1. Running Head: WEEK 7 SIGNATURE ASSIGMENT PART 5 1
Week 7- Signature Assignment, Part 5
Michelle Lamon-Paredes
Azusa Pacific University College
04/27/15

2. WEEK 7 SIGNATURE ASSIGMENT PART 5 2
Cognitive Therapy was started by Dr. Aron Beck in the 1960’s when he decided after
studying psychology at the University of Pennsylvania that he would create a better way to deal
with the diagnosis of depression. Psychoanalysis was very popular at the time and Dr. Beck
“found that the patients’ automatic thoughts fell into three categories. The patients had negative
ideas about themselves, the world and/or the future” (Beck Institute). The three disorders that I
have been researching this quarter can benefit from Cognitive Therapy in that disorders can
change thinking in people and cause certain behaviors. These behaviors can be identified with
CBT and can be broken down into negative thinking about themselves, the environment around
them or what the future holds.
Distorted thinking can fuel disorders like Obsessive Compulsive Disorder, Narcissistic
Personality Disorder and Schizophrenia, Paranoid Type- Psychotic Disorder. Dr. Beck made it
possible for psychologists to have another outlet for understanding and treating clients who
needed help but did not have to rely on psychoanalysis for treatment. The fundamental premise
being if you can change your thoughts, you can change your behavior. CBT is a great way to
approach treatment for disorders that had negative thinking as a fundamental part of the disorder.
Identifying the reasons behind the behavior is a large majority of the work of a psychologist. My
other signature assignments have gone into great detail about what these disorders are and what
their possible causes may be so to avoid redundancy, I will discuss other possibilities or causes
for the disorders.
My first selected disorder Narcissistic Personality Disorder can create severe problems
for the person even if they are not fully aware. This could be brought to the attention of a
medical health professional through a spouse, child or family member who notices extreme
changes. This particular disorder can cause distorted thinking and personality changes that are

3. WEEK 7 SIGNATURE ASSIGMENT PART 5 3
focused inward on the person with emphasis on the way they look, sound, and act. I would
imagine that this would be a very difficult disorder to treat because the person would need to
want help and accept the fact that they do have the disorder, which could be challenging because
these people are perfectionists and feel that they are infallible. Causes for Narcissistic Personality
Disorder could range from the inherited gene to an environmental stimulus to drug use.
My second disorder, OCD is more common but just as challenging to treat. Depending on
what the trigger is for the person, for example hand washing excessively, it takes time to change
those habits and create new types of thinking. Causes for OCD could be anything from genetic
traits to learned behaviors to drug or alcohol use. A traumatic event could set off OCD like
PTSD. In any case, I would want to work closely with the person in order to develop a good
working treatment plan that would do the most good for the person in the shortest amount of
time. I think I might ask them to keep a journal of their inner monologue as well so we could
also discuss thoughts and feelings regarding the matter.
The last disorder, Schizophrenia, Paranoid Type is a severe anxiety related paranoid
disorder with distorted thinking and manic type behavior. There are strong theories that support
it is caused in the brain by an imbalance. It can run in families and can happen at any age for any
reason. Most schizophrenics have to be on medication to be able to function normal lives. The
paranoia adds another level of complexity to the disorder and I believe that every case is unique.
Depending on the age and severity of the individual I would try to tailor my plan for them
accordingly and reach out to the family and the attending physician.

