Williams Family Case Study Treatment Plan
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This paperwork is a representation of the endeavors of the writer to create a treatment strategy plan for the family of Williams. The paper does not include a diagnostic and statistical manual of mental disorders (DSM) axis diagnosis. The paper, therefore, does not include diagnostic measures. Nonetheless, it is an intersession plan for the Williams family. It outlines a cohesive treatment strategy plan for the whole family of Williams based on the model of community counseling. The counselor will use the community counseling model to help the family address numerous issues it has presented. The counselor will decide where to begin the treatment plan based on the information the counselor gathers and deduces from the family intake sessions. The treatment plan is to help identify numerous, obvious, and hidden problems the family of Williams is believed to be experiencing. The counselor will then identify the services deemed necessary to offer to the family based on the issues the family will present, and other services Williams’s family may require that can be locally provided.
Although family-centered treatment incorporates various elements of evidence-based theoretical models, two models in the particular form its foundation. These models are emotionally focused therapy and eco-structural family therapy (Ellis et al., 2018). The two models depend on interaction patterns and emotional tone changes among family members. The eco-structural family therapy model incorporates the family’s larger social context or environment (Ellis et al., 2018). The brief strategic family therapy is the most researched model of eco-structural family therapy model. Emotionally focused therapy heavily depends on the practice of enactments. Both the eco-structural and attachment theories emphasize the benefits of emotional expression and experience (Andersen et al., 2020). A family-centered treatment strategy plan gets to the behavioral functions rather than just symptoms treatment making it an effective model for families with a history of trauma.
The Williams Family
The family of Williams comprises Sandy and Jeff. Jeff and Sandy have been married for twenty-one years and they have two sons. Jacob the eldest son is eighteen years old while Leo is fifteen years old. Jeff is the owner of a used car dealership whereas Sandy has been working at a local elementary school as a teacher’s aide for the previous ten years. However, the family is experiencing financial pressure as a result of the downturn in the economy at the car lot and slow business that has resulted in family anxieties. Additionally, the family’s stressful situation is also aided by poor financial management procedures and spending behaviors. This is an area the family needs to improve on. William opts to go out and drink liquor the entire night instead of talking about how he feels with the family. He prefers to use drugs to feel better. Using drugs to feel better has long-term consequences while achieving short-term excitement. For instance, alcohol will negatively impact William’s work in the long run. Alcohol only results in offensive, irresponsible, and dangerous behaviors as one starts to care less about family or home life. William finds it hard to spare time for his family particularly his wife and children. William has frequent conflicts with his children and wife that have led to Leo and Jacob developing a distant relationship with their father.
Case Conceptualization Tactics
People respond to stressful situations individually in unique ways. However, most people deal with different stressful situations or crises by concentrating on the difficulty while putting everything else aside. This approach only works for the short-term to most people. One of the central aspects of psychotherapy and cognitive-behavioral therapy is case conceptualization where the definition is commonly referred to as evidence-based exercise soul (Andersen et al., 2020). Conceptualization yields the concerns raised by a client and provides guidelines for an intervention plan. Case conceptualization is, therefore, a medium through which various components are put together to understand the concerns presented by a family or a client. In this case, case conceptualization within the community or locally using the community models (Andersen et al., 2020). Case conceptualization is, therefore, the description of the concerns raised by a family or a client. On the other hand, case formulation is the process of designing or advancing a case conceptualization. For this family treatment plan, only case formulation techniques and cognitive-behavioral therapy (CBT) will be used.
