My View and Treatment Paper

Published: 2021-06-17 08:34:37
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Some may enter therapy to address major life changes, such as divorce, and others may seek help in managing mental health conditions, like depression. However, all these events and incidents in one’s life that give an individual a reason to seek help boil down to the level of distress they are experiencing. Any situation whether environmental, such as a looming work deadline or psychological such as persistent worry about failing a subject can trigger that “stress” button that in turn provoke a cascade of stress hormones.
These stress hormones produce well-orchestrated physiological changes that convince our human body that we need to either “fight or flight” to combat the perceived threatening situations and stay safe (Rubinshteyn, 2009). Many people are unable to find a way to put the brakes on stress. Chronic low-level stress is much like a motor that is idling too high for too long. After a while, always being on a high-alert state takes a toll on the body that contributes to physical and mental health problems. In essence, problem begins when client’s distress level tip over the threshold that their body and mind can handle and the vicious cycle of distress and impairment will continue to cause destruction to their wellbeing. The definition of threats, however is subjective to every individual as cultural values, past experiences, personality can all shape one’s perception towards their surroundings, daily tasks and challenges. Some people have an early warning system that’s a little too sensitive.For these people, the fight or flight responses are triggered by events that would be ignored by many others. This hypersensitivity can be caused by a number of factors, including genetically inherited hormone imbalance like bipolar disorder, exposure to abusive events or other traumatic experiences. Personality can play a role in determining one’s responses towards the environment and things happening. For example, people who is more extraverted may experience less stress and anxiety in a social setting comparing to somebody who is introverted. Clients should be accountable for their problems but not labelled as the “problem”. They should focus on tackling the thoughts and incidents that are negatively affecting them but not attacking their self-worth and value. They need to play an active role in being mindful about their triggers and wellbeing in order to more accurately solve the problem.
Professional counsellors must be able to “start where the client is at. ” This phrase is often used in counselling to describe the ability to relate to clients with an open, non-judgmental attitude and accept the client for who she is in her present situation. Counsellors need to be able to convey acceptance to their clients with empathy and active listening throughout the treatment process. Stages of change is also a good marker for counsellor to check our client’s readiness in moving forward so that we can develop achievable treatment goals that meet their level of insights and motivations. Dr Hana’s precursors model of change can be a good tool to explore multiple dimension of our client’s life that are critical in helping them to change like social support and their own state of mind (Hana, 2002). It also better prepare our client for the hardship of changing as it may involves heighten anxiety towards unfamiliar situations or constant effort to push through the stagnation stage. I find Cognitive Behavioral therapy useful in many ways. There is undoubtedly some connection between client’s distant past and painful feelings in the present. But CBT focus on a much more immediate and accessible source of emotions which is our current train of thought (McKay, Davis & Fanning, 2011). Many painful emotions are immediately preceded by some kind of interpreting thought. How our brain interprets and process the information we received has a direct relationship with our emotions.
Therefore, CBT focus on changing feelings by changing thoughts. It is impossible to completely eliminate negative thoughts from our client’s life, but educating them the model of how our cognition and emotions connects is teaching them a tool of a life time that they can continue to practice throughout their life. I personally think that existential therapy is very applicable when working with young and older clients who are actively searching for life meaning. People in this generation experienced more boredom as they gained access to everything conveniently. People can experience a loss of interest in the world and portray a lack of motivation to initiate change that ultimately results in living in-authentically. The central goal of existential therapy is to increase self-awareness in client and assist them in discovering their potential that they have never recognized before (Badiee, 2008). We as counsellor can walk them through the process of unveiling existential conflicts and anxiety that they try to avoid and invite clients to explore pieces of their life where they did not live genuinely and encourage them to take up the responsibility to make choices that can unleash their potential.
Counselling is effective only when clients are actively involved in the counselling process as they are the core and theme of the treatment. Clients do not have to come in to counselling with a well-planned agenda for the entire treatment process or be very insightful and knowledgeable, but be genuine and transparent in the session. Although counsellor plays a significant role in making clients feel comfortable about sharing themselves, client needs to be real about their emotions and thoughts in order to establish a collaborative therapeutic relationship. Clients need to take ownership of their share of the therapeutic work and realize that their life is a piece of art work that they are painting and counsellor are only there to support and provide guidance. As a counsellor, I see myself as a tool provider to assist clients in brainstorming ideas or provide some positive tools that can help them to move forward or change things around, at the same time, be part of their support system by being a safe emotional outlet.
The client sets the pace of therapeutic change; the counsellor needs to create the environment, structure the treatment and allow for clients to pursue natural change opportunities at a self-determined pace. Despite the fact that counsellor should be observant and aim to identify the blind spots in the client’s life, we need to be hyper vigilant to our thought processes. These assumptions that we have should be a tool for us to narrow down the presenting problem of the client but it should not limit our therapeutic work with our client. Client’s support system like families and friends should be a strength in therapy. In reality, their interpersonal relationships are the one that can provide immediate help and guidance. These people can create or share positive experiences with clients which can be a great resource when clients are developing coping strategies. They are also a good source of information to help us to learn about our clients especially when clients are not motivated or insightful.
There are many factors to count into consideration when developing a treatment plan. Identify suicidal or self-harm ideation is crucial throughout treatment as client’s safety is always the priority. Potential suicide risk should be assessed during the intake, when client mood changes drastically or during termination of counselling services. Counsellor needs to be vigilant in every session to make sure we don’t miss minor changes in our clients that could be signs of harmful behaviour or plans. Determining the level of care for the client is the most crucial step after identifying, for an effective suicide intervention (Kress & Paylo, 2015). Clients with suicidal thoughts but no immediate risk of acting upon it can generally be managed in a less restrictive level of care like partial hospitalization or outpatient services within 24 hours of suicidal thoughts. A detailed risk assessment, crisis plan and appropriate consultation are the best course of action with a suicidal client. It may also alter the direction of the initial treatment plans as it is important to explore and address the strong emotions and thoughts client experience when they are suicidal.
Diagnosis is also critical when conceptualizing client’s problem and providing treatment. We should always utilize formal and informal assessments to gain thorough understanding of the client’s initial concerns and also more accurately conceptualize client’s situation and determine appropriate treatment approach. Diagnosing mental disorder is very complex as just learning about the DSM5 diagnostic criteria is not sufficient, we still need to understand the process of diagnostic ascription and matching those criteria with the symptoms reported by clients (Kress & Paylo, 2015). At times, we need to acquire opinions and ideas from client’s close friends and family in order to get a more grounded support before any diagnostic decision especially when working with clients who are not insightful enough to provide information about their behaviours, emotions and thoughts.

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