Chronic Disease example
10 Minute CBT in Chronic Disease
10 Minute CBT is also a useful approach to understanding individual responses to chronic physical disease. Using the approach may identify co-existing psychological disorders, such as depression or anxiety, as well as revealing important concerns or worries about the illness.
Understanding negative beliefs about health and illness can help to improve management of these conditions. The approach helps patients to terms with how illnesses are affecting their lives and may help to improve concordance with complex treatment regimes.
Increasing positive activities and improving mood can often help patients learn to cope with unpleasant physical symptoms associated with their illness.
Case example: Using the 10-Minute CBT approach in diabetes
(Adapted from Using CBT in General Practice: the 10-Minute Consultation, Author: Lee David, Publisher: Scion Publishing)
Donald is a 56-year old overweight decorator who has been diagnosed with diabetes for 3-4 years. His tests show that his diabetes is poorly controlled but he does not seem interested in his illness. His GP suspects that Donald is not taking his medication regularly, as he rarely asks for repeat prescriptions. But whenever health professionals try to educate him about his diabetes and encourage him to take his medication, he gets irritated and aggressive, saying that he has ‘heard it all before'.
Lecturing Donald unsuccessfully has been causing frustration for both his GP and Donald himself. Eventually, his GP decides to use the 10 Minute CBT approach to understand a little more about why Donald is so reluctant to discuss his diabetes:
“Having diabetes means that I am ‘ill' and my body is weak”
“If I think too much about diabetes it will take over my life – better to ignore it”
“It is dangerous to take medications – my uncle got an ulcer from his tablets last year
Fed up / low
Tired and lethargic
‘Forgets' tablets – so diabetes gets out of control
Avoids thinking about health
Fails to exercise or lose weight
Approaches to making change
By understanding Donald better, his GP feels less frustrated and is able to express genuine empathy for the patient's difficulties. This helps improve their relationship and encourages Donald to attend the diabetic clinic more regularly.
Donald and his GP are able to openly discuss his fears and gradually move towards a more balanced and helpful view of the situation, with thoughts such as, “ Taking tablets could protect me from serious harm,” which helps Donald to feel more in control of his health and life and improve his mood.