The cognitive approach stresses that the thinking pattern is directly related to the mood or feelings—or that the feelings and mood are a direct response to the thinking pattern.  Beck believes that when someone has a faulty thinking pattern, it signifies that he/she has a mood or feeling that makes sense to their thinking pattern, but may not make sense outside of the faulty thinking. For example, Carla’s faulty thinking of personalization—taking responsibility for actions outside of her control, the rape—has led to her feelings that she is too “stained” and “unworthy” to attend her religious services. The uncontrollable actions of the rapist are personalized into her faulty thinking. She also exhibits the faulty thinking pattern of negative beliefs about self, others, and the world. This is evident in the fact that she refuses to date. She may be associating the horrible behavior of the man who drugged and raped her to all men and people in the world. This faulty thinking pattern is associated with her feelings of not wanting to date, withdrawing socially with co-workers and family. According to this theory, if the faulty thinking patterns that Carla displays are changed, her depression will decrease and her positive mood will increase.

Define the problem: Carla is experiencing an emotional crisis. She has experienced an accumulation of stressful events—moving from her parents, starting a new job, withdrew from college—and she is currently underutilizing her coping skills and support systems. She is exhibiting social withdraw, high degree of emotionality, and impaired decision making. Her frequent headaches are probably a psychosomatic illness brought on by stress. The precipitating event—not the cause—is the rape. She is experiencing the emotional illness of depression. Carla is not using her support systems due to her social withdrawal. She has withdrawn from family, co-workers, and the members of her fellowship. Lack of coping strategies is causing her to do poorly at work, so much in fact her supervisor referred her to the health facility. Carla has experienced all three causes of an emotional crisis and three symptoms.
Ensure/Provide for Client’s Safety:  Carla is not exhibiting any behaviors that would lead one to feel that she would do physical harm to others or herself. However, her depression is a concern to harm her emotional well-being. There are no indications that anyone around her would want to harm her. She lives alone and her friends and family are concerned about her.
Be Ready to Respond in the Context of Creativity:  The crisis response was done when her supervisor referred her to the health facility associated with the corporation.
Provide Support: Social support systems include Carla’s adult fellowship group from her church as well as others in her religious community. Her friends, co-workers, and family also can provide a system of support for Carla. The Rape Crisis Center may be able to provide her with group counseling sessions, which may help her connect to others familiar with her situation to allow her to “vent” her feelings around those who “understand”. Other counseling may help her better understand coping strategies. She can attend some of her social events, movies, dinner, sports, to help her with coping skills.
