Cognitive Psychotherapy Approach in Treatment
Scenario
A young man was admitted in the morning hours and appears calm and even-tempered. In the afternoon, upon being awakened from a nap the man becomes agitated and angry. The man is found on the floor and the nurses cannot calm him enough to return him to bed. The nurses discover that the man views his leg as being that of someone else and in an attempt to throw the foreign leg out of his bed the man throws himself upon the floor. The nurses point out to the man that the leg is his own leg. The patient has complete loss of awareness of his hemiplegic limb but interestingly enough he is unable to tell whether his own leg on that side was in bed with him because he is so caught up with the unpleasant foreign leg that was there.
Introduction
Cognitive therapy is reported to be based on the theory that holds that much of how the individual feels is determined by what the individual thinks. Cognitive therapy involves the therapist working with the individual and challenging errors in their thinking through leading them to alternative views about a life situation. (Herkov, 2012, p.1) Hemiplegic limbs often occur in individuals who have strokes or in younger individuals with cerebral palsy. This study investigates the use of cognitive psychotherapy for the young man in this scenario and intends to demonstrate how cognitive psychotherapy can enable the individual in a functional and effective manner in such as the case at hand.
I. Cognition and Intervention
The mind's power over the body and its functions, health, and physically fit status is well acknowledged in contemporary science. One method has linked together physical movement combined with the individual's 'thinking' processes aligned to physical movement in a cognitive physical therapy that results in a part of the brain learning how to process certain information and send the correct information to the individual's limbs to perform specific actions related to physical movement and function.
This method is known as the KAWAHIRA Method, which involves activation of neurons, by a "stretch reflex" which is a timed to "discharge when neuronal excitation of the patient's intention comes from the prefrontal cortex." (Kawahira, 2006) Involved in this therapy is a repetitive movement exercise therapy for recovery of motor function of hemilplegia. (Kawahira, 2006) In fact, there are various therapies when combined with cognitive psychotherapy that will assist individuals such as the young man in this scenario in regaining use of hemiplegic limbs. It is reported that part of assessing patients with hemiplegia requires assessing "mental functions, speech, motor system, sensory system, cranial nerves, pain, cardio-respiratory system, balance, ADL, and gait." (Kawahira, 2006)
II. Treatment Principles
Treatment principles for successful rehabilitation includes " a problem-solving approach" requiring that the therapist conducted assessment of the patient and identify the disorder to the movement and choose strategies for treatment that are appropriate. Motor relearning is described as "an active process…" and the patient must have the capacity for active participation in activities and exercise in what is a treatment focused on functional improvements since the best facilitation is that of muscle groups rather than isolated exercise of muscles. Practice is critical and the therapy required is focused on repetitive movement in a skill acquisition process. While this may sound simple enough in reality, it is the ongoing repetition, repeating difficulties that the individual must overcome in their way of thinking before they will have the commitment that is needed to face yet another exercise session in a long line of many that regaining use of the hemiplegic limb requires. Stages of recovery include the "early recovery stage (acute or shock stage) involving variation in the flaccidity stage between patients ranging 2 to 6-week. Rehabilitation can begin immediately upon the medical stabilization of the patient and generally between 24 to 36 hours. (Sullivan and Schmitz, 2006) Involved in this phase of the therapy are the beginning activities of learning to cope with the hemiplegic limb. General goals include minimizing the "effects of tone abnormalities among other tasks including that of the individual initiating "self-care activities." (Sullivan and Schmitz, 2006) Included in the early tasks are such as positioning of...
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