PU Intake & Treatment Planning Developing Plans & Conceptualizing Cases Discussion
Question Description
Discussion #1: Intake and Treatment Planning
Dr. January and Class,
The intake should provide us with an opportunity to obtain specific information about the problem and the behavioral issues that are occurring as a result of it. At this time, it is also important to note the level of interaction that the members of the family have, as well as the result of the interaction. Likewise, it is essential to ask the family what they have done at home to try to resolve the problem and what the results were of their efforts (Assessment and the Initial Treatment Plan, 2020). McCollam (n.d.) states the level of quality with which the family communicates and the satisfaction they have with the communication is key to functional family therapy, especially with adolescents. In this scenario, although Beth is the member who is struggling with her stepparent, Lucy is also a teenager and appears to be somewhat indifferent to the process of therapy.
As the therapist, my first question is How has the relationship between Beth and Katie been prior to the current problem? If the relationship has always been a bit tense, the issues they have are reaching a peak. However, if this is a new problem between the two, I would look to find out any incidents that led up to it. I would also ask What type of discipline is being used in the household and what are the infractions that lead to it? If Beth feels the discipline is too harsh for what she may consider to be a minor infraction, she may resent Katie for it.
I am also curious to learn more about Susan. Why is she stepping in when her child is being disciplined? Does she believe the punishment is harsher than it needs to be, or does she want Katie to stop disciplining altogether? Have Susan and Katie had an agreement in the past regarding disciplining the children or is this a new development? I also wonder what Katie means when she states that Susan allows Beth to do whatever she wants? Katie may believe that she is caught in the middle of a power struggle between her wife and her stepchildren, while her authority as an adult and a stepparent is being undermined.
Assessment and Initial Treatment Plan. (2020). Post University. Retrieved from file:///E:/HSV521%20-%20Unit%204%20Assessment%20and%20the%20Initial%20Treatment%20Plan.pdf.
McCollam, P. (n.d.). Family therapy assessment and treatment planning. New Haven Residential Treatment Center. Retrieved from file:///E:/1.2_article_8.pdf.
Dr. January and Class,
Due to the history of discrimination that LGBTQ individuals receive, this student would want to ensure that she does not display any negative body language. It is unknown if the two adolescents in the scenario have a father, but would imagine that if could play a big part into how Beth has been reacting to Kate’s attempted disciplinary measures. The first thing this would would want to find out is each family member’s perspective on the perceived issue. This is because perception is important and in order to include the entire family, the therapist should make each family member feel included in on the session. In addition, this student would want to know the basis of Beth and Katie’s relationship before the conflict started to arise. This writer would also want to ask each of the family members when they believe the problems started. The therapist should never push their own feelings or beliefs on the situation on to the family. In other words, the counselor should accept each member’s description of the problem and find other ways to describe it without sounding against the family. In addition, the therapist should encourage each of the family members to view the problem from other perspectives, as their family members might feel different about the situation.
The two questions this student would utilize to aid in the treatment plan are:
1). What is your ultimate goal that you hope to get from therapy?
2). Is there any kind of substance or alcohol abuse in the family?
The reason this student chose these two questions is because it is crucial for therapist to establish an idea as to what each family member hopes to get out of therapy, regardless of how many sessions it takes. Furthermore, it is obvious that substance and/or alcohol abuse could affect a family and the dynamics within it. However, the main reason this student would ask this is because being under the influence of alcohol or drugs can seriously inhibit one’s choices and functioning, which could be the ultimate reason for the problems in the family. However, the only way the counselor is going to know this information is by asking the family.
This student could see herself utilzing solution-focused therapy with this family because she would ask each of the family members what life would look like if they did not have to go to therapy anymore. In other words, she would want the family members to look at the brighter side to things and really think what a ‘miracle’ would look like (Metcalf, 2011). In addition, she would want to use scaling questions as a way to guide her sessions. She would want the family to know that they have the power to make the changes necessary to make them a happy family again. For example, she might ask each of them, ‘on a scale of 1-10, 1 being the worst, how bad is Beth behaving?’. This is because Kate might have an uptight parenting style while Beth might not be as bad as Kate makes her out to be. Due to the fact that Lucy stayed quiet during the session, this student would definitely want to get her input seeing as it is always the quiet ones you should look out for.
Class, what does everyong think of solution-focused therapy for the provided family scenario?
Reference
Linda Metcalf, P. L.-S. L.-S. (2011). Marriage and family therapy?: A practice-oriented approach. Springer Publishing Company.
Discussion #2: Solution-Focused and Collaborative Models
Hello class and Professor
The writer would always find out exactly who will be the client in the family, or will all members of the family be the clients.
