PSY6095WK10FINAL NGUYENA-1

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Week 10 Assignment: Psychotherapy Final 1 Week 10 Assignment: Psychotherapy Final Amanda Nguyen Capella University PSY6095 Theories of Counseling & Psychotherapy Dr. Zack Held, Ph.D September 15th, 2023

Week 10 Assignment: Psychotherapy Final 2 Abstract The project will investigate the implementation of two therapies that have been shown to help treat individuals with substance use disorders (SUD) and are supported by empirical data. This suggests thorough investigation and substantiating evidence regarding the efficacy of specific therapeutic modalities. The patient receives guidance from their therapist in cognitive-behavioral therapy on changing detrimental thoughts and behaviors, establishing new coping strategies, and so on. Using rational emotive behavioral therapy, relationships may be strengthened, decision-making skills may be reinforced to prevent relapse, and unhealthy choices can be substituted with healthier ones. In today's society, the issue of substance abuse has reached alarming proportions, affecting individuals from all walks of life. This formal exposition aims to shed light on the struggles faced by a 33-year-old Asian American client who has been traumatized by her father's infidelity, leading her down the treacherous path of substance abuse.

Week 10 Assignment: Psychotherapy Final 3 Client and Concern The client, an Asian American woman in her thirties, is locked in a cycle of substance abuse that has become a way to cope with the profound emotional pain caused by her father’s betrayal. As an Asian American woman growing up in a culture rooted in trust and stability, the client witnessed her mother’s silent suffering. She watched her father cheat on her, destroying the family’s trust in her. This traumatic experience triggered a chain reaction of emotional and mental struggles that drove her into a downward spiral of substance abuse. Like many Asian Americans who struggle with substance abuse, the client conceals her drug use from her friends and family until the consequences of her addiction become too severe (e.g., incarceration, hospitalizations, and homelessness) and intervention is forced upon her. She was receiving treatment because of a court order for her risky behaviors around others and herself. According to the S.A.H.S.A., only 3.3 percent of Asian Americans in need of substance addiction treatment receive treatment, which is significantly lower than the national average (more than three times the rate of Asian Americans in treatment compared to the general population) (Kaliszewski, 2022)—addressing the disparity in mental health treatment between eastern and western cultures. The client, in this instance, was an Asian American lady who expressed concern about the complicated cultural, familial, and social issues she encounters that increase her family's susceptibility to substance abuse and addiction. Asian American females may be discouraged from getting treatment for substance abuse due to cultural obstacles and cultural stigmas associated with mental health. To prevent and cure substance misuse in this community, addressing its underlying reasons and offering culturally sensitive aid is crucial.

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Week 10 Assignment: Psychotherapy Final 4 Treatment Cognitive-behavioral therapy (CBT) Both as a monotherapy and a component of combination treatment regimens, cognitive behavioral therapy (CBT) for drug use disorders has proven effective. The authors evaluate the research that supports the use of CBT and discuss its clinical applications, new therapy modalities for enhancing treatment response, and outreach initiatives. It includes various behavioral therapies, such as those that focus on motivating barriers to development, operant learning processes, and conventional varieties of other cognitive-behavioral interventions. A combination of these therapies or medications may be used to produce more significant results because they have all shown effectiveness in controlled studies. The authors also note that CBT for SUDs includes a range of interventions that place different emphasis on particular targets, and they review both individual and group therapies, including motivational interventions, contingency management techniques, and avoiding recurrence and related interventions with a focus on functional assessment. “To address motivational barriers to change, motivational enhancement techniques have been created and tested. Motivational Interviewing (MI) is an approach based on targeting ambivalence toward behavior change relative to drug and alcohol use, with subsequent application to motivation and adherence to a wide variety of other disorders and behaviors” (McHugh et al. 2010). During contingency management, Wedding & Corsini 2019 mentions, “methods that are based on the operant learning theory administer a non-drug reinforcer (such as vouchers for goods) after a demonstration of substance abstinence. According to McHugh et al. (2010), Relapse Prevention (RP) focuses on identifying and avoiding high-risk settings where a patient may be more prone to engage in drug use (e.g., favorite bars, friends that use). To assist the patient in making a better-informed decision in the hazardous

