Nathan's Situation of Agoraphobia in Development - Case Study Example

Treatment plan Nathan Jones condition of agoraphobia (a type of anxiety disorder) has been becoming so intense and that the reason he had to seek for medication from a therapist. However the therapist identification of the potential in him as he was self-driven in achieving some of the difficulties that he was facing recommended the use of person-centered therapy treatment. This model was the appropriate one that will effectively address the issues the client is facing. During Nathan Jones childhood time up to the time, he was arrested at the age of twenty-two he had only hard one operation. However when he was released from the prison after taking eighteen years he developed agoraphobia. This made him rely on his partner for everything. However, the situation worsened when they separated with his partner and was taken to a therapist by one of his friends. Identifying Information The increased intensity of Nathan Jones agoraphobia is the reason one of his friends accompanied him to a psychologist to seek some help for the first several weeks after the breakup. Presenting Problem Nathan Jones has been very disturbed since he left the prison after being sentenced for 18 years his only friend how he has been living with left him a later on morning that he will be living to start a new life in a different town. For the few month since relies on, Nathan Jones has accepted that he has been deeply moved with depression, agoraphobia, panic attacks, and this has made him depend on his partner for everything. Nathan Jones could not go into the store of grocery, or freely travel to various parts of the metropolitan in which they lived and do laundry. Nathan Jones thought that his overdependence on the partner may have become more burdensome to the partner and thats why he decided to move to move in with another person in a different city. The increased intensity of Nathan Jones agoraphobia is why he needed the help a psychologist. Nathan Jones agoraphobia had been so strong that in the first several weak a friend accompanied him in the therapy office. Relevant History Nathan Jones childhood history was not that attractive as his parents separated when he was ten years. In their family, he was the first bone with the second bone being a brother and the last bone being a sister. Living with her mother they faced different challenges as her mother found it hard providing the basic need. He stopped his education at the age of fifteen, a few years after his mother separated with his father. This was mainly to help his mother to look after his younger brother and sister. This is where he realized his interest in the sales and did it to perfection. With his hard work in the sales, he managed to help his mother take care of the basic needs of his younger brothers and even education. Because of his good work in sales and his desperation to make more money to help the family; he met a man who introduced him to the drug business. At this time, Nathan Jones was now twenty years of age. A few months after being involved with the new guy and making some good money, Nathan Jones reported interference with his vision. A few days after the incident, he reported feeling rigorous headache at the temporally and right frontal part moving to the occipital area at the right. The headache was magnified with the coughing and straining, and he was prescribed Panadol. The medication brought no changes as he started experiencing mild photophobia, nausea, vomiting and a nape pain at the neck. As the headache persisted, Nathan Jones was directed to an ophthalmologist. Signs of venous blockage in the veins of retinal were shown by an angiogram. The headache continued, and he experienced weight loss, poor appetite and disturbance in sleeping. As the headache persisted, he went for a CT scan that identified a tumor in the frontal lobe at the right. This tumor was causing a midline shift and oedema. Nathan Jones then admitted for the tumor biopsy. On the finding that it is a neural tumor, Nathan Jones was taken for an operation, and the bill was settled by the drug dealers to be referred later. The operation was successful, and Nathan Jones commenced to work after some months of rest. However after the second week of illegal drug sales, Nathan Jones was arrested and jailed for eighteen years. Larger Systems Nathan Jones is a roman catholic the religion of his parents who are now separated. He shares a divers culture as his father is a Mexican and mother is Spanish. Since his childhood, he has never experienced any mental disorder issues. He has been a determined and responsible person trying to help her mother take care of the family. However, the lands on the wrong side of the law and he is sentenced for eighteen years at the age of twenty-two. Theoretical Orientation Person-centered therapy was developed by Carl Rogers, who was an American Psychologist in the year 1930. Rogers believe that therapy should be encouraged in an environment that is supportive and formed by a close personal communication between the therapist and the client. The use of the word Client by Rogers instead of the word Patient showed his dismissal of the customary hierarchical relationship between the client and the therapist and his perception for them being the same. In the use of person- centered therapy, the main direction of the therapist is determined by the client. The therapist is determined to the insight of the client and self- understanding through relaxed clarification of the questions (Rana, & Upton, 2013). Starting in the year 1960, the therapy of person-centered became linked with the potential movement of a human. This movement is recalled to the start of the 1900s reflected the perspective of human nature that is altered. The past theories of psychology perceived human beings as creations that are corrupt and selfish. For instance, the theory of Freud focused on aggressive and sexual tendency as the force that is primarily driving the behavior of human (Gannon, Ward, Beech & Fisher, 2009). The potential movement of human differed by Freuds theory and defined human nature as good. For his perspective, the behavior of human is aggravated by the determination to achieve the potential of a person to the fullest. A term obtained from the movement of human