Abstract
This paper aims to discuss a comprehensive treatment strategy for the Williams family based on the facts presented in the case study. The treatment strategy focuses on helping the family towards healing and recovery. The clients’ history will first be analyzed as a way of helping the community mental health counselor (CMHC) to understand the dynamics of the Williams’ family concerns in order to create a treatment strategy and intervention plan that can achieve the desired goal. Such background information helps the therapist to understand the underlying factors behind the identified problems. The case is conceptualized using a relational agency, which analyzes the ability of the patients to offer and seek support from others. The services to be offered by the community mental health counselor are stipulated based on the information deduced from the case. However, to ensure that effective services are provided to the clients, referral to some external service providers will be necessary. A referral is based on the principle of the collaborative care model in which service providers seek to improve patient outcomes through interprofessional collaboration. The results of the case study indicate that the Solution-Focused Brief Therapy (SFBT) is the most appropriate intervention plan to inform a treatment strategy for the Williams family.
Case Treatment Strategy: The Williams’s Family
As an approach to psychological practice, community counseling calls for practitioners to evaluate how they understand and counter human problems. Psychologists should review ‘the person-in-context’ and endeavor to respond comprehensively by addressing challenges at different levels of their social system. The life of a human being is complex and challenging, sometimes taking us to weary places where only God can provide the desperately needed subsistence and encouragement. In Isaiah 61:11, the Lord pledges to deliver man from emotional pain and mental as well as physical illnesses. Further, He is present to guide people in times of hardship through His everlasting compassion (Psalms 63:1, Isaiah 55: 1-12). The Creator, therefore, uses mental health counselors as instruments to lead mankind towards an infinite source of happiness. This paper describes a treatment strategy for the Williams family based on a community counseling approach. Therefore, the paper focuses on the interactions and relationships between individuals and social contexts in a bid to develop a comprehensive strategy towards healing and recovery for the family as a whole. The community counseling approach helps the counselor provide the necessary support to the family by analyzing how the clients cope with their feelings through methods directed towards the external environment, such as social alienation, depression, aggressive behavior, and alcohol abuse.
Williams Family Synopsis and Case Conceptualization
The Williams family comprises of Jeff and Sandy, a couple married for 21 years, together with their two sons, Jacob (18-years-old) and Leo (15-years-old). Jeff runs a used car business, although the family has faced financial challenges due to the economic downturn. His wife Sandy has been working at a local elementary school for the last 10 years as a teacher’s aide. However, financial difficulties, as a result of slow business at the car lot, have increased family worries. Additionally, the couple’s spending habits and the absence of financial management skills have added to the family’s financial woes.
Jeff has a serious drinking problem; he drinks each day when he arrives home from work. The following day, he remembers very little of his late-night conversations or behaviors, a factor that has resulted in conflicts between him and his wife, Sandy. On the other hand, Jacob’s awkwardness has led to social alienation. Several years ago, he was diagnosed with Asperger’s syndrome. Further, he suffers from overall sadness and depression. Jacob also finds it hard to engage in social activities. At the same time, he feels lonely and misunderstood. Jeff and Sandy are puzzled about their son’s behavior and believe that Jacob’s situation may be connected to their own feelings of loneliness. While Jeff reacts angrily towards Jacob, Sandy is more lenient. Just like Jacob, Leo seems disengaged and distant from the family. He does not contribute much to conversations during counseling sessions. Further, he rarely goes out with the family anymore. Jeff and Sandy feel that the school system is doing enough to help their two sons.
The case in Williams’s family is conceptualized using the concept of relational agency. Relational agency entails the capacity to offer support and seek support from others. Therefore, a person’s ability to engage in the world is enhanced by doing so with others. Clients who seek therapy are deemed to have lost sensation in one or more key domains of life (Van Dieren, Rijckmans, Mathijssen, Lobbestael, & Arntz, 2013). From this viewpoint, the relational agency can be a strong conceptual tool that can help in understanding patients and assisting them in exploring the complex social life they face. In developing a treatment strategy and intervention plan for the family, the data collected and deduced from the family interaction throughout the sessions will inform and direct where the community mental health counselor will start (Wiltsey Stirman et al., 2013). Similarly, the apparent, hidden issues that the family may be experiencing will be identified. The best practices for addressing their issues and needs will be determined based on the problems identified. The services to be provided by the community mental health counselor will be identified as well as any other additional services that need to be sought out from other agencies.
