Paranoia from PTSD: Intervention Technique - Case Study Example

Narrative Perspective Therapy The client is evidently depressed because of constant exposure to stressors and trauma from her daughter in law and son. In addition, she is made more vulnerable to these stressors by her isolation from her family who she left in unsafe conditions back in Iraq. Given her background, she could also be suffering from post-traumatic stress disorder from the events leading up to her escaping her homeland and coming to the US. From a narrative perspective, the analysis of a patient is based on the assumption that one’s psychological problems should be discoursed from the notion that human lives can be understood as stories. Using this perspective, Sultana’s problem can be diagnosed from her story in terms of both current and retrospective. The problem can be understood in the context of her loneliness and her constant conflict with her family, which largely emerges from the radically different social roles. In Iraq, she commanded and expected respect from her family because of her age but in the US, this has changed. The goals of this theory are to establish a connection between the patient’s story and the preset condition so that it can be used to diagnose and recommend the best intervention technique. The theory tries to articulate the relationships between personal stories and the social cultural and political forces that ultimately consolidate into an individual’s self-identity. In this case study, it is possible that the patient’s problems can be attributed to their social political environment and the inability to adapt to them, which make the narrative theory particular fitting since it allows the client to reflect on the problem in the context of their history. The first stage of treatment is to have her talk to a therapist and by so doing “narrate her story”. Secondly, the hospital should engage her family and involve social workers so that they can verify the extent to which her story is accurate. This way they can factor the possibility of her being delusional since she could very well be making up the stories because of paranoia from PSTD. The third stage will be a mental health assessment to determine if she is indeed suffering from depression or perhaps even post-traumatic stress disorder. This will be done through a series of oral interviews in which the doctor will determine her mental state by examining her cognitive abilities, reactions, emotions as well as an observation of her general behavior. Thirdly, there should be an assessment to assess the primary causative agents of her condition. Some of the factors examined can include the exposure to a new and diverse culture from which she has spent most of her life. In addition, she could be suffering low self-esteem from the fact that she does not feel she gets as much respect and recognition from her family as is her due. There is a very real possibility that she is actually being abused, mistreated and taken advantage of by her family, which precipitates the possibility of her being physiologically unwell. The client’s goal is clearly to get assistance both psychological and sociological if she is found to be suffering from depression and/or PSTD; she will be assisted through therapy and medication. However, whichever the result, action must be taken to ensure that the conditions in which she lives are not abusive or cruel since this can create or escalate the condition. After the initial phase, which will be engaging her and other parties in a narrative to establish the story of her condition, the middle or working phase will be to provide her with the assistance and counselling needed to help her regain her mental and social stability. In many ways, the narrative theory draws from the psychoanalytical theory by Sigmund Freud where the client engages in discussion with the therapist as the former helps them express their negative feelings and face up to them bringing them to a catharsis. Through a series of sessions, Sultana can talk with the therapist and he or she can try to help purge her negative feelings about her experiences back home during the war which may be causing her to feel isolated and lonely. She can also open up about her feelings towards her family, what she feels about her daughter in law and son’s treatments of her. If she is deemed depressed, medical intervention may be recommended if needful. Family therapy can also be used if it is found that her son is not actually treating her as badly as she claims given the possibility of her being delusional and paranoid. Should this be the case, the family members with whom she lives can be present at therapy and they can all try to assist her deal with her problem, which in any case is affecting all of them. However, aside from the psychological matters some legal and social issue must be addressed before she can be released to her family. For one, if it is indeed proven that they have been starving and locking her up; the hospital in collaboration with social services is obligated to come up with alternatives accommodation for her. In addition, legal actions should be taken against her son who should be held accountable for neglect and cruelty as well as taking advantage of her and withdrawing her money without her consent. Solution Focused Therapy Solution focused therapy is a therapy that focuses on helping patients construct solutions rather than try to solve problems, over the years it has evolved in the context of clinical and anecdotal studies. In a space of less than two decades, the SFBT technique has evolved from an obscure and experimental therapeutic approach to one of the mainstream alternative therapies used in mental health setting, public schools, social works and hospitals. It is also a common therapy for child welfare and prison rehabilitations. According to the theory, Sultana’s case can be analyzed by looking at the elements of her present life that she is comfortable with. For example, she probably feels grateful of living with her family in a safe country away from the war that forced her into exile. Assuming, for the purposes of this particular case study that she is giving a honest account of herself, the focus on the therapy should be directed towards helping her create a positive attitude towards her present situation. The first step should be a mental health assessment to determine the extent to which she may have mental challenges. The client can then be engaged in a discussion by therapists as they try to establish which elements of her life she can use to construct a positive outlook of her situation. She is suffering because of her alienation from her homeland and the family she left behind. However, she can be guided to look on the positive side, which is that she is now safe, and can no longer be persecuted nor does she have to live in fear of constant harassment. Conventional therapy would require her to think of a way to solve her problems but in some, the solution-focused approach has her looking to provide a solution by making her responsible for her own goals in life guiding her in achieving them. She has clearly stated that her key objective is to get her family to treat her with the respect she deserves rather than have her antagonists punished. This is essentially a solution-focused goal since convectional sociological and even psychological perspectives would pay attention correcting the wrongful treatment she is suffering at the hands of her family. In the pre-therapy phase, that is the first stage of the theory, she will be asked an open (skeleton) question about what she thinks is the best thing in her current situations. This way she can be helped to identify a positive attribute of her otherwise stressful situations. The first stage will be to integrate her into the hospital environment and help her socialize with the community preferably the therapist and nurses so she can honestly open up to them, and express her feelings. The second stage is for the client to describe her problem, in this case it can be predicted that she will complain about being neglected and being ill-treated. The next step is to set goals, which she wants to achieve in improving her life rather than trying to solve the problem. In this case, she may not take any action against her relatives, but she will want to come up with a way to co-exist with them. From a sociological point of view, a possible scenario is one where she uses her money since she clearly has an income from the government to rent a house of her own and hire a caregiver. This way, although she will not have solved the causal problem of her family treating her baldly she will have empowered herself by moving out of their home. She had clearly tried to get her independence by changing the bank account details so that she could control her own money and this made her son try to win her over with food. Therefore, she can be advised and helped to make herself more independent, which may ultimately result in her family respecting her more that is, what she wants. The sessions with the therapists should focus on empowering the client by helping her identify her strengths and means by which she can use them to get a solution to her current problem. She is evidently an honest and indent minded person, which explains her attempts to take away her son’s control over her money. Therefore, this strength can be used to implement the solution discussed above in which she gets to live by herself and possibly use her money to hire some help. Before discharging her, it is nevertheless critical that the therapists understand that given the sociological nature of her challenge, she may need further support to implement the advice. This call for the involvement of social services to help her seize her independence and provide her with the means to find new accommodation. The final phase of the theory should be therefore to aid her in settling in her new house; however, the family should also be involved in the ultimate solution since they were responsible for her also to create an opportunity for reconciliations. If she is to live in her own home and control her funds, she can have more say on how she is treated and in the long run the solution centered approach will end up both providing a solution and solving the underlying problem or her disenfranchisement which made her vulnerable to abuse and neglect. Read More