C-T-E Structure and EBP Model Assignment
Fawcett (2005) proposed the conceptual-theoretical-empirical (CTE) formalization for developing theories (as cited in Butts, 2018, p. 98). The components of a CTE are the conceptual model (C), the foundation for the research topic, the theory (T) that is to be formulated or tested, and the empirical indicators (E) that offer a way to directly observe the theory (Butts, 2018, p. 98). The C-T-E structure for this project will be as follows: Depression (C) - Behavioral Systems Model Theory (T) - PHQ-2 (E). The C-T-E structure refers to a system that is governed by knowledge or expertise of nursing. It requires a high nursing level that encompasses interpersonal skills, creative and critical thinking abilities,
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The Cognitive Behavior Theory focuses on the problem and is “action-oriented.” CBT is grounded on the notion that people’s thought distortions and poor adaptive behaviors have a huge role to play in the development and also in the maintenance of psychological disorders (Field, Beeson, & Jones, 2015). Like most models, CBT triangulates thoughts, behavior, and emotions. In CBT, the therapist assists the patient in coming up with and also practicing strategies that decrease the symptoms of MDD. CBT has been found to be effective in the treatment of depression, anxiety, post-traumatic stress disorder (PTSD), and substance abuse among others. CBT is related to the goal of decreasing the suicide rate by 50% amongst those patients screened for depression. This is feasible because the CBT model combines both the behavioral and cognitive psychology to achieve positive …show more content…
The purpose of this tool is to serve as the first step of screening for depression. The scores in the questionnaire range from 0 to 6. If a patient scores three or more, he or she is required to be further evaluated using tools such as the PHQ-9 to establish the final diagnosis. This screening method is brief (can take less than a minute to a minute) and it assesses if there is presence of a depressed mood or if the patient has lost interest in routine activities. The minimum cutoff score of 3 was assessed as good in addition to “a sensitivity of 83% and a specificity of 93%” (Kroenke et al., 2003, as cited in Tvaryanas et al., 2017, p. 2). Its performance to screen for any depressive disorder was likewise acceptable in a patient population of outpatient clinics and family practices (sensitivity of 79% and a specificity of 86%) (Löwe, Kroenke, & Gräfe, 2005, as cited in Tvaryanas et al., 2017, p. 2). For a sample of older male veterans, Corson, Gerrity, and Dobscha (2004) learned that the PHQ-2 was an efficient depression screening tool (sensitivity of 97% and specificity of 91%) (as cited in Tvaryanas et al., 2017, p.
The PHQ-9 is a widely utilized tool in Primary Care to assist clinicians with the detection, diagnosing, monitoring, and measuring of severity of depression in adults (Kroenke, Spitzer, Williams 2001). It is a nine item self-administered questionnaire based on the Diagnostic Statistic Manual IV (DSM-IV) criteria for diagnosing depression in adults. There is a tenth question at the end regarding effect, if any, on functioning. It has also been used in many medical specialty populations for adults presenting with, or suspicion of depressive symptoms. It may be completed in clinic by the patient and takes two to five minutes (Nease et al. 2003). It is reviewed by the clinician and interpretation of the score is made using the algorithm that accompanies the questionnaire in 1-3 minutes. The expense of the paper is the only cost. The training is simply the clinician becoming familiar with the questions and the scoring.
The Beck Depression Inventory-II (BDI-II) is the latest version of one of the most extensively used assessments of depression that utilizes a self-report method to measure depression severity in individuals aged thirteen and older (Beck, Steer & Brown, 1996). The BDI-II proves to be an effective measure of depression as evidenced by its prevalent use in both clinical and counseling settings, as well as its use in studies of psychotherapy and antidepressant treatment (Beck, Steer & Brown, 1996). Even though the BDI-II is meant to be administered individually, the test administration time is only 5 to 10 minutes and Beck, Steer & Brown (1996) remark that the interpretive guidelines presented in the test manual are straightforward, making the 21 item Likert-type measure an enticing option to measure depression in appropriate educational settings. However it is important to remember that even though the BDI-II may be easy to administer and interpret, doing so should be left to highly trained individuals who plan to use the results in correlation with other assessments and client specific data when diagnosing a client with depression. An additional consideration is the response bias that can occur in any self-report instrument; Beck, Steer & Brown (1996, pg. 1) posit that clinicians are often “faced with clients who alter their presentation to forward a personal agenda that may not be shared.” This serves as an additional reminder that self-report assessments should not be the only assessment used in the diagnoses process.