Services Provided by the Community Mental Health Counselor
Community mental health counselors (CMHCs) provide an array of essential services to people who, for whatever reasons, are not able to get needed help anywhere else. Typically, community-based mental health care entails a wide variety of services and programs designed to meet local needs (Thornicroft, Deb, & Henderson, 2016). At the Community Mental Health Centre (CMHC), a range of outpatient services will be offered to the patients. Individual and group therapy sessions will also be available to Williams’ family members as a way of fostering intervention at an individual and family-wide level. The community-based counseling program will combine skillset with those of other key health professionals and work towards familial and individual enrichments. Sessions will be themed around certain topics, such as anger management and underlying triggers, to ensure that the correct steps towards healing and recovery are achieved during the intervention program. Some activities, such as games and puzzles and arts and crafts, especially for the boys, will be held. Such activities assist patients in developing healthy social skills, which, in turn, help them communicate with each other.
The services provided at the Community Mental Health Centre seek to implement and promote evidence-based practices suitable for intervention programs for people with mental disorders similar to those witnessed in the Williams family. Specific services to be provided include counseling, therapy, mentoring, linking youth and families to necessary community resources, prevention services, and facilitation of adolescent and parents support groups (Thornicroft, Deb, & Henderson, 2016). Therapy services include art or music therapy, chelation therapy, and horse therapy. Such therapies will be particularly useful to Jacob, who has been diagnosed with Asperger’s syndrome. On the other hand, mentoring and counseling services are a wide array of activities intended to enhance the overall mental health of the patients. These services will work towards promoting the mental health and overall well-being of patients, psychosocial support, prevention of harm resulting from substance and alcohol abuse, and rehabilitation to those in need (Reisner, Vetters, Leclerc, Zaslow, Wolfrum, Shumer, & Mimiaga, 2015). The services are based on the philosophy that patients ought to remain with their families and community as much as possible to avoid rehabilitation and alienation.
Various professionals contribute to overall patient wellness in a Community Mental Health Centre (CMHC). For instance, therapists and counselors offer group and individual counseling to patients. Similarly, licensed clinical social workers engage in different roles, whereby they may function as resource locators, outreach coordinators, care coordinators, and intake specialists (Wiltsey Stirman et al., 2013). Activity coordinators offer programs and workshops during daytime and evening hours. On the other hand, registered nurses (RNs) and social workers coordinate care with patient medical providers and other service programs. Other support staff, such as administrators, assists in the handling of scheduling, general operations, billing, and payments in the facility. All these groups are essential to ensuring that the best care is provided to patients. Any gap in the whole system may lead to an inferior quality of services, consequently affecting the counselor’s ability to foster patients towards healing and recovery (Van Dieren et al., 2013). Coordinating between all these activities will be crucial in Williams’ family intervention plan and treatment strategy.
Community mental health services involve more than just the implementation of outpatient psychiatric treatment. CHMC supports and treats patients with mental dysfunction challenges by applying the practice of care in which the client’s community becomes the principal provider of responsibility for those who have a mental illness (Thornicroft et al., 2016). Community assistance covers different issues, such as local primary care, subsidized housing, therapeutic assistance, and self-help groups for patients with mental health problems. Peer support and self-help programs bring together patients with similar illnesses or circumstances to share challenges, experiences, and coping strategies.
Williams’ Family Therapy
At the beginning of the psychotherapeutic process, the therapist tries to build a relationship with the clients through empathy, recognition and reconnecting them to social life by addressing their feelings. For instance, Jacob and Leo shared stories of feeling hurt, rejected, misunderstood, alienated and being lonely. Allowing the clients to share their stories creates interventions that promote processes of perceived responsiveness in family relationships and other interpersonal contexts (Pedrelli, Nyer, Yeung, Zulauf, & Wilens, 2015). As a result, the family is approached not as a problem but rather as an important resource that facilitates processes of responsiveness and recognition. In Williams’ family case, the counselor stipulated ideas on how to restrict the relationship between the family members in therapeutic practice.