According to the ACA, (2014). A.7. Multiple Clients; when a counselor agrees to provide their professional services to two or more people who
have a relationship, the counselor clarifies in the beginning which person or persons are clients and the relationships the counselor will
have with each involved person. If it becomes obvious that the counselor may be called upon to perform potentially roles that conflicts, the
counselor will clarify, adjust, or withdraw from roles appropriately (ACA, 2014. The two strategies the counselor would use in this case is first
the writer would have the family to research the resources that they feel will benefitial for them, this would help them to realize they are in charge
of their treatment process and they will learn and understand the solution to their problem.
The next strategy that the writer would use, is to have the family to give each other positive affirmations about one anther, to help
each member of the family to stay motivated and encouraged them to be able to overcome their problem or problems by realizing that they are
not bad people, they could just be people who make bad decisions or misunderstood. The idea is to help them to know that they have the
answers to their problems inside of them the entire time just need they help to bring it out. According to Metcalf, (2011). Although
solution-focused therapists do not define problems or families, they do tend to define the context of the families in the context of being stuck.
The therapist then sees it as his or her responsibility is to help the clients to try something different rather than continuing to do what is not
working (Metcalf, 2011). When the counselor communicates with the family and get them to realize that they are in charge of the answers they
already have within the family as a unit, it is an easy process just to help guide the family in digging within themselves for the solution.
The constructionist model which works together with both Solution-Focused (SF) and collaborative modalities is highly excepted for
displaying to the client that their concerns are indeed being accounted for (Hecker & Wetchler, 2015). With accepting both models, a
therapist can utilize the groundbreaking work of dissipative nature structures in which was evolved by experts to become the collaborative
language systems (Hecker & Wetchler, 2015). This can leave room for the counselor to act as if they don’t know other person’s problem even if
they have knowledge of the person problem. The counselor will also listen to the client/clients closely to understand the client’s problem
better, then talk to them in a language that the client/clients understand. Solution Focused therapy can effectively work its way into the
intervention solutions. In this process will bring a focus on the positives rather than the negatives and the counselor will feel that is a key
part of an already intimidating situation(Hecker & Wetchler, 2015).
Reference:
ACA, (2014). American Counseling Association code of ethics
Metcalf, L. (2011). Marriage and family therapy: A practice-oriented approach. New York.: Springer Pub. Co.
Hecker, L. & Wetchler, J. (2015). An introduction to marriage and family therapy. New York: Routledge
Samantha S.
Dr. January and Class,
This student likes solution-focused therapy and can see her utilizing it her her future career as a mental health professional. This is because instead of looking at the problem and spending time analyzing how the problem occurred, the therapist focuses on a solution (Institute for Solution-Focused Therapy, 2020). In addition, it is an approach that emphasizes the client being the expert of the situation. In other words, the client has the power to change their life for the better. Something that this student took away from the unit’s reading is the statement, “There is no such thing as a resistant client, only an inflexible therapist (Metcalf, 2011, pg. 291). Furthermore, the technique of using ‘miracle questions’ interested this student because it makes the client think of the positive side to their situation. For example, the therapist will do this by asking the client to think about how things would be like if the problem no longer existed. In other words, a miracle occurs. It allows the clients to assume their lives are going to get better, which provides them with a more open outlook on their future. Exception-finding questions have said to be effective as well. This is because it allows the clients to think about times where their problems were less severe. Furthermore, it helps the client realize that they already know how to work on managing their problems because there have been times where it was worse. An example the book uses is “Tell me about a time when things went slightly better for you in school” (Metcalf, 2011). One last type of question that is used in family therapy is known as ‘scaling questions’. Essentially, this technique has clients use numbers to rate how they feel on what is currently going on in their life. 1 usually represents the worst that things could be while 10 is what the aftermath of a miracle would look like. This technique would be beneficial for a family who is going through a divorce. This is because the parents might have a different number in mind than the children. For example, the book talks about the fact that the mother feels as if the divorce has affected her daughter in a negative way. However, with the use of scaling questions, the therapist and mother soon realized that the divorce was a relief for the daughter because of how much fighting was going on when her parents were together (Metcalf, 2011). Overall, this student feels as if solution-focused therapy is one that will be rather effective in her future career because it focuses on the solution to things, instead of dwelling on the past and/or past problems.
