Application of Egan Theory in Critical Analysis - Case Study Example

?Introduction A combination of experiential knowledge and evidence based practice reveal that the most effective modules in clinical counselling are patient-centred and this is exactly what Egan’s model is all about. It enables the helper to facilitate the patient’s efforts in establishing the existing problem, what is desired instead and how this could be arrived at (Wosken 2006, p. 23). An explorative study of Egan’s model is perhaps best done through a case like Rose Amber’s; a 36 year old client who is overweight (50Kg heavier than her ideal weight). In the first session with Amber, she indicates that she needs to lose the extra weight quickly and permanently. Egan’s model requires that Roger’s core conditions be in existence for optimum application; empathy, genuineness and positive regard (Cormium, Nurius and Osborn 74; Hays & Singh 2011, p. 135). She further reveals that she is engaged to a 50 year old lawyer, Doug who is noncommittal to marrying her due to her weight. She also dislikes her job at a call centre and has a difficult relationship with her mother. I help Amber through empowering her to conceptualize a preferred scenario and then develop action strategies towards it. She commits to lose the extra 50Kg within one year and find a better job. In the second session, Amber feels that she has had some success with the suggestions I gave. Doug is supportive in her efforts to lose weight although he says she will not succeed. She is also concerned about Doug’s health, since he is a Type II diabetic who does not look after himself quite well. Amber also informs me that she is considering finding another job and that although she has three or four close relationships with her girlfriends, these have faded due to her relationship with Doug. I suggest that she improves communication between her, Doug and with her friends and show concern for his health. Application of Egan’s Theory in the third Session with Rose Amber The first stage is establishing the current scenario first by listening to Amber’s story. Her mother has put her under pressure about a set wedding date besides taunting her about her weight. Amber had tried to talk to Doug about the wedding to only end up being hit after a fight, although she feels that he is sorry and that they were still living together. This did not quite explain her emotional condition and so I used probing skills to fill up the blind spots in the current situation. Amber revealed that although they were still living together and that Doug appeared sorry, she was quite upset about the entire situation and uncertain about whom to turn to for support. I asked her if there was anything more she had overlooked and she noted that she had not followed the suggestions from the previous session and was quite worried that she had lost the weight loss battle and maybe she could even reverse her gains. To help focus Amber’s concerns, I asked her to establish what aspects of her predicament was the root cause of the others. She thought that her weight, relationship with her mother and current situation with Doug concerned her the most. The second stage in Egan’s model is establishing the client’s preferred scenario. To begin with, I asked Amber for the possibilities she felt she would have wanted to be in currently. Amber figured that she wanted her mother to stop interfering in her life; she also needed her relationship with Doug to be better; she also felt that she needed to get back on track on weight loss. The reality testing part requires that the patient is aided to come up with SMART goals; specific, measurable, achievable, realistic and within a time frame (Wosken 2006, p. 155). I asked Amber what her exact goals were, how she would know when she achieved them, how achievable they were and how long she would need to achieve them. Amber realized that it was impossible to kick her mother out of her life and that her relationship with Doug was more important at this time. She felt she could mend the relationship within half a year and that the regimen she had started earlier for losing weight would still be sufficient. The last part of the second stage was to establish Amber’s commitment so I asked her what she felt the benefits and costs were of these goals. She pictured a stable and improved relationship with Doug. She would however need to be patient and improve her communication with Doug and her friends. According to Feltham and Horton (2006, p. 334) the last stage in Egan’s model involves development of client-centred action strategies. I asked Amber to figure out several ways to go about her goals. She felt that attending relationship counselling sessions with Doug would work since she had seen it being successful for other couples. This would be by going for picnics to re-establish the bond between them and relieving pressure off Doug on the issue of marriage. I suggested that she could also enhance communication with Doug as a way of finding someone to talk to besides re-establishing friendship with her friends and she found this as a good idea. We then brainstormed on what were the best fit action strategies to her situation. Amber figured that it would be difficult to get Doug to go for a picnic with her since he was already apprehensive towards going out. He would however be open to visiting a relationship counsellor with Amber as he would be willing to get help to prevent further fights and besides it had worked for several of Amber’s friends. The last step was to develop a plan of action. I suggested that Amber first talks to Doug about her suggestion of visiting a relationship counsellor before booking an appointment with one, something that Amber found particularly insightful. She deemed that two months were enough to convince Doug on visiting the counsellor after which they would book the appointment and start attending the sessions. I find Egan’s theory to be particularly useful in developing a modality that can perfectly establish the underlying problems facing a client and generate personalized and client-centred interventions that are highly likely to work. This is evident in Amber’s case where the modality does not miss a single underlying problem. However, giving extra weight to the patient’s perspective in intervention may be counteractive since they lack competence and their emotional predisposition may interfere with objective reasoning. For example, Amber initially wanted to kick her mother out of her life, and in finally ended up not addressing her in the final strategy which demonstrates lack of objectivity and lack of tact to deal with issues. Reflection on Amber’s Case The sessions with Amber and the use of Egan’s model provided me with an opportunity to realize the importance of creating a rapport with the patient. Amber was able to trust me and opened up on each occasion. I had a chance to practice my micro-skills where I realized I was able to create rapport and understanding, probe, facilitate self-disclosure, establish a therapeutic alliance with the patient and help in goal-setting. I would however wish to strengthen my ability of using force field analysis to establish best fit strategies (Wosken 2006, p. 65). One area I would wish to have done differently in Amber’s case is suggest a solution for improving her relationship with her mother which I instead let her to relegate to the background. In conclusion, Egan’s theory enabled me to establish that Amber was worried about her weight chiefly because it was interfering with her relationship with her fiance Doug. She had a sour relationship with her mother, disliked her job and her lost close relationships with her girlfriends. Through the model, I helped Amber to come up with intervention strategies including a weight loss program, improving communication with Doug, her mother and her friends. The final action strategy was to attend relationship counselling sessions with Doug since their situation had deteriorated. Egan’s model essentially helped me to create a modality that was client-centred with regard to Amber. References Cormium, S, Nurius, P and Osborn, CJ 2008, Interviewing and change strategies for helpers: fundamental skills and cognitive-behavioral interventions, Cengage Learning, Belmont. Feltham, C & Horton, I 2006, The SAGE handbook of counselling and psychotherapy, Sage Publications, California. Hays, DG & Singh, AA 2011, Qualitative inquiry in clinical and educational settings, Guilford Press, USA. Wosken, V 2006, Egan's skilled helper model: Developments and applications in counseling, Psychology Press, Canada. Read More