Family and marital therapy have proved effective in reducing the severity of substance abuse, as seen in Jeff’s case, and lowering family conflicts, as witnessed in the relationship between Jeff and his wife, Sandy. Family therapy also helps in improving overall family cohesion and communication and enhancing proper parenting practices. Williams’ family lacks proper family cohesion as the members are disengaged from the family as witnessed through continuous conflicts, feelings of misunderstanding, and alienation. The issues in the case illustrate the impact of the family as a unit and which directly impacts the children’s behavior (Wolfe & Price, 2017). Similarly, many other areas of adolescent life and how they may be affected by dysfunctional families are evident. For instance, academics, poor social behavior, home life, and relationships can all be negatively influenced by conflicts and issues in a family unit. During the family therapy sessions, each family member is given an opportunity to discuss the differences between the complexities of communication and what it implies for each member of the family.
Treatment Intervention Plan Using Solution-Focused Brief Therapy
In light of the necessary guidelines, requirements, and available funding, Solution-Focused Brief Therapy (SFBT) appears as a powerful plan to provide guidance to Williams’ family condition. The intervention focuses on meeting some specific objectives by creating an essential difference in the clients’ way of life by targeting behaviors that need to be changed (Taathadi, 2014). Typically, SFBT is a goal-centered, future-focused approach that focuses on solutions rather than the problems that necessitated the clients to seek therapy. The counseling intervention also focuses on facilitating the transformation of the behavioral changes necessary to achieve total healing and recovery from the various psychological issues affecting the Williams’ family, both at the individual and familial level. In the case of Jeff’s alcoholic condition, the action is primary to resolving the situation by advocating for alcohol abuse. Such actions revolve around providing counseling interventions based on the client’s strength to focus on the future and the present. The session also seeks to intervene in providing the necessary assistance to the members of the Williams’ family facing mental health issues. The brief therapy sessions are based on the idea that even tiny differences can make a huge impact on the lives of the family members.
The creation of a healthy counselor-client relationship is key to fostering a beneficial therapy session. The community mental health counselor listens to the clients’ condition, difficulties, and emotions actively and engages in a way that resonates with the clients’ feelings to build such rapport (Wolfe & Price, 2017). The counselor uses methods, such as rephrasing and paraphrasing the clients’ worlds as a way of confirming agreement to the issues discussed to show that he/she is committed to listening and engaging with the Williams’ family members fully (Franklin et al., 2017). Typically, relationship building is central to the counseling process. Through such relationships, the counselor is able to evaluate patterns of successful past interventions and focus on identified strengths while dealing with the client’s core weaknesses. The community counselor also identifies strengths by inviting and allowing the family members to talk openly about times when the family experiences some positive results. The goal of such sessions is to decipher the success the clients have had in dealing with their problems. Any positive results in the past provide a cornerstone upon which the therapy session is aligned towards reaching complete recovery.
Goal setting is crucial in helping clients achieve the intended healing and recovery milestones. The community mental health counselor, therefore, engages the family in establishing specific objectives that the clients want to achieve and needed intervention to see the goals achieved (Taathadi, 2014). The big goal, which is to attain full recovery and healing from the psychosocial problems the family is facing, smaller milestones are adopted to ensure that the goals are achievable. With these milestones, the counselor will be able to evaluate, periodically, whether the clients are working positively towards achieving the overall goal. The necessary corrective measures are initiated whenever it seems that the goals are not being met. Role-playing will play a key role in helping the client to seek improvement plans by practicing new behaviors. At the same time, the client also tries to link such behaviors to past successes already identified during the therapy sessions. Through SFBT, an evidence-based and goal-focused therapeutic approach, which assists clients to change behaviors by constructing solutions, is employed. The approach is, therefore, hope friendly, future-oriented, and elicits positive emotions by shifting away from the problems by focusing on motivating and sustained desired behavioral change.
Referral Services
Collaboration with other professionals and service providers is extremely important in achieving full recovery and healing among the clients. The principle is based on the collaborative care model in which service providers seek to improve patient outcomes through interprofessional collaboration (Matzke, Moczygemba, Williams, Czar, & Lee, 2018). Referrals ensure that physicians share skillsets and resources that are ultimately beneficial to the clients. Similarly, referrals are appropriate since the counselor is not in a position to provide all the necessary assistance needed to solve the clients’ problems. The decision is in line with the broader context of treatment intervention that aims to foster the overall well-being of the clients by utilizing all available community resources, including other professionals and services (Wiltsey Stirman et al., 2013). The community mental health therapist has, therefore, organized a series of professionals who function as a group and work together towards providing coordinated services to the Williams’ family. Further, the counselor has located outside agencies that will provide the additional services to the clients and negotiated meeting times, and established the groundwork for the clients’ visitations. The following agencies have been deemed crucial in providing the additional services for the Williams’ family;
- Alcoholic Anonymous World Services ( Jeff’s Referral Service for Alcoholism)
A.A. World Services
- verside Dr floor 11,
New York, NY, 10115.