Zung, W. W. K., (1965). A self-rating depression scale. Arch. Gen. Psychiatry. 12:63-70.[Duke Univ. Med. Ctr., Dept. Psychiatry, Durham, NC]
CBT has been known to cure a variety of disorders both in clinical environments and non-clinical environments. This type of therapy technique has been tested for efficacy and has proven to be highly effective. Furthermore, the future for CBT looks very positive as well. Researchers and theorist are now working on making this type of therapy available for suicide prevention, schizophrenia, and other psychopathologies.
The Beck Depression Inventory is a self-report inventory that attempts to understand the severity of depression in adults and or adolescents. The original Beck Depression Inventory was created in 1961 by Aaron Beck and his associates and was revised in 1971. In 1971, the Beck Depression Inventory was introduced at the Center for Cognitive Therapy, CCT, at the University of Pennsylvania Medical School. Much of the research on the Beck Depression Inventory has been done at the University of Pennsylvania Medical School. In the current version, of the Beck Depression Inventory, the subject rates 21 symptoms and attitudes on a 4 point scale depending on severity. Test takers rate the items listed in the inventory according to a one week timeframe, which includes the day the test takers took the test. The items that that the inventory measures covers cognitive, somatic, affective and vegetative dimensions of depression and although it was developed atheoretically, the items correspond with depression symptoms as outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV, American Psychiatric Association, 1994). The Beck Depression Inventory is widely known and is well known by psychiatric populations and clinicians. The BDI can be administered in a group or individual format by oral or written form. The 1993 version targets more trait aspects of depression versus the previous and earlier versions measured state aspects of depression. The test is to be administered with no more than 15 minutes to take the test, regardless of the mode administered. The 21 symptoms that are rated on the 4 point scale are then totaled and the range can vary from 0 to 63. Patients that score...
Cognitive Behavioral Therapy provides a collaborative relationship between the client and the therapist with the ultimate goal of identifying irrational beliefs and disputing those beliefs in an effort to change or adapt behavior (Corey, 2013). The developers of Cognitive Behavioral Therapy saw humans as capable of both rational and irrational thoughts and able to change the processes that contribute to irrational thinking (Corey, 2013). CBT is a more direct approach than some other therapy theories practiced today in that it challenges the client to identify aspects about their self through cognitions. This therapy, as discussed in Corey (2013) also provides an educational component such that therapist teach clients tools to effectively change the way they think to a healthier way. There are a multitude of techniques associated with CBT such as shame attacking exercises, changing ones language...
In it's simplest form, Cognitive Behavioral Therapy, (or CBT as it will be referred to from here on out), refers to the approach of changing dysfunctional behaviors and thoughts to realistic and healthy ones. CBT encompasses several types of therapy focusing on the impact of an individual's thinking as it relates to expressed behaviors. Such models include rational emotive therapy (RET), rational emotive behavioral therapy (REBT), behavior therapy (BT), Rational Behavior Therapy (RBT), Schema Focused Therapy, Cognitive therapy (CT). Most recently a few other variations have been linked to CBT such as acceptance and commitment therapy (ACT), dialectic behavioral therapy (DBT), and Mindfulness-Based Cognitive Therapy (MBCT) (Harrington and Pickles, 2009). The main aspect that all of these branches of therapy share, is that our thoughts relate to our external behaviors. External events and individuals do not cause the negative thoughts or feelings, but, instead the perception of events and situations is the root cause (National Association of Cognitive Behavioral Therapists, 2010).
