How effective is cognitive behavioural therapy in treating stress-related disorders - Free Essay Example

Sample details Pages: 8 Words: 2549 Downloads: 5 Date added: 2017/06/26 Category Psychology Essay Type Argumentative essay Did you like this example? Introduction Individuals respond to stressful events in different ways and their responses are influenced by a number of factors, such as personality characteristics or temperament, that can have an effect on the how the stressor is perceived (Anthony, Frederici, and Stein, 2009). Anxiety and stress are closely related, although stress tends to relate to a specific event or circumstances, whereas anxiety can be a non-specific, internal anticipation of something that might happen (Kahn, 2006). However, anxiety can cause stress for example, imagining the consequences of being late (anticipation). Don’t waste time! Our writers will create an original "How effective is cognitive behavioural therapy in treating stress-related disorders?" essay for you Create order Anxiety disorders are very common and can be debilitating and chronic, with patients experiencing distress over many years. It is suggested that anxiety is multifaceted and may be caused by biological factors for example, high levels of serotonin, which is also a factor in depression. Another contributing cause to anxiety appears to be hyperactivity in the amygdala region of the brain, which results in high levels of neuroticism and anxiety. People who have a tendency towards neuroticism, for example, are more likely to experience anxiety disorders and negative emotions in response to stressors (Eysenck, 1967; Gray 1982). Psychological treatments and interventions focus on cognitive processes and behavioural responses that attempt to explain the acquisition and continuation of anxiety disorders (Anthony, et al. 2009). The aim of the following essay is to examine the efficacy of CBT interventions on treating anxiety and stress-related disorders. Anxiety Disorders The Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V) classifies anxiety disorders into three main groups: anxiety disorders, obsessive compulsive disorders (OCD), and trauma and stress related disorders (American Psychiatric Association, APA, 2013). Anxiety disordersinclude separation anxiety disorder, phobias, social phobia, panic disorder, agoraphobia, and generalised anxiety disorder. Obsessive-compulsive disordersincludes hoarding disorder, while the third group, trauma and stressor-related disorders,includes post-traumatic stress disorder (PTSD) and acute stress disorder (DSM-V, APA, 2013). The DSM-V classifications of anxiety emphasise the relationship between disorders and therefore the possibility of comorbidity between anxiety, stress and depression (APA, 2013). Cognitive Behavioural Therapy (CBT) As will be discussed in the following section, many of the stress and anxiety related conditions listed in the DSM-V category of anxiety disorders can be treated using cognitive behaviour therapy (CBT). CBT aims to change negative and maladaptive thought patterns and behaviours to more positive ways of dealing with stress-related problems. Therapy is non-directive and a therapist will facilitate change through working with the client or patient to achieve a series of goals. The therapist will also challenge the clients negative beliefs and help the client develop strategies to manage their stress more effectively in the long term in order to prevent any relapses (Beck, 2011). Exposure-based CBT (Torp et al. 2015) has also been reported to be effective with young people and children. As discussed by Beck (2011) the relationship between the therapist and the patient is central to the success of the intervention, as it is necessary to have a rapport in order to sometimes discuss di fficult topics. The Efficacy of CBT in Stress-Related Disorders In their meta-analyses of 269 studies that used CBT in studies, including anxiety disorders and general stress, Hoffman, Asnaani, Vonk, Sawyer and Fang (2012) found that the most effective results were for anxiety disorders and general stress (together with bulimia, somatoform disorders and anger control). A study comparing 65 patients with generalised anxiety disorder (GAD), who were randomly allocated to one of three groups CBT, relaxation techniques, and a control group of patients on the waiting list was undertaken by Dugas et al. (2010). The follow-up sessions took place 6-, 12- and 24-months after the intervention and consisted of self-report and clinician ratings. It was found that both CBT and relaxation were more effective than the control group, although long-term improvement continued only with CBT (Dugas et al. 2010). Other research has also found that CBT has been effective in generalised anxiety for example, Otte (2011) states that a number of studies have demon strated that CBT is effective for patients with anxiety conditions and states the efficacy and effectiveness of CBT in anxiety in adults appears to be well established (Otte, 2011, p.418). However, despite the positive findings, Otto also states that there are there are various methodological problems in many studies, for example studies that do not include a control group, and therefore the effect size of the