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Depending on this case study please identify the following points…
Depending on this case study please identify the following points as paragraph:
“Sandra is a 14 year old Mexican-American high school student. She was born in the United States; her parents were born in Mexico. She has been referred to the community counseling center in which you work by her high school counselor. The school counselor informs you that Sandra is experiencing family issues at home and that these are manifesting themselves in the classroom. Among the issues that Sandra is experiencing are an apathetic attitude toward her schoolwork, aggression toward classmates, and disrespectful behavior school personnel. The school counselor elaborates on the issues in the home by saying that Sandra is at odds with her parents’ child-rearing practices; in particular, Sandra says that her parents are “much more strict” than her peers’ parents. Moreover, Sandra’s parents are going back to Mexico this summer for the entire 3 months of summer vacation, and Sandra does not want to go with them. She’d rather be left with an aunt who lives in a nearby town. Finally, your colleague informs you that Sandra ahs reported “being fed up with all this speaking Spanish stuff in the house, Spanish TV and radio, and tortillas for breakfast, lunch, and dinner. I just wish I was more American like my friends, and not Mexican.” The parents have agreed with the school counselor that a community counseling referral would be most beneficial for Sandra. You agree to see Sandra, fully aware of the multiple factors involved in Sandra’s presenting school issues, as well as the deeper layers of cultural resentment and parental conflict”.
Identifying Data: This section will include all relevant demographic information,
Age
sex
race/ethnic background
partner status
living situation
manner of dress
physical appearance
general self-presentation
The purpose of this section is to target demographic and descriptive information about the client. By reading through it, both supervisor and trainee should be able to develop an impression of the client. As an example, a practicum student may describe a client as “a 20-year-old college student of medium build dressed in wrinkled and soiled clothes, who is extremely verbal and articulate in the interview.”
Presenting Problem: This section should include a listing of the problem areas, from the client’s perspective, noting particularly the client’s view of their order of importance. Suggested items to focus upon:
Was there a precipitating set of circumstances?
How long has/have the problem(s) persisted?
Has/have this/these problem(s) occurred before?
What were the circumstances at the time?
The trainee must help the client to be specific about the presenting problem(s). It is not uncommon for counselor trainees to have had three or four interviews with a client and still be unsure about the presenting problem. The trainee should help the client to identify the precipitating circumstances, consequences, how long the client has been cognizant of the problem, and whether or not it has occurred previously.
Relevant History: This section will vary in comprehensiveness according to depth and length of treatment, and will vary in focus according to theoretical orientation and specific nature of the problem is).
It is important that the reported history be relevant to the content and depth of the client’s concerns. The trainee who collects ream after ream of data on the client and becomes lost in the process is encouraged to focus only on material pertinent to the problems. The history may then focus on academic content, sequel history, issues of social development, adjustment in school, and early family history. The data properly fitting into this section will be determined in part by the depth and length of treatment, by the particular focus of the problem, and by [the] theoretical orientation of the trainee and supervisor.
Cultural Considerations:
How does the counselor’s cultural lens impact on her/his view of the client or presenting issue?
What cultural factors are most significant in understanding the client and the world?
How do they interpret their situation
Family Dynamic
Interpersonal Style: This section should include a description of the client’s orientation
toward others in his environment and should include two sections:
Is there an overall posture he/she takes toward others?
What is the nature of his/her typical relationships?
How is the client’s interpersonal stance manifested specifically within the therapeutic dyad?
What is the client’s interpersonal orientation toward the counselor?
The client’s general attitudes toward others, including the nature of interpersonal relationships
The manner in which this orientation is manifested within the counseling dyad. Karen Horney’s (1939) “submission, dominance, and withdrawal” conceptualization may be used by the trainee as it general way to describe the client’s interpersonal style.
It is important for the trainee to learn the way in which the client relates to people outside of counseling and to be able to recognize parallels when they occur in the sessions. Thererefore, the trainee is asked not only to attend to what the client is saying but also the manner in which it is said. Clients’ behavior in counseling often reflects to a degree, their behavior in other social situations (Cashdan, 1973).
Environmental Factors: This section should include:
Identify the client’s vulnerabilities and strengths/resources of support.
Elements in the environment which function as stressors to the client. Both those centrally related to the problem and more peripheral stressors.
Elements in the environment which function as support for the client; friends, family, living accommodations, recreational activities, financial situation.
The trainee is now asked to describe the elements in the client’s environment that may be creating tension (stressors) and to be concrete about people, activities, and situations that are directly or peripherally related to the problem. The trainee may be surprised to discover that certain people, places, and events may serve as both stressors an supporters at different times (or even concomitantly). Elements identified as either stressors or supporters often include friends, family, living accommodation, recreational activities, financial situation, and so forth.
Personality Dynamics
Cognitive Factors: Cognitive Factors that deal with the thinking and mental processes of the client. Here, the trainee will report on the general intelligence or alertness of the client arrived at either by referring to test results or interview impressions. Such a discussion should include the client’s ability to make sound judgments and decisions and to function adequately in the tasks of daily living, noting any persistent negative cognitions and then giving some indication of the client’s level of insight. In addition the client’s fantasy life may be recorded in terms of the content and frequency of fantasies and the circumstances under which they tend to occur
intelligence
mental alertness
persistence of negative cognitions
positive cognitions
nature and content of fantasy life
level of insight-client’s “psychological mindedness” or ability to be aware and observant of changes in feeling state and behavior and client’s ability to place his/her behavior in some interpretive scheme and to consider hypotheses about his/ her own and other’s behavior
capacity for judgment. Client’s ability to make decisions and carry out the practical affairs of daily living
Emotional Factors that should be addressed by the trainee include: the client’s mood during interviews, appropriateness of affects, range of emotions displayed, and any cyclical aspects of the client’s emotional life. Here, the trainee is forced away from an intellectual approach to the client and guided to attend to what is going on emotionally in the sessions. Information concerning the client’s outside emotional life should also be described and discussed in this section.
typical or most common emotional states
mood during interview
appropriateness of affect
range of emotions the client has the capacity to display
cyclical aspects of the client’s emotional life
Behavioral Factors should attend to all areas of the person’s behavior. This section can help the trainee determine major patterns of symptoms, and often provides the concrete focus for the initial phases of the treatment plan.
psychosomatic symptoms
other physical related symptoms
existence of persistent habits or mannerisms
sexual functioning
eating patterns
sleeping patterns
impairment in functioning
Counselor’s Conceptualization of the Problem
This section will include a summary of the counselor’s view of the problem. Include only the most central and core dynamics of the client’s personality and note in particular the inter-relationships between the major dynamics. What are the common themes? What ties it all together? Are there any ethical implications to be aware of? This is a synthesis of all the above data and the essence of the conceptualization.
Evaluation based theory 1
Evaluation based theory 2
Counseling Goals and Interventions
All treatment goals must be objective and measurable, with estimated time frames for completion. The treatment plan is to be developed with the patient, and the patient’s understanding of the treatment plan is to be well documented in their record, and should include:
Goal(s) for counseling
Research to be done
Professional consultation that will help
Planned Strategies and Intervention (Resources Needed)
Evaluation: Explanation of how progress will be measured. How will you know change has occurred?
Sample Treatment Chart:
Issue or Goal:
Research to be done
Consultation
Techniques/Intervention
Resources needed
Evaluation
