Change in Primary Health Care Setting - Assignment Example

 Change in Primary Health Care Setting I. Introduction (100 words) Here it will be attempted to make five different reflections upon the counseling of a specific client. As a novice practitioner, my goal here will be to reflect on counselling a client when the problem is mood and low self-esteem as a result of a life crisis. 
Advanced counselling methods will be evaluated, and the rationale for my final choice will be discussed. 
A comprehensive review of current evidence from relevant literature that supports this choice and that refutes the other options will be presented. It is hoped that the client will be able to get the help he needs. II.Analyze the effects of your specific communication and choice of counseling methods on the 
client’s ability to change through the use of evidence-based literature. (725 words) The client’s ability to change has mainly to do with whether he or she will tackle a mood disorder, and how he or she will respond to treatment. According to Rosenthal (2007), “Clinical depression, dysthymia (a low level depression that has a longer duration than clinical unipolar depression), and bipolar disorder fall neatly into the category we call ‘mood disorders’” (pp. 559). The specific communication that would be used in order to counsel a patient who has a mood disorder would probably be open communication. In addition, various counselling methods would be used in order to ensure the health, safety, and well-being of the patient. It would treat any kind of trauma that the patient had experienced. According to Brown (2007), “Mood disorders are often related to traumatic exposure. One common reaction to trauma is depression” (pp. 13). In addition, any kind of treatment would be made by taking into account the fact that the patient who has the mood problem may indeed have a mood disorder, and might very well be on some type of medications for the issue. This could interfere with the patient’s ability to be counseled or treated. According to Seligman (2004), “Psychotropic medication is usually combined with counseling in the treatment of Bipolar I and II Disorders and Major Depressive Disorder and also may be used for the other Mood Disorders” (pp. 175). Counselling is considered an asset for someone who has a mood disorder. According to Griez (2005), “A recent primary care study randomized patients with major depression to antidepressants or counselling, with additional non-randomized arms allowing patient preference” (pp. 295). It is very common for people with mood problems to be diagnosed with some sort of mood disorder. According to Thompson (2002), “The most frequently diagnosed mood disorders are major depressive disorder, dysthymic disorder, and bipolar disorder” (pp. 106). These people are also encouraged to attend a mood disorder support group. There may be additional underlying issues that the client being counselled may be dealing with as well. According to Kapalka (2009), “Mood disorders commonly coexist with ADHD. Up to 32% of children with ADHD present a comorbid depressive disorder, and up to 13% are diagnosed with some variant of bipolar disorder” (pp. 85). If the client happens to be a woman, it might be possible that she is suffering from depression—so this should be taken into account. According to Sanders (1997), “Major depression is a mood disorder prevalent in 15 percent of the population — maybe as high as 25 percent in the female population. This gender discrepancy is found in all cultures” (pp. 188). Depression is a common problem that many people struggle with, and the chances that one will have depression is exponentially greater. According to Van Voorhis, Braswell, and Lester (2000), “A person with major depression experiences a depressed mood on a daily basis…” (pp. 67). Not only that, but depression is identified as one of the most commonly found disorders within families that suffer from mood disorders. According to Vyas and Ahuja (1999), “Major depression is the most frequent mood disorder found in families of both unipolar and bipolar patients” (pp. 197). Counselling, however, can help and definitely does have a place in aiding patients to improve their lifestyles. According to Moxley and Finch (2003), “The most effective treatment interventions for affective disorders have included medications and counseling” (pp. 67). What can complicate a counselling session is when the patient not only has a mood disorder, but also has low self-esteem due to a dual diagnosis—in other words, the person usually has a disorder along with some form of substance abuse issue. According to Sadock and Sadock (2008), “Research, data from records, and resource persons usually reveal that alcohol contributed to the mood disorder” (pp. 103). The third most common type of mental health disorder is a mood disorder. According to Palmo, Weikel, and Borsos (2006), “The AAGP (2004) reported that the most common mental health disorders, “in order of prevalence, are: anxiety, severe cognitive impairment, and mood disorders” (pp. 115). Of course, being diagnosed with a mood disorder, the patient will probably suffer from self-esteem issues, especially in the patient’s quest to learn to accept the illness. It is important that the client find a good support system and continue to stay in counselling. These are the stepping stones to success. III.If the methods used produced a negative effect, what would you do differently next time? What 
is your rationale? Support your statement with evidence from current, evidence-based literature. (250 words) 
