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Introduction
The following paper evaluates a particular case in which an individual is experiencing physical symptoms of distress and anxiety as a result of family-centered pressure. The therapeutic method selected to address the patients needs includes the person centered approach. Due to the clients diverse background and conflicting perceptions of the self, the paper argues that the values upheld by the person centered approach are the most beneficial for the patients future personal growth.
Clinical Case Overview
The case study selected for this paper is focused on a female patient named Janelle who is thirty two years old and heterosexual. In order to better understand the symptoms experienced by the patient it is vital to acknowledge her background. Janelle comes from a culturally Egyptian background due to her family but likely experiences influences of Canadian culture due to her upbringing as her parents had emigrated to Toronto when she was only two years old. Throughout her youth, her parents had placed quite demanding expectations and rules on her such as constant high grades and limited interaction with boys her age. Janelle explains that this had caused her to feel different and even stirred emotional distress. As an adult, Janelle enjoys her social and professional life and can be categorized as economically and socially secure. However, she experiences pressure from her family in terms of marriage and starting a family.
Janelle frequently attends weekend family dinners, which she has expressed have begun to potentially cause her severe distress and even physical symptoms of unwellness. The dinners are attended by her entire family, including her siblings which are all married and have children. Janelle explains that the gatherings cause her to feel sad and isolated, as if she is the fifteenth wheel in her own terms. Over the past month, Janelle has also recounted a number of physical symptoms that really worry her. These include panic, shaking, sweating, and choking sensations that have resulted in two visits to the emergency room. Janelle describes a situation in which she began to feel numbness in her extremities, stomach discomfort, and warmth that was severe enough for her to feel the need to remove her clothes and cool herself with a washcloth. Janelle summarizes that she feels scared, uncertain, and not in control, as if she is going crazy.
Theoretical Orientation
All of the incidents that Janelle describes may be triggered by the dinner gatherings that she describes as upsetting and pressure-inducing. Because Janelle faces a unique issue that has cultural, social, and familial elements of influence, she may benefit from a person centered approach. A person centered approach places the individual as the priority of a service or treatment. Essentially, the focus is directed at the person and their potential actions to improve their state rather than their disability or condition. Additionally, the approach aims to achieve the persons goals, aspirations, and ambitions without ignoring their particular environment, situation, or needs.
The theoretical tenets of the approach can be summarized through five statements. First, the approach must support the patient and allow them to formulate decisions regarding their life. Second, the approach is aware of the persons age, experiences, heritage, language, culture, gender, beliefs, and other fundamental aspects of identity (Safran et al., 2019). Third, the services provided must be flexible and easily tailored to the individuals needs. Fourth, the approach focuses on strengths and an individuals abilities. Fifth, the approach works to include the support network of the person in the process of treatment.
The theory of person centered approach hosts a number of assumptions. Primarily, the approach proposes that individuals are inherently trustworthy and possess the potential to understand themselves and issues that may be occuring in their lives. It also makes the assumption that individuals have the capability to come to these realizations without direct intervention of a therapist or specialist (Hamovitch et al., 2018). The theme of freedom and choice is also prevalent within the approach, as they allow individuals to foster positive change. Some vital principles of the approach include self-governed growth and the ability to formulate therapeutic relationships.
The person centered approachs foundation is closely related to the humanistic perceptual theory which stipulates that a persons subjective and personal perceptions are valuable in constructive growth. The humanistic perceptual theory also incorporates the influence of formative childhood experiences and their impact on later responsibility in becoming a fulfilled person. The theory, and its most prevalent figure, Carl Rogers, did not see patients as ill or bad but ultimately good and healthy with the option to pursue their potential growth (Swan et al., 2020). The prioritization of the patient in therapy over the therapists approach or methodology was common in his practice.
The tenants, assumptions, principles, and the foundation of the person centered approach can beneit Janelle for a variety of reasons including childhood influences, her individuality, and family involvement. Janelle herself outlines that some elements of her childhood had caused her to feel isolated and upset, such as following strict prohibitions in her social life or pressure to do well academically or pursue parent-approved colleges. It is likely that this pressure and guidelines continue to affect her in the present and existing outside her parents expectations can make her feel at a loss. Janelle is also influenced by a unique cultural background, having her Egyptian roots as well as growing up in a Canadian environment. As the culture has both mutual and opposing values, this may have caused Janelle to feel conflicted and uncertain about her own choices. It is likely that the family gatherings trigger her issues with familial expectations and pressure, and as such, their involvement in her journey is essential. Fostering healthy communication within her inner circle and being secure in herself as an individual are two concepts that can become more effective in Janelles life through the person centered approach.
