Term Paper on "Advanced Clinical Practice With Individuals Critique"

Term Paper 10 pages (4351 words) Sources: 8

[EXCERPT] . . . .

Clinical Practice with Individuals Critique of Practice

Behavioral change theories and designs mainly allow an individual to adapt and change a negative or damaging habit into a positive and healthier one. All behavioral change theories help the researcher to categorize the changes that individuals go through and the behavioral change designs help the individual to have basic guideline form where they can start to initiate the change themselves. The main aspects in the behavioral changes theories are internal factors like the confidence, behavior, attitude and beliefs of the individual and the external factors like the social structure, family and environment that surrounds the individual (Maurer, 1996).

Purpose of the Paper

In this paper we will analyze the behavioral changes that a teenager, 19-year-old Sarah, is going through as she lives through the foster care system in Miami. Her foster care structure is similar to almost any other foster care structure and leaves her feeling lonely, depressed and anxious with her life. The depression is the main cause of worry for the client as it disallows her to feel good about her achievements. She constantly finds herself breaking down in tears because of depression. She has been my patient for nearly two years now and whenever in such circumstances she comes to my clinic, I make sure that she is always made to feel welcomed and is surrounded by a calming influence and atmosphere whether she is in the waiting room or in my office. She usually is very reclusive whenever she comes for regular session and complains subtly about her depressive state. But at times, she does get overwhelmed and breaks down. I've used the findings of many behavioral studies to help her calm down and try to get herself out of her depressive inclinations.

It has been a very recent development that the behavioral changes theories have started incorporating the health maintenance strategies for individuals who do not have serious diseases like AIDS, but instead suffer milder diseases like depression; this has helped me deal with my patient a lot better than before. Furthermore, there are many researchers who believe that the behavior change models can provide important information on why certain individuals and certain societies undergo a higher percentage of depression. This is so because all behavior change models tend to categorize behavior patterns in clusters which can help present statistical information of the lifestyles and life choices of societies all over the world (NIH 2003).

In this paper we will mainly highlight how the different behavior change models has and will impact the chosen individual suffering from depression when she chooses to change her lifestyle. The paper will highlight the five important stages of change that the individual will go through in order to accurately apply the behavioral change method required to help her alter her depressive inclinations. The research will mainly use two behavioral change methods: the Stages of Changes Method and the Health Belief Model (HBM).

Methods Applied

The method applied in this study is the "Stages of Changes" procedure. This was a combination of interpersonal and environmental intervention and the first thing I did in this when altering the clients' depressive behavior was that I observed the patterns of behavior as they existed before the change process is initiated so that comparison of results could be evaluated accurately. In this way, I observed the resilience and willingness of the individual to adapt to change that would better her lifestyle. This I did through observing Sarah's attitude towards her peers, her social attachments, the willingness of the individual to stand up for her and for what's right in a tough spot, the food preferences, etc. All of the observations were recorded and documented with reasons for the preferences i.e. all of the actions and addictions to certain situations that could possibly instigate depressive inclinations.

The next step included the planning of the change process, risk assessment and recognition of protective factors. First thing done here was the recognition of unhealthy patterns in the current habits and the appropriate solutions that could bring about the necessary change in them. Second thing in this stage was the designing and distribution of the five methods explained below over a period of six to eight weeks which included all changes being made in the prior behavioral patterns. The five methods implemented in the behavioral pattern for this study include:

Pre-contemplation

Contemplation

Preparation

Action

Maintenance (Prochaska et al., 1992).

In the first stage of the pre-contemplation, the problem with the depression is obvious, whether or not it is recognized by the individual. If the individual does acknowledge the problem, she does not really resolve to take steps for its solution. In this stage, the individual (Sarah) mainly recognized the problem and gathered all knowledge that was directly or indirectly linked to the problem as well as recognized how her problem affected her environment through the process of observation (Prochaska et al., 1992). Here the method applied basically was aimed to increase the awareness of the individual to the problem through indirect, subtle and at times direct dialogue. This was chosen as the line of action due to the individual's episodic refusal towards therapeutic solutions; it was important that Sarah realized what she needed instead of me telling it to her.

In the second stage of contemplation, the problem was considered to be a serious yet solvable one by the individual and she took the necessary steps to engage herself in a process of change that were designed to help her resolve this depression issue. This is the stage where, for this paper, Sarah was able to recognize the root causes of the problem within her lifestyle and living patterns by researching the impact that each choice has on the overall mental and physical fitness of the individual. Here, the issue of depression is the lack of support from peers. Hence, the method used helped Sarah analyze all aspects that will increase the daily support, her confidence in her ability as well as the ability to trust in others who want to help while simultaneously decreasing the amount of depression or loneliness that she feels (Prochaska et al., 1992).

The third stage of preparation is usually the toughest stage because while people might recognize the problem and the need for a change, they might not always be mentally prepared to take on such a task because behavioral patterns are not easy to change especially if they have existed or been built up for many years as was the case of the chosen individual.

This is where the importance of the first step comes; if the awareness and knowledge of the individual acquired in the first step is thorough and detailed then the overall adaptation might prove to be a little easier. Here the most important task for the individual is to form a self-belief on the personal abilities to not only be able to apply the behavioral change plan but the belief that she can not only apply it but also get the desired results from it (Prochaska et al., 1992). Here, the method used included most psychological techniques used to enhance the self-confidence, self-esteem and self-belief of the individual (Sarah) by beginning with conversing about the completion of tasks in the past or the completion of smaller tasks that had been given within the psychological sessions. This is the stage where the client was in our last session. Interesting to note here is that Sarah took a long time in this particular stage and even though at times her self-esteem seemed to be high, mostly it was here lowered levels of self-esteem that delayed her progression from this step to the next. The next stage will be the focus of our future session.

Process Recordings and Analysis of Practice:

Below is a table where some of the client's responses, my own reactions and supporting theory have been represented from the sessions that have taken place thus far. These transcripts were chosen because they helped me to better understand my contributions through my interactions with Sarah.

Goal or intended focus:

The intended focus of this particular session was to help the client deal with her depressive inclinations in a positive and constructive way.

Aspects to consider when tuning in:

During the session, the client seemed very vulnerable towards what fear in general made her feel and act thereof. She seemed really nervous, finicky and apprehensive about how the fearful energy around her made her feel more depressed. She was definitely looking for psychological input and a solution she could apply in the long run.

Client / Worker Transactions (C)

Skill Name

Worker Reflections (Gut level) (W)

Supervisor's Comments

C: Hi! It's a weird day huh?!

W: Hello! Well, it depends on how you define weird! (Smiling) how would you define weird?

Displaying understanding for the client's feelings

Please let it not be a depressive breakdown, not after the progress we've made!

C: It's just that I feel traumatized and… READ MORE

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