potential known as Self-actualization is a concept that is important, and can be used in person-centered therapy. Furthermore, it refers to the nature of human being to grow and reach their potential that is the fullest. When human shift towards self- actualization, they tend to be pro-social, this means that human being tends to be others concern and acts in dependable, honest, and in a way that is constructive. The concept of self-actualization, with the strength of mankind, and this is as opposed to their weaknesses. Rogers explains that this concept can be un-healthy to mankind (Feltham, & Horton, 2006). Some of the terms adopted by Rogers are the term Way of being and that of person-centered approach and started to concentrate on self-actualization and personal growth. Rogers also pioneered the utilization of sensitive and adaptive training, the use of encounter groups; Kurt Lewin developed methods and other findings at the Laboratories of National Training in the 1950s. Recently, person-centered major variations have been developed: the 1979 theory of experiential developed by Eugene Gendlin (Thackery, & Harris, 2003) and 1993 theory of process-experiential that were developed by Leslie Greenberg (Jones & Butman, 2011). Even as the therapy of person-centered taken as one of the therapeutic approaches that is major. Also, with therapy of cognitive behavior and psychoanalytic, the influence of Rogers is felt in the therapy schools other than his own. The methods and concepts he developed are used in the fashion of eclectic by various therapists and counselors. According to Rogers, the factor that is most important for the therapy to be successful is not the training or skill of the therapist but his or her attitude. Three attitudes that are interrelated on the therapist part are core to the therapy of person-centered: unconditional positive regards, empathy and congruence. Congruence refers to the genuineness and openness of the therapist. It is mainly the willingness of the therapist to associate with the client without hiding at the back of an expert façade. The therapist that operates in this way contains their feelings during the therapy session and may share the emotional reaction that is significant to their client. Congruence does not mean that the therapist shares his personal problem with the client (Mearns & Thorne, 2000). Unconditional regards that is positive mean that the client is fully accepted by the client no matter who she or he is without censoring or evaluating and without rejecting of some characteristics, action or feeling. The attitudes are communicated to the client by the therapist willingness to listen and not to interrupt, giving advice and judging. The positive regards attitude creates an environment that is non-threatening in which the client feel safe to share and explore hostile, painful, abnormal and defensive feelings without fear of personal rejection by the therapist (Dexter & Wash, 1997). Empathy means the therapist tries to appreciate the situation of the client from the clients perception by showing sensitivity and emotional understanding to the feeling of the client during the entire session of the therapy. In other therapy system, the primary step is empathy with the client to enable the proceeding of the therapeutic work. However, in the person-centered therapy, it mainly encompasses the major part of the work of a therapeutic. The primary way of putting empathy into action is by listening actively that shows perceptive and careful attention the clients story. Also to techniques that are standard such as the contact of the eye, which are important to any good listener. Reflection is a special method that is employed by the person-centered therapist and it entails summarizing what the client has just said. This technique confirms that the therapist is accurately and carefully listening hence giving the client an added advantage to examine there personal feelings and thoughts as they hear the same story repeated by another person. In short, clients react by explaining further on the thoughts they have currently expressed (Clark, 2014). According to Rogers, when the three attitudes which include, unconditional positive regards, empathy and congruence are utilized by a therapy, clients finds it easy to explain themselves without having any worry of what the therapist says of them. The therapist doses not try to change the thinking of the client in any form. Even expressions that are negative are validated as expressions that are right. Because of this approach that is nondirective, clients get a chance to expand on the issues that are vital to them and not those measured as vital by the therapist. Based on the self-actualization principle, this uncensored, undirected self-exploration provides the clients with a chance to identify and finally an alternative way of thinking that will encourage personal growth. The therapist simply encourages self-actualization by providing an environment in which clients can generously connect in-depth, focused self-exploration. For this case study, the therapist applying this treatment method is concerned with communicating unconditional positive regards and empathy to the client. This entails the use of skills as a reflection of feeling, listening, and summary and meaning in the interaction genuine content between the client and the counselor. The role of the therapist is mainly supporting the client to identify personal strengths and to find a solution that is matching with beliefs and values. The preparation of the therapy room by the therapist includes placing the chairs in the mode of face to face. Furthermore the therapist places a box of tissue in a position that the client can easily reach and confirming the curtains position to reduce the glare. How the Current Problem of Nathan Jones Fits into the Theory. Nathan Jones had the determination in him as he was seen attending the session unaccompanied and was conscious of both his talent and intelligence. Furthermore, Nathan Jones decision no trying to work on his agoraphobia to increase his world was a sign of him achieving his potential to the fullest. Nathan Jones also knew that for him to succeed in the treatment, most of the efforts were going to come from him. This was seen as several weeks during the session he could locate a