intervention is more difficult to assess. CBT has also be found to be effective in anxiety disorders in children, although as Hogendoorn et al. (2014) reports there are children who do not respond and therefore greater research is necessary in order to understand the mechanism that allows some children to respond well, while other children do not. In a study that investigated childhood anxiety and depression using CBT intervention it was found that there were more positive effects for anxiety than for depression in terms of behaviour and coping strategies used by the children (Chu and Harrison, 2007). It was concluded that there are different factors involved when using CBT in the treatment of anxiety and/or depression. According to Leichsenring et al. (2013) social anxiety is a prevalent disorder that can cause severe psychosocial problems and can co-exist with other disorders such as depression. Social anxiety is characterised by an individual having a fear of social interactions and therefore affects a person ability to work and have a good quality of life (Yoshinaga et al. 2013). There have been a number of reports regarding the efficacy of CBT in treating social anxiety, although many studies have small sample sizes and are conducted in one location. In their study Leichsenring et al. (2013) assessed 495 outpatients who were randomly allocated to either CBT intervention, (n=209), psychodynamic therapy (n=207), or a waitlist control group (n=79). The patients baseline and post-treatment scores were compared using the Liebowitz Social Anxiety Scale (Liebowitz, 1987). It was found that both CBT and psychodynamic therapy were effective in treating social anxiety. Yoshinaga et al. (2013) also evaluated CBT and social anxiety in Japan using the Liebowitz Social Anxiety Scale (Liebowitz, 1987). The aim of the study was to assess whether results in Japan would be similar to those in Western countries. The intervention was over a 14 week period and measurements of social anxiety were taken before during and after the intervention. It was found that CBT was effective although there were a number of limitations in the study. The sample size was very small, with only 15 patients, which limits the generalisability of the study to other patients, particularly as it was a single-centre study. Another limitation was that the participants were mainly females, which again can limit generalisability of the findings to male patients. There was also no long-term follow-up, so the effects of CBT in preventing relapse were not assessed. Furthe rmore many patients were also taking medication which was not controlled for and may have had an effect on the results. Another stress-related condition which can cause serious impairment is OCD. The condition in adolescents and children is similar to that of adults, and OCD often begins in childhood (Torp et al. 2015). In a study undertaken in Denmark, Sweden and Norway, patients aged between 7- and 17-years diagnosed with OCD received CBT intervention in a community setting over 14 weeks. The study was an uncontrolled trial, which meant all patients received exposure CBT and were assessed using the Children Yale-Brown Obsessive Compulsive Scale (Scahill, et al. 1997), which both children and their parents completed, as well as other measures. The children had a range of behavioural and emotional problems and the study involved therapists and health professionals who evaluated the intervention. A strength of the study was that it was undertaken in different centres in three coun tries, which means it has good generalisability. The number of participants was also relatively high, which was also a strength of the study. The professionals helped the children and their parents complete the treatment and the findings showed a high success rate which was rated independently. It was concluded by Torp et al. (2015) that exposure-based CBT is an effective treatment for OCD in community children and adolescent outpatient clinics. The severity of the symptoms decreased in the patients and some were described as being in remission. However, there were a few limitations in the study for example, the group was not ethnically diverse and the trials were not randomised (Torp et al. 2015). A final area where CBT has been found to be effective in stress-related disorders is PTSD, which is a disorder which can occur after an individual has experienced a major traumatic event. Typical symptoms include re-living the event, recurring thought of the event, avoidance, numbing and detachment and estrangement from family and other people. In looking at the efficacy of CBT in treating PTSD, Bisson and Andrew (2007) undertook a systematic review of research in which patients had been evaluated by clinicians for traumatic stress symptoms as well as self-rating by the patient of stress, anxiety and depression. Treatment included Trauma focused CBT (TFCBT), exposure therapy, stress management which included hypnotherapy and group CBT and eye movement desensitisation and reprocessing (EMDR) and a waitlist control group with no intervention. The findings showed that TFCBT, EMDR and group CBT were all effective in treating PTSD. In the long-term TFCBT and EMDR were found to be more effective, although some of the