Week 10 Assignment: Psychotherapy Final 5 circumstance, RP techniques include addressing the patient's anticipation of the perceived benefits of usage. Cognitive-behavioral therapy (CBT) is a widely used evidence-based treatment approach for individuals struggling with substance abuse. In CBT, clients learn to identify and challenge unhelpful thoughts and behaviors contributing to their substance abuse. Through this process, clients develop more effective coping skills and better understand their triggers and vulnerabilities. CBT can also help clients improve their self-esteem, communication skills, and problem-solving abilities, translating into improved social and occupational functioning. As a therapist working with clients struggling with substance abuse, it is crucial to create a safe and non-judgmental environment where clients feel comfortable exploring their thoughts and feelings about their substance use. Through CBT techniques, such as cognitive restructuring, behavioral activation, and coping skills training, clients can develop a sense of agency and empowerment in their recovery journey. Additionally, it is essential to recognize that recovery is a process, and setbacks are a normal part of that process. With continued support and guidance, clients can learn to navigate these setbacks and develop resilience in their recovery. Research has shown that CBT can dramatically enhance treatment success for people seeking substance misuse treatment. CBT was linked to a considerable decline in drug and alcohol use among people with substance use disorders, according to research by Magill and Ray (2009). Comparing those who got CBT to those who received other or no therapy, the study indicated that those receiving CBT had a higher possibility of reaching and maintaining sobriety. CBT has also been demonstrated to help lower the anxiety and depressive symptoms that frequently co-occur with addiction. Overall, CBT presents a promising strategy for combating substance abuse and enhancing the lives of those who are addicted. The client can gain from this treatment since it will aid in her growth in coping mechanisms, emotional control, and self-efficacy. People need coping mechanisms to control urges and prevent relapse. Clients gain the ability to recognize triggers and create coping

Week 10 Assignment: Psychotherapy Final 6 mechanisms. CBT also encourages self-efficacy, or having faith in one's ability to succeed. Clients gain self-confidence in overcoming addiction and staying in recovery by developing their self-efficacy. Rational Emotive Behavior Therapy (REBT) Rational Emotive Behavior Therapy (REBT) is a form of cognitive-behavioral therapy adapted to treat substance abuse. REBT is based on the idea that people’s emotional and behavioral responses to events are primarily determined by their beliefs and attitudes about those events. REBT aims to help individuals identify and challenge self-defeating thoughts and replace them with more realistic and constructive ones. “Individuals can change their emotional and behavioral responses to events by changing their beliefs, leading to positive life changes” (Wedding & Corsini, 2019). In substance abuse, REBT is used to help individuals identify and challenge their beliefs and attitudes about drug and alcohol use. Many individuals with substance use disorders hold beliefs that support their drug or alcohol use, such as “I need drugs to cope with stress” or “I can’t have fun without alcohol.” REBT helps individuals to recognize the irrationality of these beliefs and to replace them with more rational and constructive ones, such as “I can cope with stress in healthy ways” or “I can have fun without alcohol.” Through this process, individuals can decrease their desire to use drugs or alcohol and increase their motivation to make positive life changes. "REBT can be used in various settings, including group, individual, and educational environments" (Buffo, 2023).To help you reach your objectives and improve your quality of life, REBT's ultimate goal is to establish and maintain cognitive, behavioral, and emotional functioning. Although it may also be a preventative measure, REBT responds to dysfunctional thinking patterns. More precisely, by promoting wholesome, sensible ideas, REBT may improve mood and mental health. It is essential for

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Week 10 Assignment: Psychotherapy Final 7 clients using REBT for the first time to comprehend the therapy's guiding principles and the therapist's part in the healing process. As a therapist, we take on the roles of educator and facilitator (Wedding & Corsini, 2019), helping the client recognize erroneous ideas and swap them out for healthy ones. The therapist also assists the client in learning coping mechanisms and coping skills for dealing with the pressures and triggers that might result in substance misuse. Therapy is often organized and goal-oriented, with the therapist and client working together to develop and achieve particular treatment goals. Overall, REBT is a promising strategy that can aid those battling substance abuse in long-term recovery. The therapist instructs the client to dispute, refute, and examine these irrational beliefs to reach a more reasonable conclusion if our fictitious client engages in REBT. Positive control over the drug is attained through repetition, experience, and reinforcement of this realistic concept of strongly liking but never requiring immediate comfort. Following the therapist's various behavioral suggestions to boost the chance of success, REBT training for the client includes instruction in rational-emotive imagery and coping mechanisms. These entail engaging in daily visualization practice by vividly envisioning either successfully repressing the need to use. REBT uses three primary strategies to justify a person's thinking. Therapists could urge clients to contest, appreciate their discoveries, and engage in acceptance exercises when guiding clients through REBT. A person would be asked to contest illogical ideas to contest negative thoughts. Training oneself to cling to particular upbeat thoughts is necessary to value findings (von Breton, n.d.) . Positive beliefs remind REBT participants that evil thoughts and behaviors directly result from giving in to them, not just something that happens. Although REBT acknowledges that everyone occasionally experiences illogical ideas, it maintains that

