Case 1

1. How will you approach the process of discussing informed consent?

Therapist will move on the client’s pace and not over bear him with questions. I may take over four sessions before you can assess personal questions.

2.What other areas would you like to assess?

Therapist will ask client personal background information such as sleeping patterns, diet, ask questions to such as “Are you ready to leave this earth” “Would you rather be with your wife in heaven” try asking questions that relates to death to see if client may be experiencing suicidality.

Catholic religious values are private it may be challenging to assess client’s beliefs but therapist will ask the following.

Therapist will assess client’s spirituality with questions such as “Do you pray, worship or attend service? If so how often? if not have you given up on faith since your wife has passed?

Therapist will assess family roles. Such as how often do you spend time with your children, grandchildren, relatives? Do you feel as though your family is emotionally supporting, empathetic, helpful?

Therapist will assess previous deaths in the client’s life. Such as have you ever experienced a death of a loved one that may have left you feeling depressed?

3.Please discuss Phil’s Locust of Control and responsibility?

Client is taking the death of his wife very hard. May believe in external locus of control. Phil stated his wife kept the faith going. He has lost faith now that she is gone. Client is responsible for his own actions in how he is treating himself after the death of his wife. For example, he no longer exercising, socializing, has a poor diet, and is moody. He has the same illness in which his wife has passed from Type 2 diabetes. He is creating a downward spiral for his health. He is showing signs of not wanting to live much longer.

4. What type of therapy is good fit for Phil?

Therapist suggest cognitive behavioral therapy for client such as Interpersonal therapy. This is the best treatment used to help client attain a goal and make specific changes. Make changes to present behavior and not focused on what has already happened. Therapist goal is to attain change in the client’s behavior for the following. A way of acting such as eating a healthier diet and becoming more socialized. Change fallings by decreasing depression and mood swings. Change thought process learn to get rid of self-defeating thoughts. Find a better way to deal with health issues. Help client stick to their diet, doctors’ visits, and medications. Client will also receive

Help client tap into their spiritualty by attending support groups at church. The support group will help client with loneliness, survivors guilt, and bereavement. According to McGoldrick, People use religion as a means of coping with stress or powerlessness as well as for spiritual fulfillment and emotional support. McGoldrick M. (2005) Ethnicity & Family Therapy. New York, NY: Guilford Press.

Case 2:

1.What specifically from the assigned readings informed your conceptualization of the issues for this case? (WILL UPDATE THIS INFORMATION)

2. What are some main culturally issues to keep in mind if treating this couple?

It is greatly advised as their therapist is to understand their culture. Therapist researched Japanese values, beliefs, and history. There’s a language barrier with Niwako and she’s self-conscious when she speaks. Mark may comprehend but Niwako may have a hard time in order to do so. It may be a hard task to counsel this couple due to the Japanese stigma attributed to mental health services. According to McGoldrick, Mental illness was thought to be “in the blood” and hereditary leaving the family to feel disgraced by having a mental illness family member. McGoldrick M. (2005) Ethnicity & Family Therapy. New York, NY: Guilford Press. Another issue that arise with the Niwako is feeling as if the problems can’t be solved by talking about them. In her culture, they believe in freedom of silence while western culture believes the opposite, Freedom of speech. Clients have hostile sessions due to the fact that Mark is open about the couple’s issues and Niwako wants to keep secrets. According to McGoldrick in family therapy keeping secrets tends to promote dysfunction while in Japanese culture secrets are not viewed as negative. McGoldrick M. (2005) Ethnicity & Family Therapy. New York, NY: Guilford Press. Niwako would like to keep things unquestioned. Therapist repeatedly has to reassure client that secrets will not be disclosed with anyone.

Therapist conducts a family genogram with the clients to explore their family tree. Niwako is missing home and is not adjusting well. A genogram will give therapist an idea of her family background. Client has attachment issues and this may come from the way she was brought up.

