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Suzy Q Case Study

SuzyQ Case Study

Cognitivebehavioral therapy (CBT) is a problem-focused and practical approachto treatment. It is a form of psychotherapy that is based on thescientific principles (Beck, 2011). These principles are aimed athelping people to alter the way they think about symptoms, events andsituations in their lives and how they create meaning about theworld, themselves and others (Beck, 2011). These feelings, thoughtsand behavior are believed to be false, unhelpful and harmful. Theyare believed to be triggers of physical and mental problems (Beck,2011). As such, CBT focuses on cognitive schema, thoughts, attitudes,beliefs, and attributions that influence an individual’s feelingsand thoughts. It mediates the relationship between behavior andantecedents (Hofmann et al., 2012). A therapist using CBT is expectedto focus on interrupting problematical patterns of thinking,behaviors, and feelings with a view to allow for objective thinkingpatterns, behavior, and feelings. By challenging an individual’sways of thinking, CBT can help create more realistic and helpfulthought patters (Beck, 2011). In this paper, CBT is applied to SuzyQ’s case to help her create more realistic and helpful thoughtpatterns about her condition.

SuzyQ. Case Study

SuzyQ. is an offender that is on your caseload. She has an extensivehistory of using and abusing heroin intravenously and was recentlyreleased from prison three weeks ago. Today, Suzy Q. arrives at youroffice for her bi-weekly appointment. As your session with Suzy Q.begins, you observe a mark on her arm that looks like a freshpuncture wound (which is indicative of IV drug use). Suzy Q. admitsthat she relapsed a few days ago and swears that this was a onetimeoccurrence. You ask Suzy Q. to show you her arms so that you maytake a closer look, and Suzy Q. readily shows you her arms. Afteryou have visually scanned her extremities, it does not appear thatthere are any other suspicious signs of drug use.

Applicationof CBT to Suzy Q

Itis evident from the case that Suzy Q has suffered a relapse. Itsuggests that Suzy Q is cocaine-dependent. Suzy, therefore, meets theDSM-IV criteria for cocaine dependence. When dealing with Suzy Q’scase, the important assumption will be that the continuation ofheroine dependence and abuse is contributed by the learning process(i.e., her addiction to heroine). When using CBT, the assumption willbe that the same learning processes will be useful in helping Suzy Qto reduce her drug use. This way, CBT will attempt to help Suzy Q torecognize the situation in which she is most likely to resort tousing heroine, avoid such situations when appropriate and effectivelywith a range of problematic behaviors and problems associated withthe use of heroine. As such, I will use the CBT to guide Suzy Q intoanticipating for likely problems that she could encounter. I willalso enhance her self-control by helping her to come up withefficient coping strategies. Some of the techniques that can be usedfor Suzy Q’s case will include exploring the negative and positiveconsequences of using heroin. Suzy Q will explore the techniques forself-monitoring. This will help her identify her early cravings andthe situations that could put her at risk of relapsing. She will thendevelop strategies that will help her cope with her cravings and stayaway from the high-risk situations.

Asan individualized treatment plan, CBT will help Suzy Q to identifybehaviors and thoughts that are self-defeating that could drive arelapse. Persons struggling with substance use disorder like Suzy Qare likely to have negative destructive thinking. Failing to identifythese thinking patterns would harm them. Importantly, Suzy Q changeof her harmful patterns of thinking will enable her to change hercognition. CBT will help deal with harmful patterns of thinking. Thisway, it will help Suzy Q to identify her capability in practicingalternative thoughts and enable her to regulate distressing feelingsand harmful actions.

Further,I will address areas that will appear easy to make some change. Iunderstand that it would not be easy to change her physical statesand feelings. However, I know that with time she will be able to workon her negative beliefs and thoughts. I also know that Suzy Q islikely to make possible changes in her behavior as we progress in thetherapy sessions. I will focus on small adjustments. In particular, Iwill focus on adjustments that Suzy Q is capable of doing. This willhelp influence her thinking, feeling, and behavior.

Afterthe session, I will also give Suzy Q homework. This will be aimed athelping her to continue working on the presenting issue. For example,I will give Suzy Q an assignment to read a book on negative effectsoften associated with the use of heroin. I will also ask her to keepa record of her thoughts. I will also require her to respond towardsher thoughts. I will also guide her into exploring other alternativeactivities that she enjoys doing. I will ask her to engage in theseactivities and record her negative thoughts. I will also require herto keep track of her reactions towards her thinking. I believe, inline with CBT, these activities will help Suzy Q to refrain fromheroin.

Iwill further to ask Suzy to analyze her negative beliefs andchallenge them by asking her to seek for evidence to back up thebeliefs. I will require her to think about the belief from a rationalpoint of view. This will give her the opportunity to challenge herbeliefs. In line with CBT, I will invite Suzy Q into a reality checkand help her avoid unhealthy and inaccurate negative belief systemsabout her life.

Ibelieve that monitoring Suzy’s progress through the session willhelp her identify issues that drag her into distorted thinking. Thesession will help Suzy realize what and when she tends to minimizethe positives when she thinks in all or nothing terms when shemaximizes the negatives, and when she is catastrophising. Theobjective will be to ensure Suzy Q can think objectively about heruse of heroin and its associated problems.


Beck,J. (2011). Cognitivebehavioral therapy, Second edition: Basics and Beyond.New York: McGraw-Hill.

Hofmann,S., Asnaani, A., Vonk, I., Sawyer, A. &amp Fang, A. (2012). TheEfficacy of cognitive behavioral Therapy: A review of meta-analysis.Retrieved on 13/11/2016 fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/