 If methods used produced a negative effect, what might produce more positive results next time would include getting special training for dealing with patients who suffer from mood disorders. This is because, according to Castle and Whybrow (2002), “Counselors may or may not be formally trained in psychology. They may therefore lack the knowledge and credentials to treat a serious mood disorder…people with severe mental illnesses usually benefit more from seeing someone with advanced knowledge” (pp. 212). Additionally, another factor to take into consideration would be the background of the person being counselled. According to Dwairy (2006), “Although depression is considered to be the most common disorder in Western cultures, it is not even found in the lexicon of some Asian cultures. Some scholars regard depression as a disorder of the Western world” (pp. 85). Communication style of the counselor (myself) might have to be adjusted if the client were not to react in a positive manner with the methods being used. According to Loue and Sajatovic (2007), “Evidence also exists that communication style might affect the success of counseling for Native American patients” (pp. 174). It’s very important in the counselling arena that the counsellor realise the limitations of his or her abilities to affect the client. If the counsellor’s inadequacy is related to his or her cultural insensitivity, it might be high time for the counsellor to enter into some type of social and cultural diversity training. Only a counsellor who is thoughtful is going to be successful. IV.Were the desired goals achieved? If not, why not? (200 words) The desired goals were achieved with the client being counselled. The client was receptive to hearing various avenues that could be taken with regard to his treatment, and was open to the idea of being counselled. Luckily, it was identified that the client did indeed have a treatable mood disorder, and the patient was referred to psychiatric treatment in tandem with his counselling. We have yet to see what the outcome of that appointment will be, but nevertheless, we know that the client is being counselled appropriately. If the client does have some underlying mood disorder, it’s important that that be dealt with first before the client continues treatment in counselling. Of course, since the client might be suffering from a chemical imbalance in the brain, those issues need to be figured out before any counselling sessions continue to occur. This is because counselling someone requires that the person be fully aware of what is going on around them. If the client isn’t functioning properly, he or she is going to have a difficult time focusing on the task at hand, which is counselling. It’s important to know everything that one’s client is going through so he can be helped. V.What were the particular challenges you faced with this client, and how did you resolve them? (425 words) The particular challenges that were faced with this client included the fact that the client not only had a mood disorder which was diagnosed—but also that the client had low self-esteem. The issue of the mood disorder could be easily treated with medication, which wasn’t the main issue—although the client definitely had to be advised that, in order to help himself, he had to continue on with medication management in order to fulfill the terms of his treatment. Usually medication compliance can be an issue, depending on what the illness is. However, that having been said, once the client’s mood was stabilised, the next issue which needed to be focused upon was the fact that the patient had low self-esteem. Of course, no one can ever make someone feel how they don’t already feel. It is important for the counsellor to encourage the client to the point where he realises he needs to make a change in terms of his own self-esteem. He needs to improve upon his own self image and how he views himself. There are a variety of reasons why people have low self-esteem, and the counsellor’s job is to work with the client so that these causes are identified and addressed. If one doesn’t address these issues of self-esteem, they are going to continue to bother the client as sessions go on, which may hinder his progress. Low self-esteem is usually caused by the fact that the person has not been given enough encouragement in whatever endeavours that he faces. Usually, when an adult is not encouraged to be his best self, he may feel inadequate in several areas—which could include his work, his home life, and when he is involved in social activities. Whatever life situation the client finds himself in, he will most likely want to improve upon himself to the point that he feels vindicated in situations in which he must use his social skills. At work, he must demonstrate his competence and that he is a team player. In social situations or at play, he must demonstrate his ease to navigate such situations with ease. At home, he must feel confident enough to be himself at all times. In whatever case, it is of premier importance that the client feel confident enough in order to assert himself in whatever situation he finds himself in, without being overly aggressive or hostile. These were the goals in treatment, and it is hoped that he benefited greatly from having had me counsel him through these difficult times. VI.What are your particular counselling strengths and areas in need of improvement? (450 words) My strengths are many. I realise that I take adequate time with the client, and don’t rush the client along to finish his sentences—rather, I let him open up to me at his own pace, seeing what he feels comfortable with in terms of reaching out to me for help. It is not easy for a man to admit his feelings necessarily, so I used positive reinforcement whenever he did decide