Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.

Posted: December 5th, 2022

Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.

Week 5: Solution-Focused and Cognitive Behavioral Family Therapy
When solution-focused and cognitive behavioral family therapy proved effective with individuals, therapists began applying these approaches to families. However, it quickly became evident that the translation of these approaches from individuals to families was more difficult than expected. Consider how you can successfully apply these therapies to your client families. Is one approach more effective than the other? What are the challenges of using these therapeutic approaches with families?
This week, as you continue exploring therapeutic approaches and their appropriateness for client families, you examine solution-focused and cognitive behavioral therapy. You also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.

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Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
• Standard 5F “Milieu Therapy” (pages 60-61)
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
• Chapter 12, “Family Therapy” (Review pp. 429–468.)
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.
• Chapter 10, “Cognitive-Behavior Family Therapy” (pp. 166–189)
• Chapter 12, “Solution-Focused Therapy” (pp. 225–242)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Bond, C., Woods, K., Humphrey, N., Symes, W., & Green, L. (2013). Practitioner review: The effectiveness of solution focused brief therapy with children and families: A systematic and critical evaluation of the literature from 1990–2010. Journal of Child Psychology & Psychiatry, 54(7), 707–723. doi:10.1111/jcpp.12058
Note: Retrieved from Walden Library databases.
Conoley, C., Graham, J., Neu, T., Craig, M., O’Pry, A., Cardin, S., & … Parker, R. (2003). Solution-focused family therapy with three aggressive and oppositional-acting children: An N=1 empirical study. Family Process, 42(3), 361–374. doi:10.1111/j.1545-5300.2003.00361.x
Note: Retrieved from Walden Library databases.
de Castro, S., & Guterman, J. (2008). Solution-focused therapy for families coping with suicide. Journal of Marital & Family Therapy, 34(1), 93–106. doi:10.111/j.1752-0606.2008.00055.x
Note: Retrieved from Walden Library databases.
Patterson, T. (2014). A cognitive behavioral systems approach to family therapy. Journal of Family Psychotherapy, 25(2), 132–144. doi:10.1080/08975353.2014.910023
Note: Retrieved from Walden Library databases.
Perry, A. (2014). Cognitive behavioral therapy with couples and families. Sexual & Relationship Therapy, 29(3), 366–367. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy. doi:10.1080/14681994.2014.909024
Note: Retrieved from Walden Library databases.
Ramisch, J., McVicker, M., & Sahin, Z. (2009). Helping low-conflict divorced parents establish appropriate boundaries using a variation of the miracle question: An integration of solution-focused therapy and structural family therapy. Journal of Divorce & Remarriage, 50(7), 481–495. doi:10.1080/10502550902970587
Note: Retrieved from Walden Library databases.
Washington, K. T., Wittenberg-Lyles, E., Oliver, D. P., Baldwin, P. K., Tappana, J., Wright, J. H., & Demiris, G. (2014). Rethinking family caregiving: Tailoring cognitive-behavioral therapies to the hospice experience. Health & Social Work, 39(4), 244–250. doi:10.1093/hsw/hlu031
Note: Retrieved from Walden Library databases. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.

Document: Group Therapy Progress Note

Required Media
Laureate Education (Producer). (2013c). Johnson family session 3 [Video file]. Author: Baltimore, MD.

Note: The approximate length of this media piece is 5 minutes.

