drinking a lot of alcohol at night. Maybe he's started avoiding his family and friends because he feels depressed and angry. Maybe he's sleeping around to deal with his emotions and to blank out the thought that he might never find another woman. All of these are examples of altered behaviors.
Note that the life situation is the underlying cause of the other four areas of life, but that the other four can also directly affect one another. For example, Vincent's thought that he might never find another woman could cause him to feel depressed. His sleeping patterns might cause him to drink more alcohol. Any of the five areas can affect a person's thoughts, emotions, physical symptoms, and behaviors. As a result, a comprehensive cognitive behavioral assessment will look at all five of these areas.
Benefits and Limitations
There are many benefits to cognitive behavioral assessment. First of all, it allows the psychologist to get a good idea of how the patient is thinking, feeling, and behaving in his life. Vincent's wife leaving him is just a fact; there are a number of ways that he could react to that situation. Cognitive behavioral assessment lets the psychologist see how Vincent actually is reacting to his wife's desertion.
Remember that clients are usually asked to fill out a detailed questionnaire first, and then the therapist can ask questions to dig more deeply into thoughts and feelings. By approaching patients with this two-step process, a psychologist can get a quick overview from the questionnaire and then ask questions that are pertinent to the client's issues.
However, even with these benefits, cognitive behavioral assessments don't work for everyone. They ignore the neurological and biological elements of some mental illnesses. For example, depression can be caused by a chemical imbalance in some patients. A cognitive behavioral assessment will not show a mental health professional whether or not that chemical imbalance is present.
Another problem with cognitive behavioral assessments is that they depend upon client honesty. But, what if Vincent is ashamed that he's feeling depressed, so he doesn't talk about that? If a client is less than completely honest, the therapist might not have a good picture of their needs and the best way to help them.
Cognitive behavioral assessments are questionnaires and in-person conversations meant to give a therapist an understanding of the thoughts, behaviors, and feelings of a client. They are used in the early stages of cognitive behavioral therapy, which looks at five areas of a patient's life: life situation, altered thinking, altered emotions, altered physical symptoms, and altered behaviors. There are both advantages and disadvantages of cognitive behavioral assessments.
After you've completed this lesson, you'll be able to:
- Explain how cognitive behavioral assessments and cognitive behavioral therapy are used
- List five areas of a patient's life that cognitive behavioral psychologists look at
- Describe how these five areas are intertwined and can affect the other areas