Behavioral Interventions and CBT Case Studies

Part one: Behavioral Interventions

Instructions: This assignment is in three parts. For each part, you will respond to 2 case studies. All answers must be written in complete sentences.

Part one: Behavioral Interventions

Instructions: Choose 2 of the scenarios below. Answer the following questions for each scenario you choose:

1.Identify: Name one behavioral intervention that could be appropriate for this person.

2.Describe: Generally, describe the intervention you have chosen. (i.e., Is it based off classical conditioning, operant conditioning, or social learning theory? How does the intervention generally work?)

3.Apply: Apply the intervention to the case scenario. List steps you could take to carry out the intervention with that specific person and considerations you would have while working with that person.

Case 1: Due to some past trauma, a 43-year-old policeman had a firearm phobia that was getting in the way of his ability to respond to potentially dangerous situations. He has come to you for help with his phobia (Naud, Boisvert, & Lamontagne, 1973). 

Case 2: A family has come to you seeking help for their adolescent child with autism spectrum disorder. To support positive social relationships, the adolescent and their parents have the goal of teaching the adolescent to exchange a greeting (i.e., say “hello”) to unfamiliar people without being verbally prompted. The person already says hello to familiar people without prompting after making eye-contact (Jaffe, 2010).

Case 3: A client has come to you complaining of a significant nail-biting habit. The nail-biting is so significant they often are bleeding and in pain. They have tried talk-therapy but did not have success. They are looking for a behavioral intervention to help decrease this habit.

Case 4: A first-grade teacher has a rambunctious group of students this year! The students tend to be loud when it’s quiet work time, do not clean up in a timely manner after working on projects, and generally disrespect classroom rules. The teacher has called you and asked for ideas to help with classroom management.

Part Two: Cognitive-Behavioral Therapy (CBT)

Instructions: Choose 2 of the scenarios below. Answer the following questions for each scenario you choose:

4.Identify: 
a.List one possible core belief.
b.List one possible intermediate belief

5.Describe: Pick one situation from the example. 
a.Describe the situation.
b.State the automatic thought the person had in that situation and what cognitive distortion pattern that thought might fit.
c.Discuss subsequent feelings and behaviors that could be a result of that thought.

Part Two: Cognitive-Behavioral Therapy (CBT)

6.Apply: If you were to write a treatment plan,
a.What 2 CBT-related goals would you consider for that person? 
b.What are 2 possible strategies you might consider to help the person achieve those goals (e.g., behavioral activation, thought record, downward arrow technique, role playing, identifying cognitive distortions, myths about emotions, etc.)?

Notes: 
You will not have a lot of information for the beliefs so don’t over think 1a and 1b. Simply read the examples and brainstorm possible core and intermediate beliefs. 
You may not use a strategy (for part 3b) more than once. 

Case 1: Yuxin is a 68-year-old woman who has come to you because of her low mood and low energy. She reports feeling depressed and worthless. She provides daycare for her granddaughter and fears she is too old to do a good job taking care of a young child. She described being at the park this past week. She reported crying when she drove home because she noticed other children and the park with young caregivers and nannies. She felt out of breath when playing with her grandchild and described thinking, “Because I am out of breath, I am not capable of taking care of my grandchild!” Since that moment, Yuxin has felt down, a loss of motivation, and hasn’t left the couch unless she absolutely needs to. 

Case 2: Sam (pronouns they/them) is a recent college graduate who has started their first full-time job. They met two other new employees on their first day. Sam couldn’t help but notice how well-dressed the other new employers appeared. They saw the resumes of their peers and noticed their new colleague’s college GPAs were above a 3.7. Sam felt embarrassed that their GPA was only a 3.5. They thought, “I must have been hired because there were not many other applicants.” Sam believed they were inferior to the others and felt very nervous. They went home after their first day and considered quitting their job to avoid the inevitable embarrassment of not being a good employee.

Case 3: Jon is a 40-year-old cisgender male who is married with two children (ages 13 and 15). He has come to you for help with his anger. He reports that even though he often says his opinions at home, his spouse and children do not seem to listen or understand him. He said he feels that he is often disrespected. He described an event last week when he asked for help bringing groceries in from the car, and no one in the family helped him. He reported thinking to himself, “No one ever listens to me!” He slammed the door and yelled at his family after unloading the groceries all by himself. 