Accessible player
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Discussion: Cognitive Behavioral Therapy: Family Settings Versus Individual Settings
Whether used with individuals or families, the goal of cognitive behavioral therapy (CBT) is to modify client behavior. Although CBT for families is similar to CBT for individuals, there are significant differences in their applications. As you develop treatment plans, it is important that you recognize these differences and how they may impact your therapeutic approach with families. For this Discussion, as you compare the use of CBT for families and individuals, consider challenges of applying this therapeutic approach to your own client families.
Learning Objectives. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.
Students will:
• Compare the use of cognitive behavioral therapy for families to cognitive behavioral therapy for individuals
• Analyze challenges of using cognitive behavioral therapy for families
• Recommend effective cognitive behavioral therapy strategies for families
To prepare:
• Review the media, Johnson Family Session 3, in this week’s Learning Resources and consider the insights provided on CBT in family therapy.
• Reflect on your practicum experiences with CBT in family and individual settings.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post an explanation of how the use of CBT in families compares to CBT in individual settings. Provide specific examples from your own practicum experiences. Then, explain challenges counselors might encounter when using CBT in the family setting. Support your position with specific examples from this week’s media.
Read a selection of your colleagues’ responses. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.
By Day 6
Respond to at least two of your colleagues by recommending CBT strategies to overcome the challenges your colleagues have identified. Support your recommendations with evidence-based literature and/or your own experiences with clients. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.
Submission and Grading Information
Grading Criteria

To access your rubric:
Week 5 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:
Week 5 Discussion

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Assignment 1: Practicum – Week 5 Journal Entry
Learning Objectives
Students will:
• Develop effective documentation skills for family therapy sessions *
• Develop diagnoses for clients receiving family psychotherapy *
• Evaluate the efficacy of solution-focused therapy and cognitive behavioral therapy for families *
• Analyze legal and ethical implications of counseling clients with psychiatric disorders *
* The Assignment related to this Learning Objective is introduced this week and submitted in Week 7.
Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session. Do not select the same family you selected for Week 2. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.
Then, address in your Practicum Journal the following:
• Using the Group Therapy Progress Note in this week’s Learning Resources, document the family session.
• Describe each client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
• Using the DSM-5, explain and justify your diagnosis for each client.
• Explain whether solution-focused or cognitive behavioral therapy would be more effective with this family. Include expected outcomes based on these therapeutic approaches.
• Explain any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.

Rubric Detail

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Name: NURS_6650_Week7_Assignment3_Rubric
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Satisfactory Unsatisfactory
Quality of Work Submitted:

The extent of which work meets the assignned criteria and work reflects graduate level critical and analytic thinking.
26 (26%) – 30 (30%)
Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.
0 (0%) – 25 (25%)
Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.
Quality of Work Submitted: Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.

The purpose of the paper is clear.
4 (4%) – 5 (5%)
Purpose of the assignment is stated, yet is brief and not descriptive.
0 (0%) – 3 (3%)
No purpose statement was provided.
Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Understand and interpret the assignment’s key concepts.
8 (8%) – 10 (10%)
Demonstrates a clear understanding of key concepts.
0 (0%) – 7 (7%)
Shows a lack of understanding of key concepts, deviates from topics.
Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources.
16 (16%) – 20 (20%)
Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view.
0 (0%) – 15 (15%)
Includes and integrates specific information from 0 to 1 resoruce to support major points and point of view.
Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to: Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.

Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.
16 (16%) – 20 (20%)
Summarizes information gleaned from sources to support major points, but does not synthesize.
0 (0%) – 15 (15%)
Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.
Written Expression and Formatting

Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.
4 (4%) – 5 (5%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time.
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time.
Written Expression and Formatting

English writing standards: Correct grammar, mechanics, and proper punctuation
3 (3%) – 5 (5%)
Contains a few (1-2) grammar, spelling, and punctuation errors.
0 (0%) – 2 (2%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting

The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.
3 (3%) – 5 (5%)
Contains a few (1-2) APA format errors.
0 (0%) – 2 (2%)
Contains many (≥ 5) APA format errors.
Total Points: 100
Name: NURS_6650_Week7_Assignment3_Rubric

