Psychological Treatment of Gilbert Study of His Self Assessment
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There is no prior treatment or services reported with this being Gilbert’s first initial visit. Gilbert is not currently receiving any medical or mental health treatment or services. He reports that he only went to the doctor to get his shots when he was younger. He denies any changes in his sleep pattern. He also, denies any appetite changes, but reporting that he eats a lot of unhealthy foods. No recent or prior hospitalizations within the past year. Gilbert reports that the last time he was in the hospital was when he was born. There is no reported history of or presence of suicidal ideations or homicidal ideations.
Recommended Treatment Goals/Strategies
Human problems in respect to multidimensionality, is “a consequence of the fact that human beings are social creatures who depend both on other human beings and complex social institutions to meet their needs” (Hepworth et al., 2013, p. 186). It is also, an individual’s emotions that “are complex experiences, expressing reactions to past, present, and future events” (Hepworth et al., 2013, p. 483). Both statements are reflective of Gilbert.
With this said, Gilbert’s problems, are a result of reciprocal interaction that has occurred between him and the world around him. To develop individualized treatment goals for Gilbert, while demonstrating “sensitivity to the multiple system influences” (Hepworth et al., 2013, p. 485) and clarifying his relationships, it is important to focus on Gilbert and his environment. This is done using the ecosystems perspective, which allows the ability “to address the psychosocial matrix of which individuals, families, groups, and communities are constituents” (Mattaini & Meyer, n/d., p. 1).
This can be illustrated, as an ecomap, which is “a graphic device for viewing the relevant, connected case elements together, within the boundary that clarifies for the practitioner the case system as the focus of work” (Mattaini & Meyer, n/d., p. 2). Refer to diagram 1, which is an ecomap of Gilbert and his environment, which is a “close conceptual fit with the ‘person-in-environment’” (Hepworth et al., 2013, p. 16).
It is the niche concept of the ecological systems theory, which “is central to ecology” with all aspects of the niche’s considered, “as the ‘environment’” (Holt, 2009). This is reflective of Gilbert (niche) and the ecomap of his environment. It is according to Gottfredson, the ecological niches and niche seeking are concepts “derived from developmental psychology to explain how individuals find their place in the world. As social beings, we strive to find our place in society, and vocational choice is one way to announce our place” (Swanson & Fouad, 2015, p. 160).
Gilbert appears to have a niche of human dignity and displaying kindness and concern for other people, which can be influential attributes (niches) for his future. In applying niche seeking to Gilbert, it could be utilized, as a goal to assist with finding his niche “in society, which is essential to achieving self-respect and a stable sense of identity” (Hepworth et al., 2013, p. 16).
Gottfredson explains that an individual’s vocational “preferences are so tightly linked with self-concept because individuals are very concerned about their place in social life” (Brown, 2002, p. 94). Gottfredson also, explains that it is the cognitive developmental growth of children, which allows for their individualized self-concept thus, allowing them to find purpose and meaning in their career choices (Swanson & Fouad, 2015, p. 160). Even though Gilbert is in adulthood, he is still conflicted with his identity and role confusion of adolescence development.
It is the adolescence stage when adolescents begin “[o]rienting to more internally defined goals and internally based concepts of self” and “they being to forge a more personal sense of self” (Brown, 2002, p. 99). It is Gilbert who is cognitively oriented x3 but lacks free time to himself due to his family obligations. Time that would allow Gilbert to personally define his self-concept. It is applying self-concept with Gilbert, such as involving career identity thus, separating his dependence from his family and allowing him to concentrate on himself.
Two individualized treatment goals for Gilbert are: 1) Within 6 months, Gilbert will use niche seeking to identify his own niches and allow for personal interest identification, and 2) within 6 months, Gilbert will discover himself/his own identity with the ability to distinguish himself, as one self-individual from the family.
Clients seek professional services to help them with their problems and as a result, it is the assessment process that “focuses on developing a picture” (Hepworth et al., 2013, p. 192) of the individual client’s life and their problem(s). It is a multidimensional assessment that “make[s] use of concepts drawn from the fields of ego psychology” and “concepts prominent in object relations theory, such as attachment and interpersonal relationship patterns” (Hepworth et al., 2013, p. 194).
When completing an assessment, it requires substantial knowledge and understanding about the individual, as well as various systems, such as: “economic, legal education, medical, religious, social, [and] interpersonal [,]” (Hepworth et al., 2013, p. 186) which affects or has an impact on the client system. Also, there is a need to assess the individual’s functioning, such as: “dynamic interactions among the individual’s biophysical, cognitive, emotional, cultural, behavioral, and motivational subsystems [,] and the relationships of those interactions to the client’s problems” (Hepworth et al., 2013, p. 186). Therefore, it is the needs of the client and the servicing “agency’s purpose and resources,” (Hepworth et al., 2013, p. 186) which will most definitely influence the “choices and priorities” (Hepworth et al., 2013, p. 186) of the professional social worker when completing a multidimensional assessment.
A social worker’s way “of thinking and perceiving clients [is] culturally conditioned and culturally based” (Stampley & Slaght, 2004, p. 345) and it is their actions, which are referred to as countertransference. It is this “cultural biases and/or insensitivity to cultural differences” (Stampley & Slaght, 2004, p. 333) that could result in the social worker lacking empathy while distorting an understanding of the client. Also, it can create “a clinical obstacle that interferes with the therapeutic [clinician and client] relationship” (Stampley & Slaght, 2004, p. 333) and even “impact their clinical practice” (Stampley & Slaght, 2004, p. 334).
It important to remember that there is a significant “influence of culture on development,” which has been recognized by Erickson’s Theory of Psychosocial Development along with further emphasis, that “the social world exists within the psychological makeup of each individual” (Sokol, 2009, p. 140). As a professional social worker, it’s important to be aware of one’s own “history, [beliefs], values, biases[,] and behaviors” (Hepworth et al., 2013, p. 186) while practicing ethically and with professionalism, so that any differences do not interject negatively during client interaction(s), as well as during the assessment process. Also, when engaging diversity and cultural differences, it is important to adhere to the National Association of Social Workers Code of Ethics (NASW) specifically, ethical standard 1, Social Workers’ Ethical Responsibilities to Clients, (1.05) Cultural Competence and Social Diversity (NASW) (Workers, 2008).
It is during the assessment process, which it is important for the social worker “to consider the degree to which the client experiences a goodness of fit with the culture in which he or she is situated” (Hepworth et al., 2013, p. 191). It is “[t]his ‘goodness-of-fit’ [that] is a consideration when examining any person in the context of his or her environment” (Hepworth et al., 2013, p. 191). Thus, by exhibiting “cultural awareness, communication, and understanding,” (Renzaho et al., 2012 p.265) allows for the facilitation of effectively engaging with diverse clients/families.