This student feels as if it would not be a challenge for her to honor the collaborative role while remaining productive. This is because therapists should not be ‘too’ professional to the point where clients do not trust him/her. More importantly, this student feels as if clients are only going to be able to form a relationship with their therapist if they feel heard and understood. Being collaborative includes providing affirmation and encouragement so that the client feels heard and understood (Wetchler & Hecker, 2017). Furthermore, conversational questions should always be asked in attempt to keep the conversation between therapist and client going. Due to the fact that collaborative therapy is centered around the concept that the client is the expert, this student feels as if she would definititely be able to remain collaborative and proactive. Part of being collaborative includes the therapist’s recogniton that the client is the expert on their own expereience and the therapist has to act as a potential ‘client’. In other words, the therapist should never act as if they more knowledge on how to approach the situation that they are currently in. In addition, it is important that therapists never impose their own ideas on to the individual in therapy (Good Therapy Team, 2017). This is not just suggested to collaborative therapists, but ethically mandated by the American Counseling Association. This is because counselors are never to impose their own beliefs or values on to their clients (ACA, 2014). It is important to think of collaborative therapy as therapy and not a ‘model’, as the article discusses. This is because it is not designed to treat any certain diagnosis. Instead, it addresses whatever concerns or problems the family wants to acknowledge and address in order to feel accomplished. In other words, the client or family is responsible for addressing what will be talked about in that specific session (Good Therapy Team, 2017). This student likes this approach because she will be able to allow the client to take charge. This student is a great listener, which is why she feels as if she would be able to remain proactive while being a ‘collaborative’ therapist.
References
American Counseling Association. (2014). ACA Code of ethics. https://www.counseling.org/Resources/aca-code-of-ethics.pdf.
Good Therapy Team. (2017, November 27). Collaborative therapy. GoodTherapy. https://www.goodtherapy.org/learn-about-therapy/types/collaborative-therapy.
Institute for Solution-Focused Therapy. (2020, August 5). What is solution-focused therapy? Institute for SolutionFocused Therapy. https://solutionfocused.net/what-is-solution-focused-therapy/.
Joseph L. Wetchler, & Lorna L. Hecker. (2015). An introduction to marriage and family therapy: Vol. 2nd ed. Routledge.
Linda Metcalf, P. L.-S. L.-S. (2011). Marriage and family therapy?: A practice-oriented approach. Springer Publishing Company.
Discussion #3: Behavioral and Cognitive Behavioral Models
Darren E.
Hello class and Professor
The writer agrees their are differences between “Behavioral Therapy” and “Cognitive Behavioral Therapy”, and the writer believes that the
only way you can provide an intervention for either behavioral model and cognitive behavioral model is to first understand the cause and effect
how each model has an effect on the human body. “Behavioral model deals with a person’s behavior that is caused by stimuli in their environment,
either in their house or their society. This can vary from race, religion, gender, culture, etc. The cognitive behavioral model deals with a person’s
behavior that are influenced by their thought process, and specifically the stimuli that have them to think and behave the way they are displaying”.
Both model interventions will take helping the client to learn to behave different than what they were doing, except behavioral therapy can use
consequences no matter if it’s positive or negative to change someone’s behavior, and cognitive behavioral therapy can challenge a person’s
thought process, and have them to possess different thoughts that will help them to behave in a different manner.
According to Bandura (1969), social learning theory/ behavior model is made up of classical and operant models of learning in addition
to interactions between the person and their surroundings that emphasizes the importance of awareness of rules as well contingencies of
behaviors and actions. Cognitive behavioral family therapy involves assisting the clients with changing their self-defeating or unrealistic beliefs to
change their feelings and behaviors. It assumes that family relationships, cognitions, behavior; and emotion can influence cognition
(Becvar & Becvar, 2003, pp. 242-243). Cognitive behavioral therapy does not always include all the family members; this form of therapy
includes family members who are needed to help to develop change in the family (Bandura, 1996).
Treating clients from the behavioral model intervention you can use other models like, behavioral modification to influence the client’s
behavior to change in a fashion that is persuaded by outer stimuli. This places the focus on the physical health with the client/clients and teach
them to behave in an different manner will have them to behave, like someone else wants them to behave. Cognitive behavioral interventions
focuses on someone’s mental capability and their thought process. For example, a person who has an addictive behavior, mentally they develop
an impulsion and obsessive behavior that will have them to depend on a stimuli that their thought process has changed thir their behavior to make
their life change from manageable to unmanageable that could destroy their life unless they get help for their addiction. This may take rehab,
self help programs, and psychiatry. The counselor will still have to teach the client how to behave different regardless to using outside stimuli to
influence their behavior through their environment, or focusing on someone else that will influence change, mentally to help teach them how
to change their thought process that will help change their behavior.