Interventions/Techniques
While the person centered approach offers a variety of effective techniques and interventions, two that would benefit Janelle the most are likely the acceptance of negative emotions and congruence. While the therapy technique focuses on the positive, strengths, and abilities of a client, it is also integral to acknowledge any and all negative feelings that a patient experiences (Håkansson et al., 2019). In the case of the person centered approach, the therapist should facilitate an environment in which the client can express their negative emotions without the fear of judgment. Similarly, the therapist should not take any comments personally, even if the client may be expressing negative emotions towards the therapist. Congruence is especially vital to the person centered approach as it aims to allow the client to acknowledge both their current self as well as their ideal self (Kolden et al., 2018). The therapy technique works not to turn the patient into their idealized version of themselves but to balance the two perceptions the client has. Essentially, the technique allows individuals to set realistic and favored goals and turn them into high-functioning versions of themselves without the need to be dissatisfied with their present self. This requires the therapist to be honest with the client and facilitate relationships built on trust.
Janelle is likely experiencing certain negative emotions due to the pressure and expectations that are being placed on her and that she feels she is not meeting. It is possible that she has no safe environment or way to express these feelings. Her physical symptoms may be related to these emotions of distress and could be exacerbated by them. As such, it would benefit Janelle to determine how exactly she feels about the pressure she is currently experiencing in an environment that is safe and constructive. Janelle is also likely worried about her perception by others and her view of herself. This is likely because she is worried that she is not meeting the expectations of her family, such as having a husband or children. However, Janelle can be successful according to her own values as she currently lives comfortably, has published numerous papers, maintains a satisfying social life, and participates in her interests. Within a series of sessions, Janelle may benefit from exercises that combine her idealized self, likely influenced by external pressures, and her current self to build confidence in her identity.
Multicultural Limitations
Janelles background reveals both the strengths and weaknesses of the person centered approach in terms of culture or ethnic background. The therapy approach may not be applicable to individuals whose cultures prioritize communal or collectivist values. Certain religions and ethnic practices place significant importance into social or unified rituals, systems, or practices that can even serve as the foundation of a culture (Swan & Ceballos, 2020). The compatibility of a therapists awareness of a patients culture and background is not guaranteed and they may be unable to perceive their impact on the wellness of the patient. Failing to do so may have negative effects on the growth of the patient. Therapists are also susceptible to biases and while their discipline prohibits the influence of assumptions, judgment may occur and be detrimental to the personal nature of the person centered approach. These biases have the potential to be built on cultural, ethnical, racial, or other perceptions.
Personal Alignment
My selection of the person centered approach is reflective of values I hold and experiences that have influenced me as a counselor and an individual. Personally, I prioritize concepts such as self-reliance, freedom, personal growth, and progressive worldviews. Essentially, the person centered approach aligns with my beliefs that people are in control of their own lives and certain aspects, such as illness and harmful experiences do not limit their ability to observe their own constructive growth. Having interacted and been impacted by a variety of cultures, I also find diversity to be integral to fostering environments that are safe, productive, and forward-thinking. The person centered approach upholds similar values and recognizes the importance of flexibility according to a clients needs and unique identity.
Conclusion
The client of the case study, Janelle, is having issues due to the inability to balance family expectations and her own perception of her identity. The proposed interventions in the paper outline the ways in which providing a safe environment for expressing negative emotions and congruence can benefit Janelles state. The approach also focuses ons strengths which can be integral to the personal growth of many individuals.
References
Håkansson, J., I. K., Holmström, Kumlin, T., Kaminsky, E., Skoglund, K., Höglander, J., Sundler, A. J., Condén, J., & Summer Meranius, M. (2019). Same same or different? A review of reviews of person-centered and patient-centered care. Patient Education and Counseling, 102(1), 3-11. Web.
Hamovitch, E.K., Choy-Brown, M. & Stanhope, V. (2018). Person-Centered Care and the Therapeutic Alliance. Community Mental Health Journal, 54, 951958. Web.
Kolden, G. G., Wang, C. C., Austin, S. B., Chang, Y., & Klein, M. H. (2018). Congruence/genuineness: A meta-analysis. Psychotherapy, 55(4), 424433. Web.
Safran, J. D., Kriss, A. & Foley, V. K. (2019). Psychoanalytic therapies. In D. Wedding & R. J. Corsini (Eds.), Current psychotherapies (11th ed.) pp. 21-58. Cengage.
Swan, A. M., & Ceballos, P. (2020). Person-centered conceptualization of multiculturalism and social justice in counseling. Person-Centered and Experiential Psychotherapies, 19(2), 154-167. Web.
Swan, K., Cheng, C., & Bockmier-Sommers, D. K. (2020). Relationships between Carl Rogers Person-Centered Education and the Community of Inquiry Framework: A Preliminary Exploration. Online Learning, 24(3), 4-18. Web.
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