Community Counseling Agency Services
The community counseling model refers to an agency of counselors who handle numerous clients rather than a family or an individual. The community counseling model differs from professional therapists who deal with particular cases for instance, from first to last case (Andersen et al., 2020). Case conceptualization of CBT focuses on four main corporate components; etiological factors, upkeep factors, triggering factors, and concern presented. Concern presented is the first complaint a client or family raises to a counselor (Andersen et al., 2020). Triggering factors are the latest crises that occurred in a family or a client’s life resulting in the augmented symptoms. Upkeep factors are the mental ideas, mainly research-centered, that describes why a family or a client is experiencing the presented concern (Barlow et al., 2016). Etiological factors attempt to explain the development of hypothesized mechanisms. A good conceptualization should: i) discuss all the concerns and symptoms of a patient, ii) hypothesize a mechanism that can result in and retain the concerns of a patient, iii) outline the precipitant events of the current issues, and iv) hypothesize mechanism sources (Barlow et al., 2016).
The hypothesis of maintaining a mechanism requires one to, first of all, depend on theories and nomothetic mechanisms for specific disorders and secondly general principles of psychology. The hypothesized mechanisms should have an empirical research rationale. For instance, treating a depressed person, in this case, Leo, the counselor should hypothesize inadequacy of positive reinforcement to formulate a necessary explanation for a major depressive episode (Barlow et al., 2016). Similarly, the counselor can depend on general principles of psychology like core beliefs or negative automatic thoughts as mechanisms for functional disability.
Conceptualization can also be done using the Padesky tactic that employs the use of three different levels. These levels are case, concern, and symptom. Symptom-level conceptualization focuses on the symptoms of people within illnesses or concerns. It also tries to explain why a person experiences a particular concern. Concern-level conceptualization explains why particular functional damage or illness has come up. Lastly, case-level conceptualization focuses on explaining all the issues of a client with a single clear clarification. For instance, a symptom-level conceptualization will explain the connections of symptoms of a depressed person. A concern-level conceptualization will explain how to maintain an apprehension disorder and the links between its symptoms and negative corroboration of avoidant performances. Case-level conceptualization is quite difficult and explains the connection between hospitalization, depressive disorder, and nervousness disorder. Inadequate positive support may result in negative thoughts of hopelessness and increased suicidal thoughts that may lead to hospitalization. An excellent conceptualization illustrates a client’s behavior at all three levels. The conceptualization levels should be dependable internally.
An incident conceptualization technique illuminates presentations of the consumer in regards to the mental notion that notifies correction. Situation conceptualization is a receptacle that indicates the concept and study of the buyer’s skills and cognitive-behavioral therapy. In situation conceptualization, analysts syndicate defensive causes, weakness features, preserving devices, triggering aspects, and user giving difficulties. Situation conceptualization has three philosophies; consumer fortes, conceptualization level, and collective pragmatism. Conceptualization in this regard should integrate opinions from users regarding its legitimacy, create clear data with the mental concept, and should be advanced with the user.
Another opinion concerns the close of conceptualization; that is, generic and disorder-specific. A generic conceptualization is useful for complex or comorbid disorders whereas disorder-specific conceptualization is suitable for a user who suffers from one disorder. Posttraumatic stress disorder strength disorder-specific conceptualization uses cognitive-processing treatment to hypothesize cognitive stuck-points. Using a standard posttraumatic stress disorder conceptualization helps to ascertain a particular schematic not confidentially defined by the society in terms of posttraumatic signs, connection problems, and collective dodging. Thirdly, the elasticity aspects and user power have to be comprised. Investigating the powers of a client can enhance progress behavior product, disorient the maintaining factors of hands out problems of a user, and enhance customer inspiration. Causes of resiliency and strength may also explain why unruly exists in certain backgrounds. Case conceptualization should, therefore, act as the treatment blueprint.
To establish a treatment strategy plan that targets the hypothesized mechanisms, the assessor must acquire descriptive information and then infer and interpret the acquired descriptive information. An example is where a student reports that he cannot concentrate during class. The counselor must collect descriptive information about the academic problems of the student. This information can be collected by conducting a clinical interview where the student may present concerns such as lack of concentration on schoolwork, feeling restless and related complications. The counselor has to gather enough information that helps in either refuting or reinforcing the claims of the student. Using this information, the counselor comes up with a hypothesized mechanism and a treatment strategy that aims at the chosen mechanism.