Week 10 Assignment: Psychotherapy Final 8 people can usually learn to suppress or gain control over these thoughts. Due diligence and practice are very important for this approach. Culture Sensitive Treatment It is considered that Asian Americans experience mental illness at similar rates as other Americans (Iwamasa, 2003). However, the presentation of psychological distress in Asian Americans appears to be influenced by various factors, including the kind of psychopathology, ethnicity, generational position, acculturation, and cultural background. Due to the enormous cultural diversity within the group, the many Asian cultures' views on mental health, and the importance placed on the relationship between the mind and body, it is crucial to comprehend Asian Americans' mental health problems. Interpersonal harmony and a priority on family affect how many Asian Americans experience, perceive, and express psychological suffering. These cultural beliefs impact the willingness to seek out professional psychiatric treatment. Low treatment use rates result from a combination of cultural norms, including shame and loss of face, and restricted access to culturally relevant therapies. Researchers in psychology have verified that those Asian-Americans. Mental health care providers should get training and education in culturally relevant treatment paradigms. Mental health care providers should be aware of the prevalence, symptoms, and therapies for Asian culture-bound illnesses. Conclusion The magnitude and cost associated with the substance abuse problem are already painfully known to most Americans. Many Americans consider these awful "lifestyle problems" — which they see as persistent as poverty and illiteracy — to have no real answers. However, Examining the now available research provides a far more upbeat prediction for our attempts to lessen these issues. Trauma may appear in many forms and have lasting effects on a person's

Week 10 Assignment: Psychotherapy Final 9 mind. In this instance, the client's trauma brought on by her father's adultery has resulted in emotions of abandonment, betrayal, and a distorted view of her value. She turned to narcotics, seeking consolation in their transient bliss to dull the agony and escape the haunting memories. But the momentary solace eventually became an addictive loop, worsening her already distressing emotional state. There has yet to be a single "most effective" therapy, and no single treatment is suitable for every patient seeking professional assistance for drug use. Instead, individualized, dynamic, and varied treatments for drug use disorders are typically the most successful. Effective therapy involves various evidence-based therapies and is modified to accommodate the patients' varied requirements and drug use problems. Behavioral treatments provided as individual therapy, group therapy, and family therapy are some of the most popular types of contemporary addiction treatment. Each person's experience with addiction is unique, making it crucial for treatment to be, too. Something doesn't always work for everyone just because it works for one person. Needs will alter over time, and treatment approaches should, too. While the path toward recovery may seem arduous, our client's journey toward healing and resilience offers hope. With the support of compassionate professionals, she can embark on a transformative process to address the underlying trauma and break free from the clutches of addiction. She can slowly reclaim her life and rewrite her narrative by engaging in therapeutic interventions focusing on rebuilding self-esteem, fostering healthy coping mechanisms, and establishing a support network. References Buffo, J. (2023, February 3). Rational Emotive Behavior Therapy (REBT) for Drug and Alcohol Addiction. DrugAbuse.com. https://drugabuse.com/treatment/therapy/rebt/

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Week 10 Assignment: Psychotherapy Final 10 Iwamasa, G. Y. (2003). Recommendations for the Treatment of Asian-American/Pacific Islander Populations. American Psychological Association. https://www.apa.org/pi/oema/resources/ethnicity-health/asian-american/psychological-tre atment Kaliszewski, M. (2022, September 14). Alcohol and Drug Abuse Among Asian Americans. American Addiction Centers. https://americanaddictioncenters.org/addiction-statistics/asian-americans McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. The Psychiatric clinics of North America, 33(3), 511–525. https://doi.org/10.1016/j.psc.2010.04.012 von Breton, J. (n.d.). Introduction to REBT. SMART Recovery. https://www.smartrecovery.org/smart-articles-draft/introduction-to-rebt/ Wedding, D., & Corsini, R. (Eds.). (2019). Current psychotherapies (11th ed.). Cengage. ISBN: 9781305865754

