Critical Thinking Example on Family Therapy: Comparison of EFT and CBCT

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Middlebury College
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Critical thinking
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Family problems are found in every society. As a social worker, my responsibility is to intervene and provide solutions to various social problems. To solve social problems effectively and efficiently, I have to use my skills, experience, knowledge, and input from others. One of the methods of solving a social problem is employing family therapy approaches. The overall purpose of this paper is to utilize therapy approach to solve a social problem. The objective of this work is to select two types of family therapies that can be utilized to solve a social problem. The second objective is to compare and contrast the two family therapies. After identifying strengths and weaknesses of each therapy, the third objective is to identify an approach that is most suitable for solving the family problem identified. After identifying the approach, the fourth objective is to design a plan that can be used to intervene and solve the identified family problem. Finally, the fifth objective is to evaluate the effectiveness of the family therapy that has been identified as a solution to the problem.

Presenting Problem

The client is a white male aged 45 years. He is a veteran and has worked in the US air force for 20 years. While in service, he has been deployed to work in Iraq for three years and also in South Korea for three years. The client has been diagnosed with severe post-traumatic stress disorder (PTSD). Owing to severe PTSD, he has been having problems with his wife. It has been observed that certain health dynamics are affecting military personnel and military couples and deployment-related posttraumatic stress disorder (PTSD) is one of them (Blow, Curtis, Wittenborn, & Gorman, 2015). The authors argued that PTSD creates a lot of problems with the relationships of victims. But it is not enough to just conclude that relationships involving military service personnel are more likely to suffer from PTSD without examining the underlying causes.

Military deployments to regions affected by instability are often lengthy. Although the deployment might appear short in the paper, the escalation of conflicts, unpredictable circumstances, and the emergence of new conflicts may imply that the servicemen have to spend more than the planned duration. Such lengthy deployments not only place significant stress on the servicemen but also on their families (Blow, Curtis, Wittenborn, & Gorman, 2015). During times of war, servicemen are usually deployed for extended periods depending on their specific field. Often, the deployments last over 12 months. In the case of the client, he was away for three years twice. It is at the end of the mission or the deployment period that the services men return to the country and are subsequently reintegrated with their communities as well as their families. While such reintegration plans are good, they might be problematic especially when there are health concerns affecting the veterans. Lewis, Lamson, and Leseuer (2012) found that some of the psychological problems affecting military soldiers include PTSD, depression, suicide, and substance abuse. Such psychological problems have been found to cause marital stress, dissatisfaction, and other negative health outcomes.

When veterans return home temporarily during periods of decreased operations, it is important to strengthen not only their mental health but also their family relationships. Lengthy deployments of military personnel are a source of stress to their families. While on deployment, considerable changes take place during their lengthy stay away from their families. Service members, members of their families, and spouses change. These changes, however, happen at the same time with other normative events in their lives. Consequently, such changes pose a great challenge during post-deployment reconnection. The changes taking place in the service member or spouse can exert a great deal of strain on committed relationships and marriages. Frequent separations of members of the armed forces from their family members have negatively affected the service personnels marriages. According to Blow, Curtis, Wittenborn, & Gorman (2015) situations where mental health conditions such as PTSD exits, the product is always a relationship distress. This is what happens in the case of the client.

Coping with problems associated with long-term deployment requires an intervention of several people. The client has been away for three years in each deployment. Considering that the average time is 12 months, three years has been too long for him. Further, this happened twice in his service. His condition of PTSD is largely associated with long-term deployment. Families have resources which they can utilize to minimize mental health conditions from getting worst. The greatest family resources are the wife or husband, children, parents, and other members of the extended family. The family's strength lies in their ability to give the greatest solve and assurance to their own. Nobody else can do better in fulfilling human love and care than a fellow family member. In the case of the veteran, his wife, children and other family members are his strong resources. Having interacted with various family members in the past, each family person understands particular needs and wants that can nourish his mental health.

Family Treatment Approaches for PTSD

Several treatment approaches have been identified that can be used to treat people with mental problems. In this paper, two methods of treating PTSD will be discussed. One method is Emotionally Focused Therapy (EFT), and the other approach is Cognitive-Behavioral Conjoint Therapy (CBCT). While both methods have similarities in some aspects, they also differ in other aspects.

