Cognitive Behavioral Therapy

By Support


There are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this Discussion, as you compare the use of CBT in individual, group, and family settings, consider challenges of using this approach with groups you may lead, as well as strategies for overcoming those challenges.


Respond to at least two of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own experiences with clients.

 Colleague 1

Post an explanation of how the use of CBT in groups compares to its use in family or individual settings.

        According to Wheeler (202), Cognitive behavioral therapy or CBT is a type of guided therapy which practices on the belief that our mental health depends on how well one is able to positively adapt cognitively and functionally to changes in their environment by modifying behaviors displayed through cognitive distortions, and assumptions using behavioral experiments (Wheeler, 2020). CBT is a problem focused by being transparent and narrowing down specific problem areas that need solutions, and it is also action oriented by restructuring behaviors and mindsets for a better outcome (Psych Exam Review, 2019).

CBT when used in group setting is used to treat individuals problems in a group setting . The therapist helps individual within a group setting by interacting with them to assess, diagnose and treatment symptoms by  teaching coping skills and new behaviors as a vehicle for change. Group CBT has an advantage in that the patients learn from others in the group since they have similar problems and needs, by learning how they resolve issues, and what behaviors need to be modified to achieve success (Psych Exam Review, 2019). Group therapy is more cost effective as it is typically more affordable than individual therapy, and it is more time effective for the therapist as they are able to see more patients in the same time frame as an individual session.

CBT for couples are done to teach them how couples problem-solving skills, how to communicate effectively, how to resolve present conflicts, how to deal with sexual dysfunction, how to deal with domestic violence, and empowered them on how to resolve future conflicts using behavioral contracts. Couple are also thought how to fight fairly verbally in arguments without hitting below the belt (Nichols, 2022).

CBT for family therapy focuses on systems of relationships that influences members of a family unit, and treatment is focused on the family system. CBT for family focuses on behavioral training using reward and consequences system to help members of the family learn healthy ways to communicate, manage their emotions, and modify distressing behaviors.

Explain at least two challenges PMHNPs might encounter when using CBT in one of these settings. Support your response with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources.

  1. One of the challenges that the therapist may encounter in group CBT session is that members of the group who have similar problems may pick up negative techniques of handling their problems. An example was seen when the presenter talked about members of a Bulimia nervosa group may pick up new ways to purge and hide it from their family members, or cutters learning new ways to hide their cuts (Psych Exam Review, 2019).
  2. Another challenge that the therapist may face is that they may not be able to address the issues of the members in the group completely as some tend to fall through the cracks due to the size of the group. An example in the video was that the member may not speak up or bring up the issue so it can be addresses or, there is not enough time to address all the issues encountered due to the size of the group (Psych Exam Review, 2019).

CBT is a psychotherapy that is a collaborative process between the therapist and the patient, and is an effective way to teach skills to help modify behaviors, to provide symptom relief, enhance treatment adherence, and sustain therapeutic goals and gains

Colleague 2

Cognitive Behavioral Therapy: Comparing Group, Family, and Individual Settings

Cognitive behavioral therapy (CBT) is a psychotherapy used to aid individuals with mental health concerns. This method has gained recognition as a gold standard for the treatment of several mental health disorders due to its superiority and efficacy relative to alternative therapy approaches (David et al., 2018). Using CBT, the therapist examines the relationships between an individual’s thought process, feelings, and emotions and the impact of these elements on the development of symptoms of illness. The therapist works with the patient to modify their behavior and bring changes in the maladaptive patterns. CBT is focused on changing negative thinking patterns into positive ones (Med Circle, 2019).

Differentiating CBT in Group with Family and Individual Settings

Cognitive behavioral therapy in the group helps people with similar issues learn to replace negative thought patterns with more positive ones. The therapist pays attention to how they relate to the group and each person. Group members can gain support from one another by opening about their struggles in a safe environment (López et al., 2021). Members of the group boost their motivation and urge to change their thinking patterns by listening and sharing things as these people develop harmony with each other. Cognitive therapy in groups is widely used for substance-use disorders (López et al., 2021).

Cognitive behavioral family therapy (CBFT) focuses on the mental and behavioral components of family interactions due to interpersonal conflicts that lead to certain mental illnesses such as depressive disorders, stress disorders, anxiety disorders, etc. (Butler et al., 2020; Hadi et al., 2021). CBFT main goal is to help family members develop more adaptive ways of thinking, improve the quality of family decision-making, and strengthen the family’s surrounding environment that disrupts the individual thought pattern. When a dispute emerges, family members typically resolve it among themselves (Dattilio, 2021). In CBFT sessions, distorted thought patterns within families are addressed and resolved (Frey et al., 2021). However, the individual therapy session differs from group CBT and CBFT as it focuses on an individual’s negative emotions. It is used to change individual negative thought patterns into positive ones.

Moreover, CBT is effective in individual or as well as in group settings. People in a group don’t know each other at first; then, a therapist indulges them in activities with each other that compel them to change their negative thought patterns into positive ones (Hayes & Hofmann, 2017; Psych Exam Review, 2019). In comparison, individual therapy involves a one-to-one session between an individual and a therapist. During this session, a therapist is solely focused on the individual’s disruptive thoughts and shaping them into constructive ones.  (Kathmann et al., 2022). In the case of a family session, the therapist is more focused on the conflicts among family members that trigger symptoms of mental health issues, and the therapist tries to solve them by modifying through patterns of family members (Sheidow et al., 2021).

Problems that Therapists Can Face during Sessions

A psychiatric-mental health nurse practitioner (PMHNP) may face several obstacles while doing CBT on mental health patients in any setting. For instance, in group therapy, some members will probably feel uncomfortable discussing their difficulties with the therapist in front of everyone (Psych Exam Review, 2019). Such conduct would make it impossible for a therapist to engage all group members, rendering group CBT worthless. Similarly, in group therapy, a therapist may face the issue of confidentiality and privacy. For this therapist should engage group members in activities that develop trust among the group members. Also, the therapist must remind all participants about confidentiality and privacy policies.

Moreover, communication problems are also challenging for therapists in a group as well as family sessions. In the case of group sessions, some members try to dominate, while others prefer to remain silent. The therapist needs to ensure all members participate in the session so that the session is helpful for all participants. One issue a therapist may face in a family session is when a family member thinks they are not worthy enough for their family. Promoting a healthy sense of self-worth is essential for the therapist, as it is difficult for a person to exist without care or affection. This strategy can also be utilized in family therapy sessions to overcome obstacles.

Cognitive Behavioral Therapy