Part Three: Third Wave Theories

Case 4: Amy is a 17-year-old cisgender female whose best friend is very mad at her. Amy reported that she held hands with a potential dating partner a couple weeks ago at a football game but didn’t know her friend also liked that person. When Amy discovered that she made her friend upset she thought, “I am a horrible friend.” Amy feels she should have known that her best friend also liked this potential dating partner! She tells you she is very afraid of talking to her best friend for fear that her friend will stop being friends with her forever. Amy has been avoiding this best friend at all costs so that her best friend cannot end their relationship. As time has gone by, Amy’s best friend seems to be getting even angrier with Amy. 

Case 5: Saul recently developed a fear of public speaking. He is a 26-year-old male whose job is to train others how two use dangerous equipment in a warehouse. He reported that he often thinks to himself while presenting, “Everyone thinks I’m a boring presenter.” Anytime someone checks their watch or yawns, Saul feels certain they dislike his teaching style. He described this new fear of speaking in front of others has made him feel unmotivated to go to work. 

Part Three: Third Wave Theories

Instructions: Choose 2 of the scenarios below. Answer the following questions for each scenario you choose:

7.Identify: List one third wave theory that we covered this semester that you believe would be an applicable fit for the case.

8.Describe: Generally describe the basic components of the third wave theory you have identified. (Do not yet apply it to the case.)

9.Apply: Identify one intervention or psychoeducational concept that you believe would be a good place to start if you were to work with the person in the case example.  

a.The intervention or psychoeducational concept must be from the third wave theory you have identified in part 1. 
b.Articulate why you believe that intervention could be an appropriate place to start their treatment.

Notes: 
The theories you may use must be what we covered this semester: Positive Psychology, Dialectical-Behavior Therapy (DBT), and Acceptance & Commitment Therapy (ACT).

You may not use a specific intervention or psychoeducational concept (for part 3a) more than once. 

Case 1: Lainie (she/her) has come to counseling reporting that she feels emotionally detached to nearly everyone around her. She reports that, over the past couple months, she has had moments where she realizes the emotional emptiness she feels. The emotional distance worries her to the point where she analyzes her thoughts and feelings pervasively until she feels nauseous. Once she feels physically ill, she describes intense physical anger and sadness. She admits that she has recently broken objects as a result of her emotional bursts. She describes that after a fit of emotion, she goes about a week feeling empty and detached from others. 

Case 2: Sam (he/him) is a 17-year-old make raised by a single mother. He reports feeling a lack of purpose in life since age 9. Sam has never had significant friendships and describes feeling sad or numb most of his life. He reports staying in his room as much as he can where he plays online video games for at least seven hours a day. He describes feeling hopelessness and self-doubt.

Case 3: Daisy (they/them) is seeking treatment for a fear of vomiting (emetophobia) and general anxiety. They are 18 years old and will soon be graduating high school. They report feeling ambiguous physical sensations, such as stomach pains or nausea, which prompts feelings of panic due to the fear of vomiting. Daisy reports frequently seeking reassurance from others about whether or the symptoms mean vomiting may occur, even waking their parents up in the middle of the night to talk about the symptoms. The reassurance-seeking is reportedly harming their relationships.

Case 4: George (he/him) is in his early thirties and is bisexual. He has referred himself to treatment for what he describes as an “identity crisis” with challenging relationships. He describes feeling his emotions are a roller-coaster, switching between empty inside and intense fear, anger, or sadness. He cites challenges accepting himself for who he is. He says he often misreads others and is prone to yelling or swearing at people. He says he especially over-reacts if they say or do things that make him feel like they are going to no longer be friends with him. He reports that it takes him a long time to calm down once he is upset. He says he doesn’t have a good sense of self, which makes it hard for him to connect with others.

Case 5: Felica (she/her) is a 20-year-old college student who has come to you for help. She says she feels anxiety almost all the time. She speaks quickly as she tells you she is uncertain about what major to choose, is unsatisfied with her withdrawn parents, and describes having what she calls an “overly-active” mind. She sits up straight in her chair and appears tense as she speaks. She outlines with detail the three different majors she is considering and gives an exhaustive description of all the things she needs to do in order to graduate. She tells you about her fears after college, that she is not sure if she will get a good job, find a dating partner, or locate an affordable place to live.