The case study I choose for this assignment was case 3 were there is a 30–year–old single Asian female attorney Lee Kim that lives alone, has successful legal practice in a large law firm. She lives alone in a nice condominium, which she can afford due to her lucrative legal practice. Raised in the U.S. by first–generation immigrants from Japan along with an older brother who is a successful entrepreneur. Hired by prominent law firm after graduating from a prestigious law school. No religious affiliation. She also began drinking and occasional use of marijuana after entering college and being away from home for the first time. Maintained heavy use of alcohol and marijuana throughout law school but has recently been abusing cocaine, and this …show more content…
As the counselor I will educate Lee to the synergistic effects of alcohol, marijuana, and cocaine. The counselor will also explain to Lee the purpose of the detoxification is to slowly and safely withdraw her from substance abuse and lower the risk of such an event occurring. The other danger in this case is intentional suicide. Lee is facing what may seem to her some overwhelming life tasks: possible loss of her job, embarrassment in being referred to an employee assistance program, the stigma of being an alcoholic or drug head, and needing treatment. All these and other issues may appear to Lee, now, just too much and she may toy with the possibility of suicide. This means the counselor will constantly monitor Lee’s statements and affect for clues that she may be contemplating …show more content…
The employer does not have the right to more detailed personal information on Lee. Thee ONLY thing the employer informed about is that Lee is keeping her appointments when into a treatment program, expected length of that program, and if she participated satisfactorily in that program.
The dual diagnosis issues may arouse that Lee may have several possibilities, but it would be important to begin a process of ruling out both Axis I and Axis II diagnoses as she becomes more stabilized in her treatment program. The counselor’s job would be to pass on any changes they see in the patients affect or demeanor to the medical staff, so they can do further evaluations or tests, if necessary. In Lee’s case counselors will get as much information of Lee’s family history as possible.
Lee’s has reached the induction phrase that she has made the decision to seek therapy, and the counselor will assess whether the Lee is willing to change. In this stage in Lee’s assessment the counselor will evaluate her stage of change and structures the therapy session to match Lee motivation level. This means the counselor will have to form an alliance with the client. The counselor assesses impediments to change, motivation for change, sets achievable goals and forms a treatment plan and contract. All these tasks must be accomplished in collaboration with
The LPN-Team Lead contacted the social worker about Dr. Sundaram’s patient. The patient is a single, Caucasian grandmother and mother of two; she is alert and orientated to person, place and time. The patient reports that she lives with her 16 year old daughter and 3 month old granddaughter. The patient states that she works two jobs, one full-time and one part-time job and she assist with the care of her new granddaughter while her daughter is a work. The patient report that she is feeling (angry) and hurt because her boyfriend of 11 years cheated on her when she was in the hospital and left her a month ago; this and the loss of her child last year at 6 months gestation in addition to her CHF, COPD and influenza appears to have left the patient feeling of depression and hopelessness. The social worker noted that the patient scored a 19 on her PHQ-9, although she denies thoughts of suicide at this time. The patient states that she suffers from insomnia and gets approximately 2-3 hours of non-continuous sleep a night.
Case conceptualization explains the nature of a client’s problem and how they develop such problem ( Hersen, & Porzelius, p.3, 2002) In counseling, assessment is viewed as a systematic gathering of information to address a client’s presenting concerns effectively. The assessment practice provides diagnostic formulation and counseling plans, and aids to identify assets that could help the client cope better with concern that they are current. Assessment is present as a guide for treatment and support in the “evaluation process. Although many methods can be employed to promote a thorough assessment, no one method should be used by itself” (Erford, 2010, p.269-270). Eventually, it is the counselor's job to gain adequate information concerning the client and the client's presenting concerns to establish an effective treatment strategy. Using a combination of assessment techniques increases the likelihood of positive interventions and promotes successful treatment (Erford, 2010, p.271). A case conceptualization reflects how the professional counselor understands the nature of the presenting problems and includes a diagnostic formulation. Case conceptualization organizes assessment data into meaningful outline, applying research, and theory to make sense of client’s current problem.
Kay with decreasing her depressive symptoms. The goal is to replace her feelings of helplessness with positive thoughts about herself, such as feeling pleased with herself for all that she has accomplished over the years. The following steps included in this intervention have been cited in Jacqualine Corcoran’s Collaborative Cognitive-Behavioral Intervention in Social Work Practice Workbook, (2014, p. 55). Step 1 is: Mrs. Kay will gain insight on her connection between her thoughts, emotions, behaviors and body feelings during a specific situation. Step 2: Mrs. Kay will identify the thoughts associated with the specific situation. Step 3: Mrs. Kay will examine the validity of beliefs. This objective will consist of the social worker requesting Mrs. Kay to provide examples opposing and favoring her belief. Step 4: Mrs. Kay will replace the irrational or problematic thought with more fundamental thoughts (Corcoran,
As this book points out, and what I found interesting, the therapeutic relationship between therapist and client, can be even more important than how the therapy sessions are conducted. A therapists needs to be congruent. This is important because a client needs a sense of stability. To know what is expected from him or her while being in this transitional period of change. In some cases this congruency may be the only stability in his life, and without it, there is no way of him trusting in his t...
The counseling session should be centered on the client and their understanding of their world and/or problems not heavily weighted on the counselor interpretation of the client’s situation. The role of the counselor is to examine a problem needs changing and discover options in overcoming their problem. Bringing about change can help change the client’s narrative on their problem in the future and/or on life in the process.
