Case Conceptualization: Malfractive Crisis Within Malladaptive Processs

Case Conceptualization Case conceptualization is typically initiated by the identification of the client’s problem. CBT’s view is that the problem lies within maladaptive cognitive processes (e.g. cognitive distortions and destructive, often times inaccurate, core beliefs) that lead to problematic behavioral outcomes. Once the problem has been identified, the etiology of the problem is explored. Within CBT the assumption is that learned cognitive constructs for which the client’s experiences are viewed through cause and maintain the results (e.g. anxiety, depression, etc.) of the client’s problems. Once this etiology has been mapped, appropriate CBT techniques and strategies can be selected and a therapeutic plan can be created. Case conceptualization …show more content…
For example, her fear and anxiety over relapsing was unrelated to fear of personal failure from relapse, but rather a fear of being rejected by her children should she fail. Furthermore, the client described a pattern of codependence with her mother, despite the negative ramifications of this unhealthy dynamic (e.g. using drugs for the first time with her mother who was in active addiction), which was rooted in her anxiety over her mother abandoning her should she displease her mother. This sociotropy could be traced to her childhood where her mother’s abandonment and rejection when Jane would disagree with her, increasingly consolidated her belief that she must disregard her own needs to meet the needs of others or face loneliness and isolation. Additionally, it became apparent that, in her development, Jane had learned to view her experiences through the cognitive distortions of arbitrary inference and mislabeling. I surmised that these cognitive distortions were developed and exacerbated by the sociotropy style of her core belief that the needs of other must always take precedent over her own and the behavior of self-interest will elicit social abandonment and …show more content…
The counselor’s interactions need to be intentional, focused and problem-oriented. The role of the counselor is that of a facilitator and guide. The counselor facilitates the client’s exploration into core beliefs, cognitive process and/or distortions and behavioral patterns. The counselor then guides the client in framing the conclusions they draw from this exploration into a hypothesis that can be tested and measured through goal establishment and goal follow through. At certain points in the process of CBT, the counselor’s role is that of a teacher (Freeman et al.,