group for agoraphobics who were meeting in the church. He was determined in attending the meeting even though he found it hard traveling up to that point, and he was sometimes doubtful about some of his colleges and there recovery plans. Techniques to be used With the Client Some of the techniques used in the client include Congruence, Unconditional positive regards, Empathy, Nondirectiveness, Reflection of feeling, Open question, paraphrasing, and encourages. Congruence The therapist was authentic and genuine in what he or she was saying, and the therapist ensured that the body language reflected what he or she was saying. This developed the openness and trust in the relationship between the client and the therapist. For example, the therapist told the client that he or she understood where the client is coming from. This saying was well reflected on the therapist body hence developing the clients trust. Unconditional positive regards Using this technique, the therapist showed the client some respect, accepting and caring about the client. The therapist acknowledges that the client is determined in doing his best, and he or she demonstrated this by expressing concern. The therapist ensured that the client does not feel judged but instead assisted the client to facilitate the progress in change by confirming to them that they can be accepted (Seligman, 2006). Empathy The therapist showed the client that he or she understands the emotion of the client. This allowed the client to open further. Example Nathan Jones: I feel very alone, and nobody cares about me in this world. Therapist: So you are feeling alone this minute, and its like nobody cares. Nondirectiveness The therapist allowed the client to be the therapy session main focus. At this point, the therapist did not implement any activity or strategy or provided the client with any advice. Reflection of Feelings Nathan Jones: I dont understand what to do; I was so annoyed and puzzled. Therapist: So you were feeling annoyed and puzzled. Open Questions Nathan Jones: at the time he told me he was moving out he was walking towards the door. Therapist: And how did you feel? Paraphrasing Nathan Jones: For the last two weeks since he told me he was moving to another city with another person I have been very depressed. Therapist: So the feeling of being depressed has been affecting our daily life. Encouragers Nathan Jones: It makes me feel like drinking, I dont understand what top do. Therapist: Uh-huh Goal of Treatment Some of the goals of person-centered therapy are; First was to encourage the ability and trust of Nathan Jones to be at the moment that is present. This allowed Nathan Jones at the moment to be honest as he felt the therapist is not judging him. The second goal of the therapy was for Nathan Jones self-esteem and self-awareness. The third was for Nathan Jones to be empowered to change. The fourth was to promote congruence in Nathan Jones feelings and behavior. The fifth was to assist Nathan Jones to obtain the ability to become self-actualized and manage his life. Recommendations for referral For Nathan Jones to recover from the situation he is currently facing, he will need not only the support of the therapist. Nathan Jones will also need the support of the medication, friends, and his character which was seen to be influential in his improvement. It can also be said that the client is not totally cured. This is so as he still has to overcome something in him that resists him from travelling to new places and dealing with the interpersonal relationship in the case of a conflict. Limitations of the Model This model approach may make the therapist just to be supportive of the client without providing any challenge to him. Secondly, this model may be an ineffective way of facilitating therapy if the therapist is passive and non-directive (Corey, 2005). Thirdly, this model is unrealistically optimistic and simplistic. Fourthly, caring and listening for the client may not be enough when using this model. Fifthly is that this model will not work for those clients who are not motivated to change. The sixth is that the model lacks the techniques that may assist the client to solve the problem. Seventh is that the model does not draw on psychodynamic, behavioural or developmental therapy hence limiting the entire understanding of the client. Eighth is that model fails to train the client for the actual world as a result of the therapists unconditional positive regards. The therapist finds it hard in allowing the client to find his way and finally significant psychopathologist may not find the model useful (Seligman, 2006). Alternative theoretical model for this case An alternative theoretical model for this case is Cognitive-behavioral therapy. This model will be helpful in fighting cognitive distortions and in teaching the client some new skills of encountering the real world. This model may be appropriate for this client as this client is engaged in several thoughts of self-defeating. The client also showed several cognitive distortions and irrational beliefs which contributes to his feeling of anxiety. Referencing Clark, A. J. (2014). Empathy in counseling and psychotherapy: Perspectives and practices. Routledge. Corey, C. (2005). Theory and practice of counseling & psychotherapy. (7th ed.). Belmont, CA: Thomson Learning. Dexter, G., & Wash, M. (1997). Psychiatric nursing skills: A patient-centred approach. Cheltenham: Stanley Thornes. Pg 18. Feltham, C., & Horton, I. E. (2006). The SAGE handbook of counselling and psychotherapy. London [u.a.: SAGE. Gannon, T. A., Ward, T., Beech, A. R., & Fisher, D. (Eds.). (2009). Aggressive offenders cognition: Theory, research and practice (Vol. 43). John Wiley & Sons. Pg 13. Jones, S. L., & Butman, R. E. (2011). Modern psychotherapies: A comprehensive Christian appraisal. Downers Grove, Ill: IVP Academic. Pg 294. Mearns, D., & Thorne, B. (2000). Person-centred therapy today: New frontiers in theory and practice. London: SAGE Publ. Rana, D., & Upton, D. (2013). Psychology for nurses. Routledge. Pg 53. Seligman, L. (2006). Theories of counseling and psychotherapy: Systems, strategies, and skills. (2nd ed.). Upper Saddle River, New Jersey: Pearson Education, Ltd. Thackery, E., & Harris, M. (2003). The Gale encyclopedia of mental disorders. Detroit, Mich: Gale Group. Read More