The purpose of this case study is to examine the background and treatment options for the client provided. Open-ended questions and active listening will be utilized in order to obtain the pertinent personal information from this client. This will allow for the development of an adequate treatment plan. This plan will incorporate the use of goals and objectives with established timelines to aid the client in tracking her progress, and later reevaluate her growth, should the need arise to do so.
Janet just completed her fourth divorce. She is in her early 30s. Her personal life is in chaos. She has children by three of her former husbands. Janet has struggled with addiction issues over the years including alcohol and drugs. She came from a very difficult family where her parents were alcoholics and often fought with each other. Janet was sexually abused by her uncle on more than one occasion when he lived with the family during her early teen years. Janet’s problems with drugs and alcohol began as a teenager.
In my opening session with Janet, I would begin with small talk to help put her at ease and segue into the larger issues. This will also help construct an avenue for the conversation to flow more freely from. Once a good speaking rhythm was found, I would begin to prepare her for the documentation process. At this point, I would begin to ask her for information regarding her four marriages; when she began dating her former husbands, dates they were married, and dates of their divorces. Next, I would ask her about her parents; where they live, their marital status, their occupations, and education levels. While at this junction, I would begin to ask questions regarding her uncle and the sexual abuse; how long he lived with them, how long did the abuse last, and whether or not her parents were/ are aware of the abuse. Then I would ask her about her children; what are their ages and genders, what grades they are in, whether or not they are healthy. Lastly, I would ask her about herself; what does she do for a living, what are her interests, whether or not she has siblings, etc.
The purpose of this information is to establish a foundation to build a treatment plan that is specially designed for her needs, as well as giving us ground to work up from to address her issues of sexual abuse and substance abuse. By gathering information surrounding her family background – parents, siblings, uncle, and children – and her relationship background – her former husbands – we can begin to utilize Maslow’s Needs Hierarchy theory model in her treatment plan (Lester, 2013).
Personal Biases and Limitations
After reviewing Janet’s description excerpt, I believe that I can serve her without much concern for biases or limitations. Admittedly, this is something that could change as her sessions go on and new information is gathered. In order to be useful to her, I would have to be cognizant of the fact that that is always a possibility. As it stands currently, however, I see no reason for qualms or depreciation from the counseling setting.
In Janet’s case, I would like to enhance her coping skills. She likely suffers from relational issues due to her history of sexual abuse, which has manifested itself through her unsuccessful marriages and drug and alcohol abuse. I would encourage her to begin to develop better, healthier coping skills to help facilitate change. This could be done in the form of journaling, to provide her with an outlet to pour out her emotions and vent; this would also allow her to bring some issues into the sessions that occurred during the week, should she choose to do so. Another coping mechanism would be to go for a walk or run. This would allow her to have a physical release, without requiring much of her financially.
A second goal would be for her to positively change her decision making process. Based on her age and number of divorces, as well as her substance abuse issues, I would venture that Janet is compulsive. This has led to her making some questionable choices that have adversely affected her life. I would set a goal for her to slow down her thought process before making a big decision. She could start with smaller choices, as a way to ease into learning how to deal with the bigger decisions, by asking herself questions such as: Do I need this extra cookie? Should I buy this new purse? The idea would be for her to consider her decisions, prior to acting upon them (Crockett, Prosek, 2013).
I believe that the best theoretical approach for Janet would be a combination of cognitive and behavioral therapy. This will allow the issues from her past – i.e., sexual abuse – to be addressed while congruently working on problem solving her present issues – i.e., her substance abuse and relationship issues (Vinci, Coffey, Norquist, 2015). Given the fact that Janet has young children at home, I would also encourage her seek outside resources, possibly in the form of parental training. I would take caution to explain to her that this is not to say that she is a bad mother, simply that she is ensuring that her children are able to benefit from her therapeutic advancements as well.
Therapeutic Progress and Success
In Janet’s case, I would use a simple written plan for her to track her personal progress with. It would be an outline of clear goals and objectives that we discussed in the beginning sessions, but would leave room for additions, should she decide to make them at a later time. These goals would be reviewed periodically throughout the course of her treatment, and the plan would include checkpoints for major landmarks. It may even do her well to have a colorful chart that she can chare with her children – these would have goals that were more family-oriented and would not include the more private issues that she would typically address in a session.
Janet’s case is one that is fraught with major concerns. Confronting issues of sexual abuse, substance abuse, and relational problems while caring for three young children is not an ordeal that should be taken lightly, and could very well result in multiple relapses. It is possible that Janet suffers from Post-Traumatic Stress disorder, so there is also the potential for episodes of depression or night terrors which may affect her daily living and treatment. However, with hopes of optimism, Janet will begin to adjust to her treatment plan with as little recourse as possible.
Vinci, C., Coffey, S., & Norquist, G. (2015). When to recommend cognitive behavioral therapy. The Journal of Family Practice. Retrieved February 28, 2016, from http://rx9vh3hy4r.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&rfr_id=info:sid/summon.serialssolutions.com&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=When to recommend cognitive behavioral therapy&rft.jtitle=The Journal of family practice&rft.au=Vinci, Christine&rft.au=Coffey, Scott F&rft.au=Norquist, Grayson S&rft.date=2015-04-01&rft.eissn=1533-7294&rft.volume=64&rft.issue=4&rft.spage=232&rft_id=info:pmid/25973454&rft.externalDocID=25973454¶mdict=en-US
Crockett, S., & Prosek, E. (2013). Promoting cognitive, emotional, and spiritual client change: The infusion of solution-focused counseling and ritual therapy. Counseling and Values. Retrieved February 28, 2016, from http://go.galegroup.com.ezproxy.liberty.edu:2048/ps/i.do?p=AONE&u=vic_liberty&id=GALE|A348978116&v=2.1&it=r&sid=summon&userGroup=vic_liberty&authCount=1
Lester, D. (2013). MEASURING MASLOW’S HIERARCHY OF NEEDS. Psychological Reports: Mental & Physical Health. Retrieved February 28, 2016, from http://rx9vh3hy4r.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&rfr_id=info:sid/summon.serialssolutions.com&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Measuring Maslow’s hierarchy of needs&rft.jtitle=Psychological reports&rft.au=Lester, David&rft.date=2013-08-01&rft.issn=0033-2941&rft.eissn=1558-691X&rft.volume=113&rft.issue=1&rft.spage=1027&rft_id=info:pmid/24340796&rft.externalDocID=24340796¶mdict=en-US