A Counselling Case Study Using CBT
Jocelyn works as a Human Resources Manager for a large international organisation. She is becoming more and more stressed at work as the company is constantly changing and evolving. It is a requirement of her job that she keeps up with this change by implementing new strategies as well as ensuring focus is kept on her main role of headhunting new employees.
She finds that she is working twelve-hour days, six days a week and doesn’t have time for her friends and family. She has started yelling at staff members when they ask her questions and when making small mistakes in their work. Concerned about her stress levels, Jocelyn decided to attend a counselling session.
Below is an extract from Jocelyn’s first session with her counsellor:
Transcript from counselling session
Counsellor: So Jocelyn, let’s spend a few minutes talking about the connection between your thoughts and your emotions. Can you think of some times this week when you were frustrated with work?
Jocelyn: Yes, definitely. It was on Friday and I had just implemented a new policy for staff members. I had imagined that I would get a lot of phone calls about it because I always do but I ended up snapping at people over the phone.
Counsellor: And how were you feeling at that time?
Jocelyn: I felt quite stressed and also annoyed at other staff members because they didn’t understand the policy.
Counsellor: And what was going through your mind?
Jocelyn: I guess I was thinking that no-one appreciates what I do.
Counsellor: Okay. You just identified what we call an automatic thought. Everyone has them. They are thoughts that immediately pop to mind without any effort on your part. Most of the time the thought occurs so quickly you don’t notice it but it has an impact on your emotions. It’s usually the emotion that you notice, rather than the thought. Often these automatic thoughts are distorted in some way but we usually don’t stop to question the validity of the thought. But today, that’s what we are going to do?
The counsellor proceeds to work through the cognitive behaviour process with Jocelyn as follow:
Step 1 – Identify the automatic thought
Together, the counsellor and Jocelyn identified Jocelyn’s automatic thought as: “No-one appreciates what I do”.
Step 2 – Question the validity of the automatic thought
To question the validity of Jocelyn’s automatic thought, the counsellor engages in the following dialogue:
Counsellor: Tell me Jocelyn, what is the effect of believing that ‘no-one appreciates you?’
Jocelyn: Well, it infuriates me! I feel so undervalued and it puts me in such a foul mood.
Counsellor: Okay, now I’d just like you to think for a moment what could be the effect if you changed that way of thinking
Jocelyn: You mean, if I didn’t think that ‘no-one appreciates me’?
Jocelyn: I guess I’d be a lot happier in my job. Ha, ha, I’d probably be nicer to be around. I’d be less snappy, more patient.
Step 3 – Challenge core beliefs
To challenge Jocelyn’s core belief, the counsellor engages in the following dialogue:
Counsellor: Jocelyn, I’d like you to read through this list of common false beliefs and tell me if you relate to any of them (hands Jocelyn the list of common false beliefs).
Jocelyn: (Reads list)Ah, yes,I can see how I relate to number four, ‘that it’s necessary to be competent and successful in all those things which are attempted’.That’s so true for me.
Counsellor: The reason these are called “false beliefs” is because they are extreme ways of perceiving the world. They are black or white and ignore the shades of grey in between.
Applications of CBT
Cognitive approaches have been applied as means of treatment across a variety of presenting concerns and psychological conditions. Cognitive approaches emphasise the role of thought in the development and maintenance of unhelpful or distressing patterns of emotion or behaviour.
Beck originally applied his cognitive approach to the treatment of depression. Cognitive therapy has also been successfully used to treat such conditions as anxiety disorders, obsessive disorders, substance abuse, post-traumatic stress, eating disorders, dissociative identity disorder, chronic pain and many other clinical conditions. In addition, it has been widely utilised to assist clients in enhancing their coping skills and moderating extremes in unhelpful thinking.
I recently had a call (lifeline) from a young person with similar issues as Jocelyn so it was interresting to me to see that I was on the right track helping my client to change her thinking.
I am employed as a counselling psychologist in the dept. of professional studies for graduate students, it’s the way i had been challenging irrational beliefs students hold about themselves, & CBT helps a lot in improving their academic achievement, & helps my counselling to gain ground successfully.
it was a good case study helped a lot I as a student studying about case study on CBT patients !! thanks a lot
Thank you very much. it helped me as I am a student of basic counselling course.
I think the way the process is explained is very helpful.
It’s a very good article.Therapist explicitly challenged the automatic thought and could elicit it very well. CBT is more realistic and genuine. Great case study. Expect more such case details. Thanks.
I concur many students don’t fail exams because they don’t work hard but lack of confidence and negative self talk like I can never pass cbt is powerful in replacing the negative self talk
This type of case study is useful to know about the basic job awareness and what kind of stress the employee has. Mainly useful to know about the lot of information about counseling knowledge.
I am preparing for my internship in counseling and looking for case studies. I found this case study helpful and useful in how to utilize the CBT techniques when working with my potential clients.
what psychological theory would best help understand the client’s problems and how therapy from that theoretical standpoint will help them?
Behaviorism – Operant Conditioning
Behaviorism – Classic Conditioning
Object Relations/Attachment Theory
As a psychology student this case study helped me alot in understanding the core values of CBT as well as how important of a role it is in counseling. Thank you!