studies were found to have methodological flaws which means the data must be interpreted with caution. After the attack on the Twin Towers in New York, the CATS consortium was established to help deal with the trauma experienced by young people and als o to assess the outcomes of the intervention using CBT. The CATS Consortium (2010) report on the efficacy of CBT being used with children and adolescents aged between 5- and 21-years who were traumatised after the attack. The young people (n=306) were allocated to one of two groups depending on the severity of their trauma. The first group involved trauma-specific CBT and the second group, brief CBT. The findings showed that for both groups there was a decrease in their symptoms and they were no longer diagnosed as having PTSD, and it was also found that the therapy could be effectively delivered in the community by trained professionals. The limitations of the study were that the design did not conform to a typical randomised controlled study and a control group was not used. The circumstances around the study were chaotic in the days after the attack and, as the authors state, the children may have improved without any treatment or intervention, which is, of course, the purpose of a controlled group. Nonetheless, the study has provided useful information regarding the use of CBT for young people after a traumatic event. Conclusion Overall, the evidence presented demonstrates that CBT is an effective intervention in a number of different stress-related conditions identified by the DSM-V (APA, 2013). Meta-analyses and systematic reviews are able to provide robust evidence regarding the effectiveness of interventions using CBT, although, as has been discussed, there are a number of methodological issues with some of the studies used in meta-analyses. Some of the limitations include small sample sizes, for example, which means that generalisation to other groups is not possible. Another limitation is the lack of a control group, where, as discussed by CATS Consortium (2010), the patients who were traumatised after the attack on the Twin Towers in New York may have recovered spontaneously over time without any intervention, and this can only be observed in a control group which has no intervention. Another potential issue is the use of different measures such as self-report and clinicians measures (Dugas et al. 2 010), in comparison to other studies which used validated questionnaires such as Liebowitz Social Anxiety Scale (Leichsenring et al. 2013). This means that comparisons between studies are more difficult. However research using CBT has taken place in a number of different contexts and cultures for example, Norway, Sweden and Denmark (Torp et al. 2015) and also Japan (Yoshinaga, et al. 2013) and has been shown to be effective. References American Psychiatric Association, (APA, 2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-V, fifth edition). Washington, DC: American Psychiatric Association. Anthony, M.M., Frederici, A. and Stein, M.B. (2009). Overview and introduction to anxiety disorders. In M.M. Anthony and M.B. Stein (Eds) Oxford Handbook of Anxiety and Related Disorders, pp. 3-18. Oxford: Oxford University Press. Beck, J.S. (2011). Cognitive Behaviour Therapy: Basics and Beyond. New York: Guildford Press. Bisson, J, and Andrew, M. (2007). Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews, 3, Art. No.: CD003388. CATS Consortium (2010). Implementation of CBT for youth affected by the world Trade Center disaster: matching need to treatment intensity and reducing trauma symptoms. Journal of Traumatic Stress, 23(6), 699-707 Chu, B.C. and Harrison, T.L. (2007). Disorder-specific effects of CBT for anxious and depressed youth: a meta-analysis of candidate mediators of change. Clinical Child and Family Psychology Review, 10, 352-372 Dugas, M.J., Brillion, P., Savard, P., Turcotte, J., Gaudet, A., Ladouceur, R., Leblanc, R. and Gervais, N.J. (2010). A randomized clinical trial of cognitive-behavioural therapy and applied relaxation for adults with generalized anxiety disorder. Behavior Therapy, 41(1), 46-58. Eysenck, H.J. (1967). The Biological Basis of Personality. Springfield, Il. Charles C. Thomas. Gray, J.A. (1982). The Neuropsychology of Anxiety. Oxford; Clarendon. Hoffman, S.G., Asnaani, A., Vonk, I.J.J., Sawyer, A.T. and Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy Research, 36(5), 427-440 Hogendoorn, S.M., Prins, P.J.M., Boer, F., Vervoort, L., Wolters, L.H., Moorlag, H., Nauta, M.H., Garst, H., Hartman, C.A. and de Haan, E. (2014). Mediators of cognitive behavioral therapy for anxiety-disordered children and adolescents: co gnition, perceived control, and coping. Journal of Clinical Child and Adolescent Psychology, 43(3), 486-500. Kahn, A.P. (2006). The Encyclopedia of Stress and Stress-Related Diseases, (second edition). New York: Infobase Publishing Leichsenring, F., Salzer, S. Beutel, M.E., Herpertz, S., Hiller, W., Hoyer, J., Huesing, J., Joraschky, P., Nolting, B., Poehlmann, K., Ritter, V., Stangier, U., Strauss, B., Stuhldreher, N., Tefikow, S., Teismann, T., Willutzki, S., Wiltink, J. and Leibing, E. (2013). Psychodynamic therapy and cognitive behavioural therapy in social anxiety disorder: A multicentre randomized