EFT has been described as a short-term intervention meant for couples which are based on an integration of family systems as well as experimental methods (Blow, Curtis, Wittenborn, & Gorman, 2015). It is an evidence-based approach that can be effectively and efficiently used to treat distress common in relationships. In EFT, the relationship of a couple or partners is viewed through the lens of an attachment theory. The objective is to encourage couples or people in intimate relationships to seek one another for support as well as safety during stressful times. In EFT, the key target of change is emotion. The objective of the intervention is, therefore, to focus on, expand, and regulate each partner's emotions so that the couple can express each other's emotions more adaptively. In EFT, the perspective adopted suggests that change can occur through emotional regulation, awareness, transformation, and reflection (AIPC, 2017). In essence, emotional awareness demands that clients become aware of their fundamental emotions. This not only involves an actual feeling of emotions but also becoming aware of the emotions. Consequently, the first step to change is to accept emotions.

CBCT has been defined as a time-limited intervention that is evidence-based. CBCT consist of 15 treatment sessions where each session takes 75 minutes. Given that it is a problem-focused manualized therapy, it has a combined goal of improving individual PTSD as well as enhancing the functional aspects of the intimate relationships between couples. Although there are various types of CBCT designed to deliver individual treatments for PTSD, the one intended for CBCT provides a way for people to utilize their social support to achieve treatment. CBCT for couples has two benefits: one is to capitalize off the relationship with the objective of making the individual better while the other benefit is to help couples to improve issues in their relationship (Couple Therapy for PTSD, n.d.). According to Moore (2017), CBCT not only addresses symptoms but also helps in improving relationships fulfilment among couples. CBCT is organized in phases which assist in understanding the symptoms associated with PTSD, improve problem-solving skills and interpersonal communication, and internalize the traumatic event. Phase 1 of the CBCT involve psychoeducational, Phase 2 address issues of avoidance and emotional trauma, and Phase 3 emphasizes specific trauma appraisals (BrownBowers, Fredman, Wanklyn, & Monson (2012).

A close examination of the EFT and CBCT show that they have certain similarities. Both techniques are employed in the context of a family relationship. The two therapies are used to enhance relationships among couples. EFT and CBCT are both evidence-based methods that have been proven to work in management of PTSD among couples effectively. Both therapies are short-term interventions implying that they do not last long.

While both methods are similar, they also different in some aspects. For example, EFT views the relationship between couples in attachment theory while CBCT employs cognitive theories. EFT works to improve relationships between couples while CBCT aims to not only achieve improvement between couples, but it can also be used to address individuals with PTSD. EFT is designed to help couples seek each other in stressful times for support while CBCT is designed to help in addressing symptoms, interpersonal communication, and to internalize traumatic event. EFT focuses on the emotional aspects while CBCT aims to address the cognitive aspects.

Using EFT and CBCT

After comparing and contrasting EFT and CBCT, I can use both approaches to treat the family. EFT is based on the attachment theory of couples, and this is where its strength lies. Human beings have innate desires for proximity to as well as comfort from those whom they love. Attachment theory posits that any threat to a bond or attachment results in an intense significant level of distress in the person affected (Greenman & Johnson, 2013). EFT model is strong in that it is based on clear as well as explicit conceptualizations that are associated with adult love and marital distress. EFT conceptualizations are strongly anchored on empirical research pertaining nature of adult attachment and also marital distress. Additionally, EFT intervention is not only collaborative but also respectful of clients. The threats of a bond of attachment in a couple's relationship generate a series of predictable responses. Such responses can be despair, protest, anger, clinging behavior or even detachment in extreme cases. It is, therefore, easier to use this approach since the responses are predictable. The applicability of EFT in many types of problems and populations further make it an attractive solution. However, EFT has some weaknesses. The intervention may not be suitable for individuals with significant problems. The method also focuses on people's emotions and may ignore other behaviors that may be the source of the problem.

Dealing with the clients current problem requires a suitable choice. A comparison between EFT and CBCT show that the former is the best approach. EFT has many advantages over CBCT. Previous investigations by Schumm, Fredman, Monson, & Chard (2013) revealed that veterans did not indicate any meaningful changes in their relationship satisfaction when CBCT was used. On the contrary, EFT has many advantages and has been found to be effective in solving relationship problems. It is a humanistic approach and since it emphasis positive and unconditional regard for clients. It is a comprehensive intervention since it is based on a systematic approach.

Effective problem-solving requires that one needs to identify the best approaches. In the context of PTSD, offering effective solutions to my clients in future require that I chose a better approach. Having studied the strengths and weaknesses of both EFT and CBCT, I have found out that EFT is the best approach. Consequently, I will be employing EFT as the priority in my future enco...

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