3. What type of therapy is a good fit for them and why? (Elaborate and site)

Solution-focused therapy, is best for the whole family.  The client Niwako is suffering from separation anxiety and adjustment disorder. Niwako need a supportive, encouraging, non-judgmental environment. Helping guide the client toward finding better understanding of issues in their lives as a family, find new coping mechanisms, and problem solving. Client will explore new behaviors and ideas. Therapist will guide clients Mark and Riku on ways to ensure Niwako that they are safe and will return.  Art therapy may be effective for treating Niwako as well.  According to McGoldrick, Nonverbal activities such as sculpting and drawing can be effective in working with Japanese families. ‘McGoldrick M. (2005) Ethnicity & Family Therapy. New York, NY: Guilford Press. This activity helps client open up and physically show their issues rather than disclose them. Therapist refer Niwako to a nearby art studio for Sip and paint. In which she will socialize all while telling her story through art.

CASE 3:

1. How do you build rapport with Mike?

Before making an attempt for intervention Therapist will use active listening skills to understand the client and their story. Therapist will make it known that they understand where Mike is coming from. Due to the client background, it will take longer to build trust. Therapist will watch its speed and not rush things with the client. Therapist pays attention to content and body language due t to the fact that there may be underlining issues the client will not disclose. The client discloses surface level issues. Therapist will not pay attention to the big problem first, intervention on the smaller problems will occur first. Therapist will give helpful information, positive feedback and encouragement. Therapist will also respect the client’s beliefs and not show signs of judgment. Therapist will make sessions comfortable for client.

2.What are some major issues that need to be discussed here with Mike? (Elaborate)

Mike is very true to his beliefs and values. He does not believe in LGBT. Mike has disowned his daughter due to her sexuality and has put a strain on the whole family.

3.What type of therapy is a good fit for Mike and why? (Elaborate and site)

Family therapy is the best treatment because it’s a family issue that’s affecting more than one child. Its best to get the whole family in sessions including the mother to see if she has any issues with her daughter as well.

Case 4:

1. The parents come to family therapy with you. The first question they may have for you is whether you are Christian therapist. How do you proceed?

Therapist should remain a blank canvas and is not obligated to share their personal beliefs, values and personal background information. Explain to the family that this session revolves around them and their issues and its best not to disclose anything personal from yourself. Ensure them in a nice way that you’re here to help them and not become caught up in self disclosure.

2. Major issues that are in need to be addressed?

Parents making judgment on child. The parents may feel as though the child is bad but his behavior may be stemming from their actions. The father presence will be addressed, he believes that their son problem is the mother issue alone is a major issue. The child may be acting out due to lack of attention from his father. Client Bob feels as though no one understands him and cannot express himself without being preached to. Communication and understand needs to be addressed amongst the family. Bob has been having difficulty at school, lacks friends, and is angry. These issues need to be addressed. Therapist will need to know the length of this problem, what are some things that makes him angry, the actual difficulties he is having at school. Therapist will address the issues of spoiling Bob and how this may enable his behavior. Religion will be addressed how it plays a significant role in the family.

3. Please discuss locus of control and responsibility as it relates to Bob and his parents.

Internal locust of control is viewed by the parents. The mother and father depends on religion as a way of life. They believe in a higher power and that God can make changes in their lives. The mother believes that Bob is a gift from God and their deceased son. The mother is wondering if she is being tested by God due to his behavior. They are not letting go of faith and believe that God can make changes in Bob.  On the other hand, Bob is showing external locus of control. Bob is resisting prayer, tired of hearing strict bible rules, and being preached to. Bob is starting to believe the bible is a fairy tale. He is losing faith and thinking negatively. Bob

4. What type of therapy would you provide? (Elaborate and site)

Family therapy is recommended using techniques of Gestalt therapy.  In this therapy clients will focus on the “here and Now’.  Buy gaining awareness of the present moment and context. Through therapy clients will learn to discover feelings that may have been suppressed by other feelings. For instance, the parents may not fully have recovered from previously losing a child. Gestalt therapy will help unmask some of their heartache and feelings. Bob will be able to unmask needs and emotions that were unacknowledged. Therapist will use the empty chair technique in which client will sit across from an empty chair and imagine it’s a person they have a conflict with. In this case therapist would allow Bob to imagine his father and mother is in the chair. The therapist encourages dialogue between the empty chair and client. This will engage the persons thoughts, emotions and behaviors. This technique can help the client become mindful of the situation.