Dr. Sojan Antony Assistant Professor Department of Psychiatric Social Work NIMHANS, Bengaluru

1. Application of Cognitive Behavioural Therapy
(CBT) in Caring Persons with Chronic Illness
Dr. Sojan Antony
Assistant Professor
Department of Psychiatric Social Work
NIMHANS, Bengaluru

2. Chronic Illnesses
• Bipolar Affective Disorders
• Schizophrenia
• Diabetes
• Cancer
• Heart Diseases
• Kidney diseases
• Liver Problems
• Substance use disorders

3. Chronic Illnesses: Common Characteristics
• Chronic
• Recurrence
• Less chance for recovery
• Life long medical attention
• Financial burden

4. Chronic Illnesses
• Distress
• Disability adjusted life years
• Impact on functioning
• Care givers burden

5. Chronic Illnesses
• These Diseases Affect
• Thinking
• Feeling
• Behaviour

6. CBT (Cognitive Behavioural Therapy)
• Modifying thinking
• Enabling to handle emotions
• Enhances desirable behaviour

7. CBT
• Evidence based practice
• Problem specific
• Time-bound
• Change can be measured

8. Negative Thoughts
• “ I am a burden”
• “My life is over”
• “I will not disclose others about my problem”
• “I am the reason for my problem”
• “I will not change my habits”
• “My family members are not supportive”
• “I am not sure about the treatment and the progress”

9. Negative Emotions
• Frustration
• Anger
• Helplessness
• Hopelessness
• Worthlessness
• Fear
• Emptiness

10. Undesirable Behaviours
• Poor adherence to treatment
• Unhealthy Life style
• Substance abuse
• Withdrawal from social interaction
• Aggression
• Suicide attempts

11. CBT Process
• Listing negative thoughts, emotions, & behaviours
• Understanding ABC- Antecedents, Behaviours & Consequence
• Helping them to learn Relaxation strategies

12. Handling negative thoughts
• Developing insights
• Recognize thoughts
• Exploring alternative thoughts
• Nurturing healthy thoughts

13. Measure behaviour
• Observe behaviour
• Measure frequency & Intensity
• List out action points

14. Relaxation strategies
• Muscle relaxation techniques
• Mindfulness
• Guided imagery
• Physical Activity

15. Use Reinforcement
• Positive Reinforcement
• Negative Reinforcement

16. Other BT techniques
• Desensitization
• Flooding
• Front Chaining
• Back Chaining

17. Some principles
• Measure
• Micro targets
• Focus on micro gains
• Use of reinforcements
• Sensitive to life cycle stages

18. Some principles
• Directive
• Realistic goals
• Have supervision
• Recording

19. Conclusion
• CBT is an effective therapy to mitigate the psychosocial impact of
chronic illness on Individual.

20. Thank you