to confide in me about his issues or problems. Other strengths include my ability to listen and my ability to use active listening in order to not exactly repeat what the client has said, but to be able to mirror what the client has said by using different language. I don’t have many weaknesses, but some of them are evident and problematic. I have a terrible habit of sometimes interrupting my clients to ask additional questions or make a comment. I am trying to curb this habit. The reason I do do this sometimes is because I have a thought and I don’t want to lose it, so I just say it outright immediately. I should probably focus on just writing those thoughts down instead of having to express every objection or issue I have with what the client is trying to say. Another weakness that I realise I have is sometimes I have a hard time mentally distancing myself from the client’s problems which he confides to me. Sometimes I internalise those feelings that the client has and I end up getting stressed out about problems that are not my own—obviously—but there are many ways in which I wish I could help the client, but just can’t. I realise my limitations and I realise that I can’t be Superman for everyone. I can’t save everyone. But I can try to do my best in order to ensure that my client receives the best counselling he can. In that regard, I really hope that he thinks that I have done everything in my power in order to help this client with his issues in a way that is as non-invasive as possible, but still plumbing the depths of his consciousness, searching for ways in which I can help him live his best life. Ultimately, that is my goal—it’s to help clients live their best lives, and be able to live independently with a modicum of success. Hopefully, I have communicated to my client that he has the ability to succeed at whatever he does, and that the power is there, it definitely lies within. He just has to learn how to harness that power and use it for the good of himself and others, too. VII.Conclusion (350 words) The main issues that were dealt with in counselling this particular client were: analyzing the available literature and use of communication and theory to treat the client; how things might be done differently were the client’ reaction negative; if the desired results were achieved; the particular challenges that were dealt with regarding the client; and what the particular areas of strength and weakness were in counselling the client. Many things were learned in counselling this particular client. It is hoped that other people will be able to learn from my having counselled a client with a mood disorder who also faced issues with low self-esteem. It makes sense that in the process of counselling such a client, much was learned in the arena of mood disorders. In counselling someone with a mood disorder, it is important to remember that medication management and medication compliance should be duly stressed, as well as the necessity of the client to take care of himself in order to stay healthy. Since people with mood disorders can have a plethora of problems—including sleep interruptions and various other underlying diagnoses—it’s important that the client has a balanced view of work, play, and home life. This can be a difficult balance to achieve for someone who is very busy with several commitments and little time with which to manage them all. Especially for someone who had an active life before he found out he had a mood disorder and difficulty with self-esteem issues, the patient’s life may have completely changed after finding out he had an illness. This can radically change how he would live his life. He will have to devise a schedule he can use in order to make his life more manageable now knowing that he has this mood disorder. It has been proven that people who have mood disorders do better when they are in controlled environments and have schedules and routines to follow. These are just some of the aspects of counselling this patient that have become highlighted in the course of this patient’s treatment. Hopefully these conclusions help others. REFERENCES Brown, S.L. (2007). Counseling victims of violence: a handbook for helping professionals. US: Hunter House. Castle, L.R., & Whybrow, P.C. (2002). Bipolar disorder demystified: mastering the tightrope of manic depression. US: Da Capo Press. Dwairy, M.A. (2006). Counseling and psychotherapy with Arabs and Muslims. US: Teachers College Press. Griez, E.J.L. (2005). Mood disorders: clinical management and research issues. US: Wiley. Kapalka, G. (2009). Counseling boys and men with ADHD. US: CRC Press. Loue, S., & Sajatovic, M. (2007). Diversity issues in the diagnosis, treatment, and research of mood disorders. US: Oxford University Press US. Moxley, D.P., & Finch, J.R. (2003). Sourcebook of rehabilitation and mental health practice. US: Springer. Palmo, A.J., Weikel, W.J., & Borsos, D.P. (2006). Foundations of mental health counseling. US: Charles C. Thomas Publisher. Rosenthal, H. (2007). Encyclopedia of counseling. US: CRC Press. Sadock, B.J., & Sadock, V.A. (2008). Kaplan and Sadock’s concise textbook of clinical psychiatry. US: Wolters Kluwer Health. Sanders, R.K. (1997). Christian counseling ethics. US: InterVarsity Press. Seligman, L. (2004). Diagnosis and treatment planning in counseling. US: Springer. Thompson, R. (2002). School counseling: best practices for working in the schools. US: Psychology Press. Van Voorhis, P., Braswell, M., & Lester, D. (2000). Correctional counseling and rehabilitation. US: Anderson. Vyas, J.N., & Ahuja, N. (1999). Textbook of postgraduate psychiatry, 2nd ed. New Delhi, India: Jaypee Brothers Medical Publishers, Ltd. Read More