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Cognitive behaviour therapy in chronic illness

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Application of Cognitive Behavioural Therapy in Caring Persons with Chronic Illness

1) Sojan Antony, 2) A Thirumoorthy, 3) K Janaki Raman
(1 & 3) Assistant Professor, Department of Psychiatric Social Work, NIMHANS, Bengaluru and (2) Professor & Head, Assistant Professor, Department of Psychiatric Social Work, NIMHANS, Bengaluru

Persons with Chronic Illness suffer physically and mentally. Chronic nature of illness causes stress to the person. Cognitive Behavioural Therapy (CBT) is useful in reducing negative thoughts and emotions, and increasing desirable behaviour in stress-related mental health problems. A person with chronic illness thinks that it is impossible to live with chronic health problems initially. It takes time to develop relatively healthy coping. Such difficulty in coping with emotions and solving problems affect their mental health. Professional Social Workers are trained in CBT. Techniques used in CBT, such as ABC analysis, relaxation training, substituting negative thoughts with positive thoughts, and nurturing the process of learning adaptive behaviour are likely to enhance the quality of life among persons with chronic illness. Chronic health problems such as diabetes, hypertension, heart disease, cancer, kidney diseases, liver diseases and chronic mental health disorders pose challenges to individual’s social functioning. To adapt to the illness, the person has to learn a new lifestyle. For example, the person with diabetes starts doing exercises and regulates the use of carbohydrate. Caregivers including professional social workers can use conditioning techniques and reinforcement strategies to accelerate the momentum of adaptation among persons with chronic illness.

**Presented in Almoners 2018, National Conference for Professional Social Workers, on 7 February 2018, Organized by Medical Social Work, Amala Institute of Medical Sciences, Thrissur, Kerala, India.

Veröffentlicht in: Gesundheit & Medizin
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Cognitive behaviour therapy in chronic illness

  1. 1. Application of Cognitive Behavioural Therapy (CBT) in Caring Persons with Chronic Illness Dr. Sojan Antony Assistant Professor Department of Psychiatric Social Work NIMHANS, Bengaluru
  2. 2. Chronic Illnesses • Bipolar Affective Disorders • Schizophrenia • Diabetes • Cancer • Heart Diseases • Kidney diseases • Liver Problems • Substance use disorders
  3. 3. Chronic Illnesses: Common Characteristics • Chronic • Recurrence • Less chance for recovery • Life long medical attention • Financial burden
  4. 4. Chronic Illnesses • Distress • Disability adjusted life years • Impact on functioning • Care givers burden
  5. 5. Chronic Illnesses • These Diseases Affect • Thinking • Feeling • Behaviour
  6. 6. CBT (Cognitive Behavioural Therapy) • Modifying thinking • Enabling to handle emotions • Enhances desirable behaviour
  7. 7. CBT • Evidence based practice • Problem specific • Time-bound • Change can be measured
  8. 8. Negative Thoughts • “ I am a burden” • “My life is over” • “I will not disclose others about my problem” • “I am the reason for my problem” • “I will not change my habits” • “My family members are not supportive” • “I am not sure about the treatment and the progress”
  9. 9. Negative Emotions • Frustration • Anger • Helplessness • Hopelessness • Worthlessness • Fear • Emptiness
  10. 10. Undesirable Behaviours • Poor adherence to treatment • Unhealthy Life style • Substance abuse • Withdrawal from social interaction • Aggression • Suicide attempts
  11. 11. CBT Process • Listing negative thoughts, emotions, & behaviours • Understanding ABC- Antecedents, Behaviours & Consequence • Helping them to learn Relaxation strategies
  12. 12. Handling negative thoughts • Developing insights • Recognize thoughts • Exploring alternative thoughts • Nurturing healthy thoughts
  13. 13. Measure behaviour • Observe behaviour • Measure frequency & Intensity • List out action points
  14. 14. Relaxation strategies • Muscle relaxation techniques • Mindfulness • Guided imagery • Physical Activity
  15. 15. Use Reinforcement • Positive Reinforcement • Negative Reinforcement
  16. 16. Other BT techniques • Desensitization • Flooding • Front Chaining • Back Chaining
  17. 17. Some principles • Measure • Micro targets • Focus on micro gains • Use of reinforcements • Sensitive to life cycle stages
  18. 18. Some principles • Directive • Realistic goals • Have supervision • Recording
  19. 19. Conclusion • CBT is an effective therapy to mitigate the psychosocial impact of chronic illness on Individual.
  20. 20. Thank you

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