Week 10 Assignment: Psychotherapy Final 11 TRANSCRIPT Therapist: Good morning. How are you today? Client: I'm doing alright, thanks for asking. Therapist: Great. So, today, we'll be discussing your substance abuse disorder. I wanted to start by exploring your understanding of the condition. Client: Well, substance abuse disorder is a chronic condition characterized by the compulsive use of drugs or alcohol despite adverse consequences. Therapist: Yes, that's correct. It's important to note that substance abuse disorder is a complex condition that affects various aspects of an individual's life, including their physical, mental, and social well-being. Client: Right. And I also know there are different levels of severity when it comes to substance abuse disorder. Therapist: Absolutely. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) distinguishes between mild, moderate, and severe substance use disorders based on the number of diagnostic criteria an individual meets. Client: That makes sense. Therapist: You mentioned that you're seeking therapy to aid in your substance recovery. Have you heard of cognitive-behavioral treatment and rational emotive-behavior therapy? Client: Yes, I have heard of them, but I need to figure out how they differ regarding substance recovery. Therapist: That's certainly a valid question. Research has shown that therapy can effectively assist with substance use disorders. It provides a safe space for clients to work through their emotions and can help develop coping mechanisms.

Week 10 Assignment: Psychotherapy Final 12 Client: That makes sense. I've been struggling with addiction for a while, and I'm not sure I can do it alone. Therapist: That's a realistic perspective. Substance use disorder is a complicated condition, and receiving professional help, such as therapy, can significantly increase the chances of success. Have you considered any specific types of treatment? Client: I've heard of cognitive-behavioral therapy, but I don't know if that fits me. Therapist: Cognitive-behavioral therapy focuses on identifying and changing negative thought patterns and behaviors that may lead to substance use. It emphasizes the importance of changing how we think about things to change our behaviors. Rational emotive behavior therapy, on the other hand, focuses on irrational beliefs and how they may contribute to destructive behaviors such as substance abuse. It emphasizes the importance of challenging and changing these irrational beliefs to change behaviors. Client: I see. Which one would be more beneficial for me? Therapist: It depends on you. Let me expand more on both therapies, and next time we meet, we can perform a couple of tasks associated with the therapies. Is that okay? Client: I am more interested now. Therapist: Well, CBT is a type of therapy that focuses on changing negative thought patterns and behaviors through various techniques and exercises. It is an effective treatment option for substance use disorders. Client: That sounds interesting. How does it work? Therapist: Essentially, CBT helps individuals identify and challenge negative thoughts and beliefs that may be contributing to their substance use. It also allows individuals to develop coping skills and strategies to manage cravings and triggers. Client: What about REBT?

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Week 10 Assignment: Psychotherapy Final 13 Therapist: It is a form of cognitive-behavioral therapy that focuses on changing irrational beliefs and attitudes that lead to emotional distress and problematic behavior. It teaches individuals to identify and challenge irrational thoughts and replace them with more rational and healthy ones. Could this approach help you in your recovery? Client: I think it could be helpful. I’ve struggled with negative thoughts and emotions that have led me to use substances. So, learning how to change my irrational beliefs could help me stay sober. Therapist: That’s a good point. Some studies have shown that REBT can be effective as well. Client: Thanks for providing solid information about these two therapies. Therapist: You are very welcome. We are coming to the end of our session today. How do you feel about our discussion today?" Client: "I feel like we made some progress towards addressing some of my concerns. I appreciate your insights and suggestions." Therapist: "Great to hear. It's important to continue to build on the work we've started today. I'd like to schedule another session for next week. How does that work for you?" Client: "That works for me. Same time next week?" Therapist: "Yes, that works. Before we close out today, I want to remind you that our work together is confidential. I take confidentiality very seriously and want to ensure you understand that anything we discuss in our sessions remains confidential." Client: "Understood. Thank you for reminding me." Therapist: "Of course. Remember to practice those strategies and continue to reflect on your emotions between now and our next session. Is there anything else that you want to discuss? Client: No, I think that's all for now.

Week 10 Assignment: Psychotherapy Final 14

PSY6095WK10FINAL NGUYENA-1

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