Shame is a feeling that most people will experience at some point in their lives. However, for some people, chronic shame can have major effects both psychological and physical. well-being. Shame has been commonly associated with mental illnesses such as anxiety (Zhong, Wang, Qian et al., 2008) and depression (Cheung, Gilbert & Irons, 2003), and has been shown to have effects on physiological health, such as having significant effects on immunological functioning (Dickerson, Kemeny, Aziz et al., 2004). Since shame can have very significant impacts on a person's well-being, it is essential to find an effective intervention to address and alleviate feelings of shame. Many different psychological approaches have proposed approaches that can help treat shame. In this particular trial, the focus will be specifically on Cognitive Behavioral Therapy (CBT). The strengths and weaknesses of this approach will be analyzed, examining two important symptoms of shame – low self-esteem and social anxiety – assessing the effectiveness with which CBT can be used to treat clients with these symptoms, and how this may relate to processing shame. shame. CBT as a whole will also be evaluated, and an alternative form of treatment will be briefly discussed in order to fully assess the effectiveness with which CBT can be used as a psychological intervention for these clients. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get an original essay In order to evaluate the effectiveness of CBT in helping clients with shame, two of the main symptoms of shame will be examined individually. Van Vliet (2008, p233) stated that "in particular, shame is elicited in response to social rejection and other events that threaten the individual's self-esteem, social status, and sense of belonging." ”, and Gruenewald, Kemeny, Aziz, and Fahey (2004) were able to find a distinct link between an increase in shame and a decrease in self-esteem. Therefore, the first aspect that will be evaluated is the effectiveness with which CBT can be used as a treatment for low self-esteem. In 2003, Hall & Tarrier proposed a form of cognitive behavioral treatment to target low self-esteem (particularly for patients suffering from psychosis). ). They tested this method of CBT on a sample of patients and found that, compared to patients who continued to receive their usual treatment without CBT intervention, there was a clinically significant increase in self-esteem. Hall & Tarrier also measured self-esteem levels again three months after treatment and found that in the majority of cases, the self-esteem benefits were maintained. The results of this study suggest that CBT may be an effective intervention for improving clients' self-esteem, which, given the strong links between low self-esteem and shame, would also suggest that this form of treatment would have a positive impact on customers. feel shame. However, this study was very specifically focused on clients with psychosis. Although this treatment was found to be very beneficial for the participants in this study, there is no way of knowing whether it would have the same benefits if used to treat otherwise healthy individuals. This lack of generalizability makes it difficult to fully assess the actual effectiveness of this treatment in improving general self-esteem issues. Furthermore, although the study haswas followed up three months after treatment, this does not constitute strong evidence of a long-term solution. Ideally for members of the general population experiencing shame, treatment should be effective in the long term. If clients had to continue to seek treatment every three months, this would not only be an inconvenience, but could also begin to have an even more negative impact on their self-esteem and lead to a stronger sense of shame. Another study conducted in 2007 (Taylor & Montgomery) examined the extent to which CBT was effective as a method of improving self-esteem in adolescents with depression. A literature review was carried out, examining the effectiveness of the treatment in two previous trials. Their research found that although CBT led to an increase in participants' self-esteem, this increase was not clinically significant. However, they found that over a five-week follow-up, participants' self-esteem continued to increase. Although not yet reaching significant levels, this suggests that CBT could lead to a gradual increase in self-esteem and could therefore potentially offer a long-term solution to the client's feelings of shame. Unfortunately, as with the study mentioned above, this review focused on a very specific group of customers, in this case adolescents aged 13 to 18 years old. Again, this may mean that the findings of this study cannot be generalized to the general population. Additionally, this study also did not examine the long-term effects of CBT on self-esteem. Although their results showed that self-esteem appeared to increase gradually, the research was only followed up five weeks after treatment. It is therefore unclear whether self-esteem would continue to increase to a stable level or whether it could begin. decrease again over time, which, as previously mentioned, could lead to further negative effects for shamed customers. Finally, this review only focused on research from two previous studies. The conclusions drawn from this study would be much more reliable if they had drawn data from a wider range of sources. Further research may therefore be necessary to fully assess the effectiveness of CBT in improving self-esteem. , and thus help clients who experience shame. The second aspect of shame that will be examined is social anxiety, which can be both the cause and result of shame. Pattison (2000) described the impact of shame as “the fear of being discovered that produces a strong desire to be covered up…a perceived threat of being exposed to the public.” If CBT can effectively alleviate social anxiety and allow the client to feel more able to go out into the world instead of feeling like they have to hide, this should also help alleviate feelings of shame. A study by Hedman, Ström, Stünkel, & Mörtberg (2013) examined the link between social anxiety disorder (SAD) and shame, and investigated the effectiveness with which CBT treated participants with SAD and in how much it reduced feelings of shame. Their results showed that there was a strong link between SAD and shame, finding that participants with SAD had significantly higher levels of shame than the control group. It was also found that after CBT, SAD symptoms were treated effectively and feelings of shame were significantly reduced. The results of this research not only confirm that treatment of SAD can also lead to a successful reduction of feelings of shame, but showalso that CBT can be used to achieve this. However, the data used in this study were collected before and shortly after treatment. No follow-up data was collected and therefore it cannot be said whether the effects of the treatment lasted or not, nor how long the treatment would need to last to have a positive and lasting effect on clients. Additionally, when testing whether CBT was an effective treatment, all participants with SAD received the same treatment. So while significant improvement was seen, there is no control group to compare this with. Given the apparent link between the treatment of social anxiety and a depletion of feelings of shame, previous studies examining the effectiveness with which CBT can treat social anxiety may also serve as evidence of the effectiveness of CBT to address customer shame. One such study, conducted in 2002 (Heimberg), evaluated the extent to which CBT could treat SAD symptoms both in the short and long term. It was found that patients reported fewer SAD symptoms and better quality of life six months after treatment ended. However, even though quality of life improved, these participants still scored significantly below average, suggesting that while CBT may result in improvements for a client experiencing shame, it may not not work as an effective long-term solution as the client's overall quality of life might. still remain below average. Another literature review conducted by Rodebaugh, Holaway, and Heimberg (2004) evaluated the effectiveness of CBT in treating children and adolescents with SAD. They found that in the literature, all CBT techniques resulted in a significant reduction in SAD symptoms, both compared to pretreatment and compared to patients who had not yet received any treatment. They also found that, on average, improvements were maintained for up to twelve months after treatment ended. However, this study focused specifically on the impact of CBT on children and adolescents, so the results of the meta-analysis conducted may not accurately reflect the effects that CBT may have on adults. . Additionally, studies by Rodebaugh et al (2004) and Heimberg (2002) identified that CBT was more effective when clients expected the treatment to help them. For clients who were more skeptical about the effects the treatment would have, the improvements they experienced were often less significant. This can create a problem when treating clients who experience shame, as one of the key emotions associated with shame is hopelessness. If a client who experiences shame already feels hopeless and feels that they can no longer be helped, CBT may not have as much positive impact on these clients as it would have on clients who already believe that CBT will help them. Finally, CBT will help them. The approach as a whole will be examined. Mollon (2002a) stated that “shame is a broken connection between a human being and others. A breakdown in understanding, expectation, and acceptance that is necessary to feel like a valued member of the human family…the cure for shame is empathy.” With this in mind, in order to evaluate the effectiveness of CBT when dealing with shameful clients, the use of empathy in CBT needs to be examined. CBT has two main axes: cognitive restructuring and behavioral activation (Nathan & Gorman, 2002). ). This is usually achieved through homework assigned to the client after each appointment. One criticism of CBT therapists is that they.