Cognitive behavioral therapy commonly known as CBT is a systematic process by which we learn to change our negative thoughts into more positive ones. CBT is a combination of two types of therapy, Cognitive Therapy and Behavioral Therapy. Cognition is our thoughts, so cognitive behavioral therapy combines working with our thought process and changing our behavior at the same time. Cognitive behavioral therapists believe that our behavior and our feelings are influenced by the way we think; also our mood is affected by our behavior and thought process. So CBT tries to tackle our thoughts, feelings and behavior. Scientific research has shown that cognitive behavioral therapy is affective for a wide range of mental health problems. The purpose is to bring positive change by alleviating emotional distress such as depression. CBT starts by breaking down your problems into smaller components, often trying to identify particular problematic thoughts or behavior. Once these problems are broken down it is then suggested a straightforward plan in which the patient and therapist can intervene to promote recovery.
Cognitive Behavioral Therapy (CBT) is a hands-on form of psychotherapy that is empirically based, which focuses on the interrelationship between emotions, behaviors, and thoughts. Through CBT, patients are able to identify their distorted thinking and modify their beliefs in order to change their behaviors. Once a patient changes their distorted thinking, they are able to think in a more positive and realistic manner. Overall, CBT focuses on consistent problem solving strategies and changing negative thought distortions and negative behavior. There are different types of CBT, which share common elements. Trauma Focused Cognitive Behavioral Therapy is a kind of CBT, which falls under the umbrella of CBT.
Cognitive is defined as a mental process; it refers to everything going on in your mind including your thought processes and the way you are thinking and feeling. Behaviour refers to everything that you may do; this includes any action that you may present or act out, this can also be an indirect action that is caused by other underlying behaviours. Therapy is a systematic approach to try and resolve a problem, illness, actions, irregular thought patterns or anything that may be a disturbance that distracts you from your everyday functioning. Cognitive Behavioural Therapy (CBT) is a dynamic mode of holistic intervention that seeks to change thought processes that are linked with emotions through a goal-orientated process (Freeman and Ronen, 2007). Individuals have a three-step thought process; inferences, evaluations and core beliefs. Cognitive Behavioural Therapy looks into the dysfunctional thinking a client may have, which influences their thoughts, mood and behaviour. This theory is kept very loose and non-structured; depending on the client different theories will have to be applied depending on their needs and emotions.
Williams, J. B. (1988) A structured interview guide for the Hamilton depression rating scale. Arch Gen Psychiatry. 45, 742-747.
NICE (2009) Depression in Adults: the treatment and management of depression in adults. National Institute for Clinical Excellence, London
Cognitive-Behavioural Therapy has its foundations in two distinctive therapeutic theories, Cognitive Therapy and Behavioural Therapy. Cognitive Therapy (CT) believes that thoughts, feelings and behaviour are connected. CT states and an individual with help; can identify an issue that is causing a behavioural or an emotional response and correcting that thinking to achieve a desired outcome. Behavioural Therapy believes that individual’s behaviour is due to conditioning during the early years of life and as such can be altered with conscious awareness. Cognitive-Behavioural Therapy is a combination of both of these theories and is based on an individual’s own history of thought an...
Simpson, C. (2007) ‘Mental Health part3: Assessment and Treatment of Depression’ British Journal of Healthcare assistants. pp 167-171.
Introduction Depression has been ranked fourth on the list of urgent health problems worldwide (Malay, Asish, Sukendu, Ranadip & Sarmila, 2012). With that being said, various scales of measurements have been developed in order to determine a reliable diagnosis. One of these scales includes the Hamilton Rating Scale for Depression (also known as the HAM-D or HRDS). The Hamilton Depression Scale, published by Max Hamilton, is the most widely used depression-rating scale in the world (Malay, Asish, Sukendu, Ranadip & Sarmila, 2012).