According to American Psychological Association, when applied to behavioral therapy, the three term contingency concept refers to the
with getting along with others and with his or her environment, this includes three elements: The first is the antecedents of behavior, includes
conditions or stimuli that will set the occasion for behavior to occur. The second is behavior, consist of anything a person does. This includes
behavior that other people can potentially see the behavior other people do, such as speak or perform some other physical movement.
The third is contingency, consequences, refers to the effect that behavior produces wether it’s positive or negative. Technically speaking,
behavior is reinforced if the consequences that follow behavior increase the likelihood of that behavior can occur in future occasions.
Reference:
American Psychology Association, (PDF). Behavioral Interventions In Cognitive Behavior Therapy: Practical Guidance
https://www.apa.org.books(PDF)
Metcalf, L. (2011). Marriage and family therapy: A practice-oriented approach. New York, N.Y.: Springer Pub. Co.
Dr. January and Class,
Behavior therapy came from three main types of therapy, which are classical conditioning, operant conditioning, and learning theory. Classical conditioning is learning through association of a conditioned stimulus. The book uses the example of dogs salivating to the sound of the bell. This was due to the dogs being given food every time the bell rang, with the bell being the conditioned stimulus. Furthermore, operant conditioning is utilized with positive and negative reinforcement (Metcalf, 2011). An example could be punishment for a child who received a bad report card. On the other hand, positive reinforcement might be praising the child in order to encourage good reports in the future.
Cognitive behavioral therapy was founded by Dr. Albert Ellis and Dr. Aaron Beck. It was Ellis that stated that disturbed feelings and dysfunctional behaviors were the result of irrational beliefs. Furthermore, Beck said that an individual’s automatic thoughts trigger feelings, not behaviors. An example the book utilizes is a negative thought by a depressed person being “no one likes me” or “I’m worthless”. A cognitive behavioral therapist is going to challenge the thought patterns that go through one’s head. They would do this by asking the client who does love him/her in order to let the individual see that he/she is not worthless. In a family, the therapist might ask each of the family members their perception on that particular family member’s thoughts (Metcalf, 2011). This student likes cognitive behavioral therapy (CBT) because it can be utilized for several different things. For example, it has been said to be at least moderately effective for treatment of depression, generalized anxiety disorder, post-traumatic stress disorder, anger issues, panic disorders, social phobia, and childhood anxiety and depressive disorders (Psychology Today, 2020). This student can see herself utilizing this approach for many of her future clients, due to the benefits to it. With that being said, this writer is now going to discuss how CBT can benefit someone with a problem with alcohol abuse.
Essentially, cogntive behavioral therapists are going to try to figure out the specific problem in the family. This is because the only way to come to a solution is to know the identified problem. Furthermore, the therapist is going to try to encourage postive interaction amongst the family members (Metcalf, 2011). Initially, therapist is not going to know the ultimate reason for the alcohol abuse, but it may be due to unhealthy relationships in the family. It is fairly common that those struggling with substance use disorder have maldaptive, negative thinking. The ultimate goal is for the therapist to help the client adjust their negative thinking patterns, which in turn will result in healther behaviors, hopefully stopping the alcohol abuse (Editorial Staff, 2020). With this approach, the therapist gives the clients ‘homework’ for outside of the sessions. In addition, the CBT therapists will give the clients coping strategies to handle the stressors that might lead him/her to drinking or using another drug (Editorial Staff, 2020). Behahavioral therapy would benefit a child with ADHD by helping them improve their behavior, self-control, and self-esteem. Essentially, therapists are going to use positive reinforcement for positive behavior peformed by the child with ADHD.In addition, consistent discipline is said to be benficial with the behavioral model to therapy (Centers for Disease Control and Prevention, 2020). When it comes to similarities between behavioral and cognitive-behavioral, this student would think that the ‘homework’ assignments given to clients would be similar. For example, families may be given suggested activies or new ways of communication to try at home in order to try to futher the progress for the family. In addition, both approaches are beneficial for working with families and not just individual therapy.
References
Centers for Disease Control and Prevention. (2020, September 4). Parent training in behavior management for ADHD. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/adhd/behavior-therapy.html.
Editorial Staff. (2020, September 3). Cognitive behavioral therapy for addiction. American Addiction Centers. https://americanaddictioncenters.org/cognitive-behavioral-therapy.
Linda Metcalf, P. L.-S. L.-S. (2011). Marriage and family therapy?: A practice-oriented approach. Springer Publishing Company.
Psychology Today. (2020). Cognitive behavioral therapy. https://www.psychologytoday.com/us/therapy-types/cognitive-behavioral-therapy.
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