- Amen Clinics, New York (Jacobs’ Asperger’s Syndrome Intervention Referral Service)
Amen Clinics,
- 40th St,
New York, NY, 10016.
- Baltic Street AEH, Inc. (Leo’s Referral Service for Anxiety Disorder)
250 Baltic St, Brooklyn,
New York, NY, 11201.
Jeff’s Referral Treatment Service for Alcohol Abuse
Jeff has developed an alcohol abuse problem culminated by financial problems arising from the economic downturn and stress-related family issues. The daily drinking affects his memory and behavior. The goal of the therapy session was to identify underlying factors contributing to the problem. Consequently, the counselor has referred Jeff to an outside service provider to assist in treating the alcohol abuse problem. Alcoholics Anonymous (AA) is a mutual aid fellowship that aims to help members stay sober whilst helping other alcoholics achieve sobriety. The organization is apolitical and self-supporting. The self-help program teaches strategies for coping with alcohol cravings and encourages activities that replace drinking habits. AA Supplements these strategies with the twelve (12)-step programs that promote participation, resulting in better outcomes. The only requirement for joining the organization is the desire to quit alcohol use. The organization is particularly useful in helping Jeff deal with his drinking problem. Members are not charged any fee.
Jacob’s Referral Treatment Service for Asperger’s Syndrome
Jacob lacks social skills, suffers from overall sadness, depression, and feels lonely and misunderstood. As a result, he is impaired in non-specific problems, such as temper tantrums, communication impairment, and phobias. Since his problem affects his ability to engage in social interactions, decision-making, and creative thinking, coping in everyday’s life is threatened (Woods, Mahdavi, & Ryan, 2013). Jacob is, therefore, recommended for treatment strategies that consider his developmental needs, family, relationships, and environmental challenges. Amen Clinics offer the highest levels of psychiatric care to patients using targeted treatment plans customized to meet patient-specific situations. The clinic applies brain imaging science to assist patients with learning challenges, emotional issues, cognitive problems, and behavioral issues. In Amen Clinics, Jacob will get an opportunity to work with mental health professionals who use play therapy, which is extremely useful for adolescents and teenagers diagnosed with Asperger’s syndrome. Fees will be charged on a sliding scale, depending on the caregiver’s annual salary.
Leo’s Referral Treatment for Anxiety Disorder
Leo’s grades have been on the downfall, moving from B average to D average in the last few years. Additionally, he only keeps a small circle of friends. He also seems frustrated and rarely interacts with other family members. Typically, Leo suffers from generalized anxiety, which is a common disorder and mental challenge for children and teenagers (Wolfe & Price, 2017). Baltic Street AEH, Inc. will foster cognitive-behavioral techniques designed to decrease the intensity and frequency of anxiety symptoms. Baltic Street AEH, Inc. focuses on improving the lives of people with mental health issues. Being a not-for-profit organization, its services are recovery-oriented. It helps its clients obtain the necessary social support, education, vocational training, and entitlements. The organization will be helpful in helping Jacob and Leo deal with their psychosocial problems. No fees are charged to patients as the organization is not-for-profit and peer-run.
Conclusion
Often, people face challenges that can lead to psychosocial problems, as witnessed in the William family. Community mental health counselors are tasked with helping their clients deal with the problems and lead them towards total healing and recovery. In developing an intervention plan and treatment strategy for patients, data collected and deduced from family counseling sessions, direct counselors on where to start. The case in Williams’s family has been conceptualized using the concept of relational agency, a theory that entails the capacity to offer support and seek support from others. As a community mental health counselor, an array of essential services that aim to help people who, for whatever reasons, are not able to get needed help from other institutions are offered. At the Community Mental Health Centre (CMHC), an array of outpatient services will be offered to the Williams’ family, which will include individual and group therapy sessions as a way of fostering intervention at an individual and family-wide level. Solution-Focused Brief Therapy (SFBT) intervention, which focuses on meeting some specific objectives by creating an essential difference in the clients’ way of life by targeting behaviors that need to be changed, is used as a primary approach in Williams’ family case. Referral service is based on the principles of the collaborative care model in which service providers seek to improve patient outcomes through interprofessional collaboration.
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