controlled trial. American Journal of Psychiatry, 170, 759-767. Liebowitz, M.R. (1987). Social Phobia. Modern Problems of Pharmacopsychiatry, 22, 141-173 Otte, C. (2011). Cognitive behavioural therapy in anxiety disorders: current state of the evidence. Dialogues Clinical Neuroscience 13, 413-412. Price, M. and Anderson, P.L. (2011). The impact of cognitive behavioral therapy on post event processing among those with social anxiety disorder. Behaviour Research and Therapy 49(2) 132-137. Scahill, L., Riddle, M.A., McSwiggin-Hardy, M. and Ort, S.I., King, R.A., Goodman, W.K., Cicchetti, D., and Leckman, J.F. (1997). Childrens Yale-Brown Obsessive Compulsive Scale: reliability and validity. Journal of American Academy of Child and Adolescent Psychiatry, 36(6) 844-852 Torp, N.C., Dahl, K., Skarphedinsson, G., Thomsen, P.H., Valderhaug, Weidle, B., Melin, K.H., Hybel, K., Nissen, J.B., Lenhard, F., Wentzel-Larsen, T., Franklin, M.E. and Ivarsson, T. (2015). Effectiveness of cognitive behavior treatment for pediatric obsessive-compulsive disorder: Acute outcomes from the Nordic Long-term OCD treatment study (NordLOTS). Behaviour Research and Therapy, 64, 15-23. Yoshinaga, N., Ohshima, F., Matsuki, S., Tanaka, M., Kobayashi, T., Ibuki, H., Asano, K., Kobori, O., Shiraishi, T., Ito, E., Nakazato, M., Nakagawa, A., Iyo, M. and Shimizu, E. (2013). A preliminary study of individual cognitive behavioural therapy for social anxiety disorder in Japanese clinical setting: a single arm uncontrolled trial. BioMed Central (BMC) Research Notes 6, 74-81

The Physics Of Pole Vaulting - 1471 Words

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The Workforce Free Essays

The workforce is contingent with the teamwork of personnel and state. The workforce remain the main concern of employers everywhere. All areas of employment are touched by economics and its affected by births, plus the quality of training each person receives. We will write a custom essay sample on The Workforce or any similar topic only for you Order Now 100 years ago, jobs were manufacturing in nature, what I mean is that individuals worked in factories or on an assembly lines. These types of positions weren’t very challenging because it’s a situation that was repetitious as the worker repeat steps. Subsequently new technology happens to be more demanding, very aggressive and creative. Women are employed within position that once was considered â€Å"only men were productive in. Work shifts are divided into three shifts for several organizations. They’re basically eight hours a shift and the employee usually work forty hours a week. Over the years the workforce has added four generation of workers. This has caused a distinctive effect on the workforce causing them to face the age differences. The HR knows that the workforce of the past consequencely will impact the future status of many organizations. They know that achieving their goal depends on how they hire workers. Also, the facts show that countless people are not retiring but are carrying on working well past the age of 65. HR specialists find that they’re having to formulate additional resolutions to link the demands relating to the workforce with the aging workers. Which requires HR specialists to understand and be able to execute ways to create jobs and to fill them with acceptable workers. Meanwhile workers and jobs are always transforming so organizations realize that they have diversity and the skill to maintain a balanced workforce being competent to accomplish their goals for the future of the organization. Also, companies have moved to global level with improved technology and communication. Besides more women employees entered the workforce which was not the state 100 years ago where women lives tended to be centered around their families. During World War I changed who the workforce would use once the men were either volunteering or being drafted to serve in the military which resulted in there was no one to fill the positions. So businesses hired the women to work in the men’s place. After showing the factories that the women were capable to carry out the duties that the men could do, but they were paid less for the same job. Since then women have demanded rights for equal pay and equal treatment. Because the workforce have become more diverse with gender, age, and culture it has caused organizations to change how they attain workers and maintain their numbers. The older workers are still present in the workforce is making HR to consider alternative ways for hiring, training, and what type of benefits plans to offer as enticements.Today HR managers needs to spend considerable time and money in training in new technology and keep them updated. The future US workforce groups in 2025 would be mostly aged population over 60 years. The workforce I filled with many kinds of technology such as computers, internet, smart phones and many mobile devices that has opened communication where everything seems to move at the speed of light. Therefore, HR will need to be on their toes to meet every task in the future. How to cite The Workforce, Papers

Cuban Missile Crisis Essay Research Paper In free essay sample

