Case Concept The nature of the treatment plan and evidence-based interventions should coincide with the needs of the client and the theoretical orientation utilized. Additionally, tre
Case Concept
The nature of the treatment plan and evidence-based interventions should coincide with the needs of the client and the theoretical orientation utilized. Additionally, treatment goals should be SMART (specific, measurable, attainable, realistic, and timely). Using your theoretical foundation of Person-Centered Theory coupled with your preferred theoretical orientation described in Part II, respond to the following elements:
· Short-term SMART goal for treatment
· Interventions, approaches, and techniques to work towards this goal
· Mid-range SMART goal for treatment
· Interventions, approaches, and techniques to work towards this goal
· Long-term SMART goal for treatment
· Interventions, approaches, and techniques to work towards this goal
Your discussion of Treatment Planning should include complete-sentence, bulleted responses to each of the prompts.
Ethical and Legal Considerations
Nearly all clients and every situation present the possibility for ethical concerns and dilemmas. It is important to be proactive and intentional in our consideration of what those might be. Ethical challenges can arise in a number of ways, including transference/countertransference, court-ordered counseling, informed consent, boundary violations, poor self-care, limits of confidentiality, and mandated reporting, to name a few. Using the ACA Code of Ethics, reflect on your work with the client and respond to the following:
· Describe potential ethical dilemmas present or potentially present
· Identify your own barriers or challenges that may complicate the ethical dilemma
· Explain the steps you should take to be intentional and proactive in your ethical approach
Your discussion of Ethical and Legal Considerations should include 2 well-formed paragraphs.
Social Change Implications
The end of your work with a client should not be the end of your work. Each client impacts us as we impact them. Reflect on your client and their circumstances. Consider their efforts in relation to their successes and failures. Keeping in mind all of the information you have considered for this case and all the insight you have gained, respond to the following elements:
· Address the systems and barriers the client experiences that impacted the current situation and outcomes
· If changed or removed, identify what systems and barriers could impact positively upon this individual in the future
· Discuss how your work with this client has informed your understanding of a larger social challenge or barrier
· Identify steps you could take to effect positive social change in relation to this social challenge or barrier
Your discussion of Social Change Implications should include 2 well-formed paragraphs.
Charlotte is a 28-year-old single African American female. She states she is heterosexual and was raised in the Christian faith. Charlotte currently resides in her small hometown near Pittsburgh, Pennsylvania. She is currently in counseling at the New Changes Outpatient Behavioral Health Treatment Facility. Charlotte reports seeking treatment for anxiety and depression due to ongoing family-related stressors, lacking self-esteem and motivation. Charlotte has experienced various symptoms over the past 6 months. She is hoping that treatment will help decrease her anxiety and depression symptoms and increase her motivation as well as self-confidence. Charlotte would like to obtain and maintain employment as well as potentially enroll in college.
Charlotte reports sleeping most of the day and eating very little. She states this has worsened over the past 2 weeks. Charlotte reports that her symptoms of anxiety and depression have worsened as well. In session today, she presents as depressed and guarded. Though defensive, she is soft spoken. Today, more so than usual, Charlotte appears disheveled. She casually mentions she has been self-medicating with marijuana. This is the first time she has reported use, and after you inquire further, she admits she has been using since the age of 16. She states it is the only thing that makes her feel better. While she has no history of suicidal behaviors and she denies current suicidal thoughts, she does report experiencing hopelessness in the past and feels she is getting to that point again.
Charlotte reports being classified with a learning disability from an early age and struggled academically throughout high school. Charlotte reports growing up in an upper-middle-class neighborhood. She reports being one of only 20 students of color at the high school she attended and feels she was treated differently as a result. Charlotte reports a history of trauma, stating she was sexually assaulted at a party in high school. She states she was under the influence of alcohol at the time and partly blames herself. Charlotte reports that she has not used alcohol since the assault. Charlotte has not discussed the assault with her previous therapist, family, or friends. She attributes her poor self-image and issues related to self-confidence to the assault and learning disability.
Charlotte talks about stressors related to financial difficulties and is overwhelmed, wondering how she will regain any financial stability and independence. Charlotte is currently unemployed and has been for the past 3 months. She reports a history of working retail and restaurant jobs but has struggled to keep any for very long. Charlotte’s parents have provided financial assistance in the past; however, they feel that, at 28 years old, she should be able to live independently. They also disapprove of her decision to not attend college and blame her for her inability to maintain employment. As a result, they have vowed to no longer provide any means of financial support and state it is time she supported herself. Charlotte is currently between places to live and temporarily staying with friends she met at her last job.
Charlotte reports she always felt a great deal of pressure to succeed from her parents, as they are both college graduates and have careers in the medical field. She states the last time she recalls them being proud of her was the day she graduated high school 10 years ago. Comparatively, Charlotte’s brother is a veterinarian, and she feels she will never measure up to him in her parents’ eyes.
Charlotte has a history of inpatient hospitalization beginning at the age of 24 after she experienced extreme depressive symptoms following a breakup with a boyfriend of 4 years. Charlotte reports that her ex-boyfriend was verbally abusive and called her names such as “stupid” and “lazy.” Charlotte denies self-injurious behavior; she reports experiencing explosive behavior at times and has admitted to destroying property at home such as punching holes in walls following an argument with her parents. She feels she learned this behavior from her father, who is an alcoholic with anger issues. She states her mother takes some kind of medication for depression.
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Theoretical Orientation
CBT, established by Aaron Beck, is my theoretical perspective. I like CBT because it links ideas, emotions, and actions. I think our ideas and perceptions affect our emotions and behavior. I believe self-reflection and cognitive restructuring may lead to good transformation, and CBT identifies and challenges cognitive distortions. CBT targets dysfunctional thoughts and behaviors that cause clients suffering. The therapist and client work together to define objectives and create solutions. CBT targets ideas and actions to reduce emotional suffering.
Cognitive restructuring, behavioral trials, and skills training help CBT achieve positive change. Cognitive restructuring includes recognizing and changing negative or distorted cognitive processes to more adaptive and realistic ones. Behavioral experiments let customers evaluate their views and assumptions in real life. Skills training helps customers cope and solve problems (Geraghty et al., 2019). CBT would help Charlotte understand her presenting issue by analyzing her negative self-perceptions, erroneous views about her talents, and how her prior traumatic experiences affect her thoughts and actions. CBT would help her recognize and confront these negative beliefs, improve her self-image, and learn coping strategies to manage her anxiety and despair. CBT would reduce anxiety and despair, improve self-esteem, and empower her by attacking cognitive distortions and maladaptive behaviors.
Psychodynamic Theory approaches Charlotte's issue differently. Psychodynamic theory, established by Sigmund Freud, emphasizes unconscious processes, early childhood events, and how the unconscious mind affects contemporary actions and symptoms. It would examine Charlotte's inner tensions, unresolved childhood memories, and the effect of her family, notably her brother. Psychodynamic treatment would help Charlotte understand her hidden conflicts and unresolved feelings (Bu et al., 2023). The therapist would investigate unconscious defensive mechanisms and how early events and family dynamics may have contributed to her present symptoms and challenges. Free association, dream analysis, and transference/countertransference interpretation would be used in therapy. Psychodynamic therapy explores the client's unconscious and history to obtain insight and understanding, whereas CBT focuses on the present and particular symptoms and behaviors. It emphasizes therapy and client interactions.
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