An example during practicum that supports my belief is the case of a terminally ill patient who had been recommended comfort care through hospice. She was ready to do so, understood and accepted her prognosis, but her daughters and husband were in denial. Every time they participated in a family session the patient held back on her wishes and verbalized whatever their wishes were as if they were her own. When treated as an individual client, she would express her concerns of not being able to “disappoint and abandon my family”. She had suffered all her life from anxiety, insecurities, severe depression, and low self-esteem. Those were issues that should have been addressed individually before she could fully engage in a family session in a healthy and productive way, if she would’ve had the time. CBT would have still been the choice of treatment for individual therapy for this client, as evidenced by Driessen et al. who stated it “is the psychotherapy method with the best evidence-base in the treatment of depression” (2017, p. 654). Not being fully engaged in the program, or believing the treatment will not help, or having other issues that need to be addressed on an individual basis, are all challenges presented in a family setting when relying on CBT.
Kellett, S., Clarke, S., & Matthews, L. (2007). Delivering Group Psychoeducational CBT in
Primary Care: Comparing Outcomes with Individual CBT and Individual
Psychodynamic-Interpersonal Psychotherapy. British Journal of Clinical Psychology,
Söchting, I., Lau, M., & Ogrodniczuk, J. (2018). Predicting Compliance in Group CBT Using the
Group Therapy Questionnaire. International Journal of Group Psychotherapy, 68(2).
Driessen,E., Van, H. L., Peen, J., Don, F. J., Twisk, J. W. R., Cuijpers, P., & Dekker, J. J. M.
(2017). Cognitive-Behavioral Versus Psychodynamic Therapy for Major Depression:
Secondary Outcomes of a Randomized Clinical Trial. Journal of Consulting Clinical