There is a case conceptualization that is socially well versed that was described by Eells in 2015. This case conceptualization proposes that therapists ought to be familiar with a client’s cultural category as well as their distinctiveness strength. According to Eells, a therapist must also consider the effects of culture on the problems a client presents. Additionally, culture should be incorporated in the client’s non-pathological considerations, for instance, social interactions and language choices. Lastly, Eells also suggested that therapists must study the effect of culture on therapeutic associations. Bucci and the colleagues arguing from a perspective of cognitive behavior suggested three more considerations for standard cognitive-behavioral therapy case formulation approaches (Bucci et al., 2016). These approaches involved identification of presenting concerns and examination of consequences and antecedents of behavior. Bucci and colleagues proposed three considerations as follows; clinicians ought to hypothesize mechanisms as dysfunctional systems, evaluate the problems of a client in a social context, and identify vulnerability and epidemiological factors (Bucci et al., 2016).
Andersen further argued that dysfunctional patterns of behavior are maintained by broad mechanisms that are first considerations. For instance, a depressed person may have a deficit of social skills that result in anxiety in social situations, inability to form inmate relationships, and difficulties at work, as evidenced by the cases of Jacob and Leo in this treatment case study (Dorsey et al., 2017). Another principle is the early experience and characteristics of a client caused by vulnerability and epidemiological factors that aggravate the likelihood of a problem occurring. For instance, a person may suffer from depression because they are abandoned while still young or they had little chance of establishing a close relationship with their parents. Thirdly, the principle of functional patterns of behavior and social relationships explains the social context of the client presented concerns (Dorsey et al., 2017). Lack of social reinforcements may be a cause for real concern for a client. A person may feel banished by people due to their poor social skills in social circumstances.
Consequently, most graduate therapists incorporate cultural problems into conceptualizations only when a client mentions culture-related problems but omit them when a client fails to mention culture-related issues. Case conceptualization has consistency with cognitive-behavioral therapy models in cases of minor stress where CBT emphasizes context and environment (Flinn et al., 2015). Case culture indirectly contributes to informing case-level conceptualization and mental illness (Flinn et al., 2015). Conceptualization outlines the presenting concerns of a client, identifies the precipitating factors that led to distress, hypothesizes the mechanisms of maintaining the issues, and explains the origin of such mechanisms (Flinn et al., 2015). Dudley and colleagues described collaborative experimentation, a fundamental constituent of CBT that combines all tactics of conceptualization. Barlow and colleagues outlined the significance of a client’s strength when making treatment applications (Ellis et al., 2018). In general, all scholars and counselors agree in one constant account of case conceptualization that shows presented concerns, mechanisms maintaining issues, triggering stressors, and etiological factors as the essential elements of an excellent case conceptualization.
Services Better Provided by Other Agencies or Organizations
Other than community models case conceptualization management, numerous counseling agencies provide professional services and follow-up activities to families and clients. For this case study, the community counselors will walk with the family of William all along to the recovery point. One of the best community agencies found within the locality of the William family is the Open Path Psychotherapy Collective. This organization is at the doorstep of William’s family (Newsome & Gladding, 2017). The organization is also found in all countries of origin. Open Path Psychotherapy Collective is a non-governmental agency that offers mental health well-being services to patients (Eells, 2015). The goal of the organization is to provide a pleasant experience that enriches an individual’s life, reduces stress, and helps in goal achievement. For instance, Jacob and Leo (sons of Jeff and Sandy) still require guidance in their academic life until completion.
Open Path Psychotherapy Collective provides both face-to-face and online counseling sessions to clients. The organization boasts among the best psychotherapists in the world. It offers services at pocket-friendly prices ranging from $30 to $200 per session (Robinson, 2020). It provides professional guidance to patients suffering from mental disorders. In this case, psychotherapists from Open Path Psychotherapy Collective assure William’s family that they will only discuss the concerns presented by the family and nothing more (Robinson, 2020). The idea of discussing what only concerns the family is to eliminate worries the family may have about being exposed by the counselors.