Cuban Missile Crisis Essay, Research Paper In October 1962 USA discovered Soviet atomic bases on Cuba. This was merely 70 stat mis off from the US coastline. It was literally in America s back-yard. It came as a daze to the Americans because Cuba and the US had such close ties so late and this was traveling against such ties. This beginning is from a historiographer named Stephen E. Ambrose. This means that it is a dependable beginning because history books have to travel through cheques from other historiographers. It tells of the Executive Committee that Kennedy appointed to rede him on the state of affairs. It is of import as it shows the importance of Kennedy s brother, Robert Bobby Kennedy. It was he that persuaded Kennedy to take the option of a encirclement of Cuba which stopped any military goods being transported to Cuba. This would non coerce an immediate response from Khruschev. The Soviet missiles with their payloads could lay waste to huge countries of the American continent. The missiles could make every bit far as south California. This map shows the work stoppage scope of the Cuban base. The full East Coast of America can be destroyed with such metropoliss as New York and Washington D.C. good within the country. If the missiles were to be launched so it would be a catastrophe. Kennedy was faced with the most unsafe crisis of the Cold War, and in the history of world. The universe looked on in fright of the jailbreak of World War III. If this were to go on so both sides would unleash their armory. These beginnings show the technological panic that could be unleashed. Source A1 shows a image of the baleful mushroom cloud that a atomic detonation would bring forth. A immense looming mass of fume, dust and fire. Source A2 ( I ) and A2 ( two ) show information on the atomic pigboats and their Polaris missiles, which could be fired, from any ocean in the universe. Kennedy s advisers told Kennedy that now was the clip to assail. Some, nevertheless, opposed to military action such as that. Kennedy decided to obstruct Cuba. This was a good determination. The encirclement began on Wednesday 24th October. The NAVY encirclement consisted of 100 war vessels environing Cuba. The US was cognizant of a fleet headed to Cuba, which was suspected to be keeping missiles. The fleet was escorted by one pigboat ; if they needed to the NAVY could hold easy defeated the fleet. The encirclement did non acquire the missiles off the island ; it did nevertheless give Kennedy more clip. This besides switched the determination devising to USSR ; it was their move. The lone ships that were stopped by the encirclement were 1s transporting violative military equipment. The encirclement played on the strengths of the US, as their NAVY was the strongest around the universe. But tensenesss were lifting. This is a British sketch from the Daily Mail. It shows the crisis as an old fashioned, wild west confrontation. With Kennedy apparently being the Sheriff and Khruschev being the no good brigand. The missile crisis was a confrontation. The hope of the universe was that neither would name DRAW! The Soviet fleet turned back and tensenesss loosened. The crisis was non over though. The missiles were still on Cuba. On Friday 26th October Kennedy received a missive from Khruschev. The missive promised that the missiles would be removed if the Americans complied with the followers: 1. The encirclement must stop. 2. The US must non occupy Cuba. The Crisis was over. The Soviets said, in the missive, that they wanted to avoid war at all costs. On Saturday 27th October another missive came. There was a different tone to this 1. It seemed more aggressive. The missive said that they Soviets would draw the missiles out of Cuba if the Americans pulled their missiles out of Turkey. USA was confused about the ground for this alteration. What ground would Khruschev hold to endanger the peace that had seemed so near merely a twenty-four hours before? Some advisers were concerned that on Friday the generals had taken over from Khruschev. If true it would do it harder now to settle the difference and halt the crisis. There was no manner the US would draw out of Turkey. Kennedy did non cognize how to react. He was faced with another quandary. Kennedy could non endorse down. Bobby Kennedy enters once more. He told Kennedy non to worry about the 2nd missive. He advised that Kennedy merely disregard it. Kennedy replied to the Soviets holding to the footings of the first missive. If there were no answer by Monday 29th October so USA would occupy Cuba. The Soviets replied on Sunday 28th October. It was accepted. The crisis was over. It had seemed that Kennedy was the master and Khruschev, the looser. Khruschev saw himself as the victor. Kennedy got the missiles removed and Khruschev managed to salvage Cuba from invasion. If Khruschev wanted war so there would hold been nil to halt it go oning. Khruschev deserves recognition for halting the crisis, as he didn t lead the state of affairs to war. This is an American sketch demoing both Kennedy and Khruschev working together to forestall atomic war. Kennedy succeeded acquiring the missiles off Cuba and avoided war. He was the Savior of the western universe. He steered the west through the most unsafe crisis Mankind had seen with a small aid from Khruschev and Bobby Kennedy.