ABNORMAL PSYCHOLOGY COGENITIVE BEHAVIORAL THEARPY THE USE OF CBT IN A THEARPUETIC COMMUNITY (TC)

BY RICKIE L. LABOUNTA

DATE: November 22, 2013

The use of cognitive behavioral therapy is widely used in the treating many mental health issues. Cognitive behavioral therapy is adapted to fit the needs of people, not only in private settings, but in large clinics, hospitals, and in correctional institutions, like community corrections and prisons. Addictions and the problems that people have while in the mist of their individual substance abuse, present challenges to the idea of how to reach and teach these people, that the cognitive learning system they now have needs to be address and changed, to fit the needs of society. Therapeutic Communities are the means of addressing the cognitive learned patterns, which addicts and alcoholics have formed to survive, the daily problems produce in living life. In the book, The Therapeutic Community, Theory, Model and Method, by George DeLeon, he states that the individuals that are found within the Therapeutic Communities (TC) have a wide range of problems beyond just addiction; many suffer both social and psychological problems beyond just addiction (pg.3). The use of recovered paraprofessional is also key, when working with clients that are in TCs, showing clients by example that recovery is possible and that the method works if you buy into the process (pg.5). In his book, Fundamentals of Abnormal Psychology, 7th ed., by Ronald J. Comer, touchs on some of what TCs and other programs like it do for people. The book coined the TCs and residential treatment centers, to the idea that they are groups who come together, to learn new ways of dealing with their problems in a manner, that allows then to lead lives while working on their addiction problems (pg. 322-323). I thought the book made both the TC and residential treatment center to be little more than group self-help, but I know from doing both, they are more than self-help. Sure you are in a group, working on problems, attitudes and behavior, develop over a period of time, and most of these are learned from childhood and situation that one has experiences do to life lessons and that. But residential treatment centers and TCs do more than self-help, they use research and knowledge gain through proven processes, to get people to understand, why their individual belief system are flawed, ways of looking at them, to change them and see the value in what is normal. So what is cognitive behavioral therapy?
Cognitive behavioral therapy (CBT) is a psychotherapeutic approach that addresses dysfunctional emotions, maladaptive behaviors and cognitive processes and contents through a number of goal-oriented, explicit systematic procedures. The name refers to behavior therapy, cognitive therapy, and to therapy based upon a combination of basic behavioral and cognitive principles and research. Most therapists working with patients dealing withanxiety and depression use a blend of cognitive and behavioral therapy. This technique acknowledges that there may be behaviors that cannot be controlled through rational thought. CBT is "problem focused" (undertaken for specific problems) and "action oriented" (therapist tries to assist the client in selecting [1] ( specific strategies to help address those problems). http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy).

Then what is a Therapeutic Community?

Therapeutic community is a term applied to a participative, group-based approach to longterm mental illness, personality disorders and drug addiction. The approach was usually residential, with the clients and therapists living together, but increasingly residential units have been superseded by day units. It is based on milieu therapy principles, and includes group psychotherapy as well as practical activities. Modified therapeutic communities are currently used for substance abuse treatment in correctional facilities of [5] [6] [7] [8] several U.S. states including Pennsylvania, Texas, Delaware, and New York. In New York City, a program for men is located in the Arthur Kill Correctional Facility on Staten Island and the womens program is [9] part of the Bayview Correctional Facility inManhattan.

This paper will focus on how TCs are used within the correctional system, more to the point the TC program, which is in Casper, Wyoming, and ran by the Community Education Centers who are located in, West Caldwell, New Jersey and operates the TC program for the Wyoming Department of Corrections. This paper will look how the program deals with clients, many of whom have serious drug and alcohol problems, many do not have an education beyond that which is required by law, have deep social and psychological problems, and have been incarnated more than one time for their individual addictions. Behaviors are developing over time, and become natural to us. Now whether we know these behaviors to be bad or not, does not matter, they are what people think them tobe what they are, and till something or someone, (namely the law, or society) tells them they are inappropriate, do they even think about or even wish to change them. Set behaviors work and if it works why fix them. Behaviors are what they are and the idea of comfort-ability, which is the name of the game if you are an alcoholic or drug addict. These set behavior must be change, challenged and modified so that the individual can become a better, productive person, where by social standard, they are living with in what is normal based on the traditional standard as set forth by society. This is where both the Cognitive Behavioral Therapy (CBT) and TC come to play. So we set out to challenge a persons belief system, having them see what they thought to be right, in truth is wrong. What tools within TC, does this? The idea behind TCs is that the community helps the individual make the changes required to grow and understand the need for change. Peers, govern the actions of the individual, guiding them , with the aid of the clinical staff, toward recognizing behaviors, action and beliefs which are not want, then through the community and staff implementing the correct changes to challenge the behavior and in so doing, bring about the new behaviors and belief toward a more positive outcome in the individual. Privileges are a driving force both in and out of TC. We all seek privileges, and these privileges are used in TC to promote change, to reward a person, or as a sanction (punishment) when an individual is not getting the program, or breaking the rules

which the community operates under. Privilege can also show progress within the program, showing the progress in change, and understanding of the need to improve.