Using a CBT (Cognitive Behavioral Theory) framework, according to the following case, what would the cognitive profile of Sophie be?

SOPHIEs CASE:

Sophieisasixteen-year-oldfemale gymnastwhoisalsoanOlympichopeful.Sheisthe only child to divorced parents and lives with her mother who she doesn't see eye to eye with.

Sophie'sfather livesinadifferentstatebuttheystillcommunicatebytelephoneeveryonceina while. Sophiestates she would rather livewith her father becausehe is theonly onewho "truly loves and understands" her.

Sophie is seeking treatment after a near fatal accident where she was hit by a car while ridingherbicycle.Sophieexplainshowthesocial workersheisworkingwithsuggestedshegets an evaluation because the social worker thinks there were suicidal intentions surrounding the accident due to a witness stating she saw Sophie ride her bike into the car. Sophie comes off as verydefensivewhentalkingaboutthesocial worker,howsheis"stupid"andshejust"wantedto kill her". Sophie then states that the social worker and the witness are both wrong because she never tried to commit suicide. Sophie denies her accident was suicidal for multiple sessions and states she was not trying to kill herself.

DuringthefirstcoupleofsessionsSophie comesoffasveryangry, aggressive,defensive and has a strong negative attitude. It comes off very clear that Sophie and her mother do not get along, that her mother ruins everything and everything is her fault. When watching Sophie interact with her mother Sophie is very rude, hostile and disrespectful. Sophie's father is not present in her life but Sophie claims that he is the reason she knows what love is. It is learned that Sophie's father is a photographer for nude models. Sophie states that her father is the only person who believes the accident was not her fault. Sophie also talks about Cy, her gymnastics coach very often. She states she used to babysit his daughter, Dana, but Cy's wife thought she was getting to attached so she is no longer able to babysit her. In reality Sophie is no longer to babysitDanabecauseshewashaving sexualrelationswithCy.During thefourthsession Sophie

admitstheaccidentwasn'treallyanaccidentandshedidinfacttrytocommitsuicide.Sophie explains that she wanted to get rid of herself because she is the biggest problem in her life.

After admitting she tried to commit suicide she overdoses on pills during one of her therapy sessions, it is seen as a "test" to who she can trust. In session five Sophie has a session with her mother which is very hostile. Sophie states that if her mother stays in therapy that she will "either slither wrists or go postal". Itis clear to see that her mother is in distraughton how todealwithSophie's behaviorsandoutbreaks butstillhashopeforchange.During thissession, it was also stated that her father has no clue about the accident, this is a real breaking point for Sophieinrealizingwhoisthereforherinlife.Sophiestarts torealizethatherfather's presence in her life is not as big as she has been making it seem. In session eight she has a breakthrough onhavingarelationshipwithhermother, shewantstotalktoherbutsheisunsurehowbecause it is something she has never done before. Sophie starts to notice that her father is in and out of her life on his terms and that she is no longer returning his phone calls. Sophie then admits she takes a tremendous amount of guilt for catching her father cheating on her mother and having that be a secret and a burden on her life for so many years. In the last session Sophie's father comes unannounced and portrays sexualized language and manipulated behavior. Here is when Sophiehasatremendousbreakthroughinadmittingtoherfather thathehasnotbeeninherlife, he doesn't know her and even tells him the accident was a suicide attempt.

TakingalookonFreudian psychoanalysis,Sophiemayhavehadsometrouble intheoral stage which is from birth to at least one year's old.This could be an explanation on why Sophie tends to demonstrate oral fixations; binge drinking tequila, always stating "that makes me want to vomit", trying to make herself throw up, having and struggling with an eating disorder, overdosingonpillsandhavingliteral aggression.Allofthesefixationsparticularlycomeout when Sophie is under stress, angry or struggling. AlfredAlder inferiority complex takes a look at experiences and feelings of inferiority as childrenthatspendtheir lifetryingtomakeupthoselostandlowerfeelings.AlthoughAldersaid inferiority is the source for human striving it seems that Sophie is stuck and is unsure on how to release herself from this. Sophie explained that her father was always there for her and he is the only one who understands, loves and cares for her. Sophie will even ignore her caring mother and blame everything wrong on her. Later on, in the sessions it is stated that Sophie's father was only around from ages 6-10 years old. When her father joins in on a session he is portrayed as manipulative and hostile. Sophie has spent a majority of her life in so much denial and shame with keeping such a great secret from her mother; her father cheating on her. Sophie was manipulated to think her father was to be praised and the mother did everything wrong and it is cleartoseethatSophieishaving ahardtimetryingtocopewithalloftheseissues fromherpast, yearslater.Alderalsodevelopedbirth orderandthiscanberelatedtoSophie'sbehaviors aswell especially her maturing early and manifesting in adult behaviors and attitudes. Sophie presents herself as very mature for her age but she also admits to engaging in adult behaviors at a young age as well as using vulgar and adult language.

Erik Erikson developed Psychosocial Stages where there is a crisis or a turning point at each developmental stage. There are two stages that connect when evaluating Sophie; initiative versusguiltandidentifyversusroleconfusion.Bringingbackupthememory ofSophiecatching her dad having an affair and Sophie holding that in so for many years she took a lot of guilt and blame for so many years that still persists now. Sophie punishes herself for her father's actions because she is full of guilt and feels she is the one to blame for him cheating and her parents splittingup.ThisisastruggleSophieishaving nowwithheridentityandroleconfusion;sheis havingtrouble findingapurpose, senseofbelonging andthedirectionshewantstobetakingin her life which can be related back to her suicide attempt, suicidal jokes, always stating she just wants to get "rid" of herself and her overdosing on pills. Initially,Sophie started hertreatment andwaspresentedasdemanding, aggressive, angry and defensive. Sophie has really been able to flourish, talk about her feelings with her motherand start to build a relationship with her. She was also able to admit what was wrong with her father and how to cope with any overpowering emotions she may have and come in contact with in the future.After admitting she had so much guilt as a child she now is able to understand that what she saw and what she knew was not something to blame on herself. Throughout her sessionsshewasindenial aboutherself,herfamilyandtheactions shewastakingpartin.Sophie plans to travel to Denver. Here she wants to be by herself for a while and train for gymnastics.

Thisisanextremely independentandmature decisionSophieismakingandwithoutthesessions it is possible Sophie would have never made this decision, or would have even thought about it. She has a very positive attitude and outlook on this journey she is about to take and this will most likely be a great growing opportunity for her that will shape her future into what it is supposed to become.