Formulation of Problem/Needs: The client 's presenting problems are caused by her mother’s emotional verbal abuse. In spite of all, her emotional problems Ana maintains a positive outlook towards her future. Ana demonstrates self-determination as she clearly expresses her current issues. She struggles with overeating because she feels unloved and worthless. Ana is seeking services to overcome the resentment she feels towards her mother. She is requesting help to manage her coping skills and reduce her feelings of depression. According to Ana these feelings started at a young age. Ana’s current challenges are learning to cope with her mother’s verbal abuse. Anna will arrange monthly meetings with her social worker to talk about what methods she’s used to coping with her depression. Ana agrees that she needs to find positive away to communicate with her mother. Ana also stays that she wants to learn to be selfish and break free from the traditional stereotypical life of East LA. Ana would like to begin addressing the following
Drug use and abuse is as old as mankind itself. Human beings have always had a desire to eat or drink substances that make them feel relaxed, stimulated, or euphoric. Wine was used at least from the time of the early Egyptians; narcotics from 4000 B.C.; and medicinal use of marijuana has been dated to 2737 B.C. in China. But it was not until the nineteenth century that the active substances in drugs were extracted. There was a time in history when some of these newly discovered substances, such as morphine, laudanum, cocaine, were completely unregulated and prescribed freely by physicians for a wide variety of ailments.
Collaboration is an important indicator of the liklihood of change occuring. When the counselors and client can cooperate resistance does not occur.
Jody was born biologically with male genitals and he was brought up as a boy. Unlike his more gender-typical older brother, Jody’s childhood behavior was considered “sissy”. Jody genetically preferred the company of girls compared to boys during childhood. Jody considered herself a bisexual male until the age of 19. At 19 years of age, she became involved with a man, and her identity would be transgender, meaning that Jody was unhappy with her gender of birth and seeks a change from male to female. It would seem that there was some late-onset dissatisfaction, and late-onset is linked to attraction to women; in comparison to early childhood-onset, which are attracted to men. Jody identified herself as bisexual. The relationship with the man ended; nevertheless, Jody’s desire to become a woman consumed her, and Jody feels that’s he was born in the
Mary Jane has come to counseling for guidance on her cannabis use. Mary Jane has been using cannabis since she was younger, however within the last ten years she has been using cannabis heavily. She explains, her use of cannabis use to just be a weekend thing for fun, but now is more of an uncontrolled habit. Mary Jane has been using a large amount of cannabis daily, since her body has become tolerant. Recently within the last three months, Mary Jane has been experiencing difficulty concentrating, paranoia, rapid heart rate, and panic attacks. Mary Jane believes these symptoms are due to using an excessive amount of cannabis. Mary Jane has started consuming supplementary amounts of alcohol to relieve these symptoms. Her
“Motivational interviewing was introduced by Dr. William R. Miller in 1983, to help problem drinkers prepare for treatment and has been developed in collaboration with Dr. Stephen Rollnick. Motivational interviewing is a client centered directive method of communication for enhancing intrinsic motivation to change by helping people to explore and work through ambivalence. (Miller &Rollnick,2002).” This definition simply means that motivational interviewing is a method that uses the techniques taught by Carl Rodgers, such as empathy, positive regard, and congruence all of which lead to a collaborative relationship between the counselor and the client. This supportive and collaborative relationship will enable the client to open up and have honest discussions with the counselor. Therefore, the counselor will be able to help the client recognize:
Motivational interviewing is an important technique and counseling style that was created by William Miller and Stephen Rollnick in the 1980’s. The brief definition of motivational interviewing (MI) that is provided by Miller and Rollnick in their influential text is “a collaborative conversation style for strengthening a person’s own motivation and commitment to change” (Miller & Rollnick, 2013). Motivational interviewing is considered to be a style that evolved from client-centered therapy. The style is considered to be empathic but requires the counselor to consciously directive so that they may help their client resolve the ambivalence they are experiencing and direct them towards change. The important thing to note is that client autonomy is key to the process (Hettema, Steele, & Miller, 2005). However, despite being able to currently give a definition of MI, one that could be considered a working definition, motivational interviewing is “a living, evolving method” (Miller & Rollnick, 2009). It will continue to evolve as times change and it is implemented in use with other maladaptive behaviors. MI is a relatively new style that it still has the ability to undergo changes to adapt to what purpose it is serving (Miller & Rollnick, 2009).
Ryan is the presented client in this case at twenty-five years old. He identifies himself as a heroin addict and first started using substances at the age of twelve years old. This was around the time that Ryan reports his parents got divorced. His substance use first began with occasional alcohol and marijuana use that became daily use by the age of fifteen. Ryan shares that he then began to experiment with a variety of drugs including opiates which became his drug of choice. His use of opiates escalated from pills to intravenous heroin use that he was supporting through dealing, stealing, and pawning. The client has made attempts at sobriety previously including detox, inpatient, intensive outpatient treatment, and one-on-one therapy. His girlfriend recently entered treatment for her heroin use and Ryan is able to report numerous consequences of his drug use over the past several years including pending legal issues that have driven him to
165). The therapeutic method involves the therapist interacting with the client and inspiring the client’s development “by listening, guiding, instructing, and requiring” (Jones & Butman, 2011, p. 311). In ET, the counseling process is tailored to assist the client in developing through the awareness of knowledge that they are the ones that make the choices and decisions in their life about the direction their life will take. Instead of utilizing a mental illness model, the effectiveness is built on a real, authentic relationship that encourages prosperity and development in the client. The therapist and the client have a relationship, the therapist is a mentor to assist the client in the art of living a full
This leads to the question of, “How do people change?” Self-awareness of one’s current plight, whether it is internally or externally, and an intense desire to discover new ways of living are two main ingredients to spur change. People must be fully aware that their current behavior is causing more harm than good in their lives. And on the same token, discovering that there are alternative ways of living can also make people change. However, in order for change to actually occur, people must be willing to live out new ways of behaving and thinking. For people who want to make changes, but find it difficult to make a step, a counselor can help facilitate change through encouragement and various self-empowering