4. WEEK 7 SIGNATURE ASSIGMENT PART 5 4
Treatment Plan for Clients A, B, C
Client A Client B Client C
Narcissistic Personality
Disorder 301.81
Schizophrenia Paranoid
Type Psychotic Disorder
295.30
Obsessive Compulsive
Disorder 300.3
Problem: 49 year old male
presents with history of
reckless behavior, lack of
regard for others and shows a
high need for excitement, and
living on the edge. Pattern of
impulsive behaviors-
gambling, alcohol use,
excessive smoking, spending
money. Irresponsible, cannot
manage money or family
commitments.
Problem: 52 year old female
with a fear of being stalked
by someone. Angry and
defensive, paced the room,
talked to herself and unable to
sleep, work or eat. Pale,
sickly and aggressive. No
family, friends or close
relationships. Does not trust
anyone, anxious behavior.
Problem: 20 year old female
presents with OCD excessive
hand washing and 2 small
children. Children are sick
frequently and client has
developed a constant fear of
being ill that has led to
frequent hand washing up to
100 times per day. She thinks
about germs on her hands
constantly and cannot
function.
Long Term Goals:
1. Accept responsibility for
their own behavior.
2. Learn to operate within the
rules of society.
3. Understand and accept the
limits of social norms and
create boundaries for
behavior.
4. Be able to live, work, and
function in the community as
a contributing member.
Long Term Goals:
1. Learn to interact with
others without fear or anger.
2. Show trust in others by
talking to them and being
positive.
3. Relax around others and be
open to conversation without
suspicion.
4. Function normally at
home, work and in social
situations.
5. Resume a normal diet,
exercise and sleep.
Long Term Goals:
1. Reduce frequency of
obsession and compulsion of
washing hands.
2. Learn to function with a
minimum time spent washing
hands.
3. Resolve issues that fuel the
stress behind the OCD.
4. Let go of anxiety of getting
sick and reassure client.
5. Accept thoughts and learn
to manage them without
acting on them.
Short Term Goals:
1. Admit mistakes and
acknowledge hurting others.
2. Give an honest account of
drug and alcohol abuse.
3. Give an honest history
about behaviors, feelings and
attitudes.
4. Make a commitment to live
within societies rules.
5. Acknowledge self-centered
behavior in relationships.
Short Term Goals:
1. Learn to trust by
developing a relationship
with therapist and talking
about feelings and beliefs.
2. Identify who is not
trustworthy and why.
3. Complete a psych
evaluation to assess paranoia
using MMPI.
4. Get a medical evaluation
from a physician for complete
medical history.
Short Term Goals:
1. Describe obsession and
compulsive thoughts of OCD.
2. Complete psych test for
OCD- Yale Brown OCD.
3. Keep a daily journal of
OCD, record thoughts and
feelings and actions.
4. Identify and replace
negative self-talk with
positive beliefs.
5. Role play and practice
good habits.

5. WEEK 7 SIGNATURE ASSIGMENT PART 5 5
Intervention:
1. Explore client’s history of
blaming behavior and
irregular thinking patterns.
2. Assess the client for drugs
and alcohol and advise
treatment if necessary.
3. Assess the client’s level of
understanding toward the
problem whether open or
reluctant and work together to
identify risk behaviors or
suicidal thoughts.
4. Get a commitment from
the client to lead a law
abiding life.
5. Discuss the self-
centeredness attitude that is
part of what is considered to
be antisocial behavior.
Intervention:
1. Build trust with client by
allowing them to lead
conversations and make their
own plan for treatment.
2. Assess extent of paranoia
about specific beliefs and
acknowledge that they are
thinking irrationally.
3. Test for psychoses using
the MMPI.
4. Refer client to a physician
for a complete medical
evaluation to look for
substance abuse, and the need
for any medical care or
psychotropic medications.
5. Explore the client’s self-
talk and beliefs that may fuel
the paranoia.
Intervention:
1. Build a relationship with
client, establish trust.
2. Assess OCD and
administer Yale Brown test.
Measure results.
3. Ask client to self-monitor
OCD and to bring journal in
to sessions to share.
4. Talk about beliefs and
identify biases in specific
feelings. Offer alternatives
for how to correct biases.
5. Role play with client
possible scenarios with hand
washing that would prove to
be positive and would not
lead to fear or illness.
Conduct exposure therapy.
uiActions:
10-1-15: Client came in and
made a commitment to live a
law abiding life.
10-8-15: Discussed client’s
history and took a drug and
alcohol test and passed.
10-15-15: Client understands
the problem but is resistant to
change. Asked client to keep
a journal of thoughts to share
at next meeting.
10-21-15: Talked about how
important it is to need others
and client has decided to
volunteer at a homeless
shelter to work with less
fortunate. Client has made
great improvement. See as
needed.
Actions:
10-1-15: Client came in and
was paranoid about being
stalked by someone.
10-8-15: Discusses client’s
history, beliefs and presenting
problem. Gave MMPI.
10-15-15: Client understands
problem but is afraid to let
her guard down for fear of
being attacked.
10-20-15: Referred client to
physician for evaluation and
physical, drug and alcohol
test.
10-25-15: Client is seeking
help at an inpatient facility
with a psychiatrist. Will
follow up with client in two
weeks.
Actions:
10-1-15: Client came in and
had OCD hand washing
problem.
10-5-15: Discusses fear of
becoming ill from germs
around children. Asked client
to keep a journal of thoughts
and feelings.
10-13-15: Client and I role
play to work through
different scenarios where she
would experience anxiety and
resort to excessive hand
washing.
10-30-15: Gave Yale Brown
test, results elevated. Will
continue to see client for next
three months and begin
exposure therapy.

6. WEEK 7 SIGNATURE ASSIGMENT PART 5 6
References
CBT Resources. (2015) History of Cognitive Therapy. Taken from:
http://www.beckinstitute.org/history-of-cbt/
Revlin, Russel. (2013). Cognition, Theory and Practice. Worth Publishing.
Jongsma, Peterson, Bruce. (2014). The Complete Adult Psychotherapy Treatment Planner. Wiley
Publishing.