Description of clients I observed during a family therapy session
George (client A), a six-year-old boy was accompanied by his mother who was mainly concerned about his son’s worries and emotional dysregulation. George’s anxieties included being in social situations that could make others scrutinize him and getting lost. Worries happened nearly every day and seemed somehow uncontrollable. At school, George’s negative emotionality could intensify into tantrums of yelling and banging his head against the wall. Symptoms initially appeared when he was four years. Physical symptoms that occurred during George’s periods of anxiety included irritability, difficulty concentrating, feeling on edge and feeling restless. George was not under any medication.
Ivy (Client B),a eight-year-old girl isaccompanied to therapysession by her mother who stated that during the past three weeks, Ivy has declined to attend school and has missed five school days. He does not sleep almost the whole night and worries about leaving her mother when going to school. As school day nears, she cries and yells that she cannot go, while pulling his hair and punching the wall. She frequently experiences stomachaches, vomiting, and headaches. She has become gloomy, stopped reading storybooks and is regularly worried about her mother’s hypertension. The client was not under any medication. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.
Diagnosis for each client using the DSM-5
Client A is suffering from generalized anxiety disorder (GAD). GAD is marked by impractical excessive and persistence worries about everyday events. The worry is excessive, hard to control and is usually accompanied by several non-specific physical and psychological symptoms. AS Campton et al (2019) indicate, diagnostic criteria in DSM-5 include excessive worry and anxiety for a period of at least six months and problematic controlling the anxiety.The worry is linked with at least three of the following symptoms: feeling on edge or restlessness, feeling exhausted, irritability, difficulty sleeping, difficulty concentrating and muscle stiffness. The worry leads in a considerableimpairment or distress in academic or social areas. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.
Client B is suffering from separation anxiety disorder (SAD). The defining symptoms of SAD are excessive anxiety or worry regarding the separation from attachment figures or home. The anxiety or fear exceeds what is anticipated of a child given her level of development. According to DSM-5, a child with SAD experiences not less than three of the following clinical features: feelings of excess distress when expecting or undergoing separation from attachment figures ( such as a caregiver or parent) or home, extreme and insistent worry about probable harm happening to attachment figure, refusal to leave home, including refusal to go to school and physical complaints, such as stomachaches, headaches and vomiting when detached from attachment figures (Campton et al, 2019). Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.
An explanation of whether solution-focused or cognitive behavioral therapy would be more effective with the family
Solution-Focused family therapy involves therapists emphasizing collaboration with members of the family in constructingsolution-oriented possibilities. According to Chan et al (2015), therapy is to help family members to understand what they desire to change and in the selection of a goal that will meet particular conditions. Precisely, Solution-focused family therapy strives to assist the family to work on a realistic, concrete and achievable goal in a certain time frame.
Cognitive behavioral therapyfocuses on the interactions between emotions, behaviors, and cognitions and assists patients to identify and adjust thoughts that provoke anxiety and to alter avoidance patterns. Cognitive behavioral family therapy (CBFT) treats clients to comprehend themselves and family dynamics in ways that will promote behavioral changes, and more family joy (Elzouki, et al, 2015).
CBFT is the most effective psychotherapy for the family asit emphasizes the significance of both behavioral and cognitive traits patients and family members. CBFT willinvolve the inpsychoeducation, cognitive coping strategies, exposure to feared stimuli and relaxation techniques to assistthe clients to change their cognitions and behaviors. As indicated Creswell et al (2016), in CBFT is a joint treatment approach in which parents and family membersare supported to develop confidence and skills to assist patients to overcome their struggles with anxiety. Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.
Ethical implications related to counseling each client
There are several ethical concerns that psychotherapists must consider when counseling children and their families. It is usually the parent who takes the childfor treatment and counseling, instead of the child seeking counseling themselves. Therefore, when getting informed consent from the parent, it is equally crucial for the counselor to get consent from the clients Sori and Hecker (2015) allege that children should be offered the opportunity to comprehend the counseling services being provided and their benefits. When obtaining informed consent, a situation might arise when one party offers their approval, but the other declines.
It is crucial for a counselor to maintain confidentiality and the type of information to be disclosed when starting a counseling relationship. When counseling both clients, it is crucial to consider how and what information is shared with associated parties. Documentation of the counseling sessions is another facet of confidentiality. The counselor should consider individuals who can access the documentation, how it is safeguarded and the way to respond when requested for documentation by family members (Sori & Hecker, 2015). Week 5: Solution-Focused and Cognitive Behavioral Family Therapy.