Psychotherapists in Open Path Psychotherapy Collective Organization provide detailed psychotherapy that is long-term as compared to community models. Community model counselors focus on specific concerns and intend to help a client disclose particular problems like stress, or addiction (Eells, 2015). Additionally, community counseling is a short-term model as compared to therapy. William’s family needs advanced sessions that will provide follow-up activities to the family until recovery is achieved. Psychotherapy will also create awareness within Leo and Jacob. More importantly, psychotherapy outlines ways through which disrupts the day-to-day life of the family, control measures of symptoms, a better understanding of anxiety and depression, as well as keeping an eye on the medical recommendation.
In summary, case conceptualization formulated by counselors is at risk of errors as counselors suffer from cognitive biases. Cognitive biases like convenient experiential affect how counselors identify their patients. It also affects how counselors assimilate a large amount of information. Clinicians get it hard to examine conceptualization validity in cases where there is no feedback or feedback is little. Psychotherapy is, therefore, the best approach the family of William can use to address their concerns such as stress, addiction, anxiety, and other mental disorders. Other than psychotherapy sessions, Sandy and Jeff must engage with their sons in activities like reading storybooks, laughing together, or playing together to achieve the desired results.
Andersen, N., Hofstadter, L., Kupzyk, S., Daly, I., Bleck, A., Collaro, L., Blevins, A. (2020). A guiding framework for integrating the consultation process and behavior analytic practice in schools: The Treatment Validation Consultation model. Journal of Behavior Assessment and Intervention in Children, 1(1): Pp. 53-84. Doi: 10.1037/h0100360
Barlow, H., Farchione, J., Fairholme, P., Ellard, K., Boisseau, L., Thompson-Holland, J., & Carl, R., (2016). Unified protocol for Tran’s diagnostic treatment of emotional disorders: A randomized controlled trial. Behavior Therapy. Pp. 666-678.doi:10.1016/j.beth.2012.01.001
Bucci, S., French, L., & Berry, K. (2016). Measures assessing the quality of case conceptualization: A systematic review. Journal of Clinical Psychology. Pp. 517- 533.doi:10.1002/jclp.22280
Dorsey, S., Pullmann, M. D., Kerns, S. E., Jungbluth, N., Meza, R., Thompson, K., & Berliner, L. (2017). The juggling act of supervision in community mental health: Implications for supporting evidence-based treatment. Administration and Policy in Mental Health and Mental Health Services Research, 44(6), 838-852.
Dudley, R., Ingham, B., Sowerby, K., & Freeston, M. (2015). The utility of case formulation in treatment decision making; the effect of experience and expertise. Journal of Behavior Therapy and Experimental Psychiatry. Pp. 4866-4874. doi:10.1016/j.jbtep.2015.01.009 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5601028/
Eells, D. (2015). Psychotherapy case formulation. Washington, DC: American Psychological Association.
Ellis, V., Hutman, H., & Deihl, M. (2018). Chalkboard Case Conceptualization: A method for integrating clinical data. Training & Education in Professional Psychology. Pp. 246-256. Doi: 10.1037/a0034132
Flinn, L., Braham, L., & Das Nair, R. (2015). How reliable are case formulations? A systematic literature review. British Journal of Clinical Psychology. Pp. 266-290.doi:10.1111/bjc.12073
Newsome, D. W., & Gladding, S. T. (2017). Clinical mental health counseling in community and agency settings. Pearson Education Canada. https://airbooks.org/sample/MedicalHealth/MH301-400/MH382/sample%EF%BC%8DClinical%20Mental%20Health%20Counseling%20in%20Community
Robinson, A. (2020). Enhancing empathy in emotion-focused group therapy for adolescents with autism spectrum disorder: a case conceptualization model for interpersonal rupture and repair. Journal of Contemporary Psychotherapy, 50(2), 133-142. https://link.springer.com/article/10.1007/s10879-019-09443-6