Adam K. is a 38 year-old, client, of the Steven A. Cohen Military Clinic at USC. He is an African American, Marine veteran, who served 3 years in the infantry. He currently lives with his wife of 5 years and their 4-year-old son. Adam reported growing up with a single parent, and witnessing domestic violence at young age before his parent’s divorce. He described his childhood as normal but also disclosed getting into a lot trouble and experimenting with drugs, although, he reported currently abstaining from alcohol and illicit drug use.
Previously homeless, Adam and his family reside in the Blue Butterfly Village(BBV), that is designated for veteran families who are recipients of the VASH vouchers. Through the Cohen clinic’s mission,
…show more content…
Diagnosis (Self Reported and Initial Measures, Burns Anxiety Inventory) Adam presents with a diagnosis of sever anxiety, and anger management. These were reinforced by measures that were recorded to form a baseline that consisted of the GAD-7 for anxiety, PHQ-9 for depression, PCL- for stress, and the Q LES. At baseline he presented with severe anxiety and moderate depression symptoms. The 33 item Burns Anxiety Inventory, yielded a score that was also align with severe anxiety at baseline.
Treatment Plan / Goals Upon establishing a therapeutic alliance and building rapport, Adam was insightful in identifying treatment goals for therapy. Stressing the recovery model, Adam and I, were determine to set reachable goals that were attainable during short-term therapy consisting of 12, one hour, weekly sessions. The first goal was set to decrease his anxiety by slowing down his automatic thought process. With the use of CBT, Adam was able to reframe his thoughts and recognize certain triggers that made his anxiety worse. The approached was to separate his thought from his actions and bring awareness in order to tolerate difficult thoughts he had about his marriage. During the time CBT was administered, I kept reminding Adam, that if we live in our stream of consciousness, we can find the ability to develop and shape the flow of that stream. Throughout the first couple of sessions it was apparent that Adam had harvest
Each story involved a different group or organization that the veterans had access to, showing that more of these successful programs need to be accessible to veterans. The stories of David Garrett, Randall Berry, and Leon Copeland all strengthen the point that veterans need legal aid. For example, the article stated that David Garret benefitted from the help of Pine Tree Legal Assistance. According to the article, “Pine Tree’s lawyers successfully negotiated an agreement with the new owner to prevent his eviction, secured federal funds through a partner nonprofit to help him pay rent and worked to help him obtain a Section 8 housing voucher. Garrett’s eviction case was dismissed, and he has been able to stay in his home.” This strong example that the authors provide show that without legal aid, Garrett would not have a home
In all honesty, cities across the country are faced with challenges and disparities of homeless American veterans. Homelessness is visible in various ways in our local and state communities. It is the empirical individual standing at the intersection holding a printed sign of “Homeless – God Bless you”, an individual pushing a grocery cart filled with clothing, sticks, and other personal belongings. By the same token, these homeless individuals may also be seen pitching an old make ship tent under overpasses, and in nearby wooded areas. As a United States Veteran, it is discouraging and disheartening to see signs that read “Homeless Veteran –
of the therapy, the client meets the therapist to describe specific problems and to set goals they
Throughout Mr. P’s life he has experienced lack of family support, victimization, rebelliousness, friends who use drugs or in gangs, lack of social and economic opportunities, and even more expanded list of risk factors that had led to adverse outcomes. His everyday life growing up consisted of reoccurring violence and abuse contributed to developmental disruptions which led to violation and wrong doing. Continued sessions with Mr. P. will focus on improving client’s social and interpersonal difficulties as client lack trust and intimacy and often finds it challenging to establish new relationships as well as utilizing resources to assist with improvement of health and wellbeing.
William Thomas is a 34-year-old African American man that lives in Killeen, TX with his wife, Sandra and his son, Timothy (9 years old). William entered the Grace Christian Center on June 23, 2016. William suffers from PTSD as a result of his combat deployment to Afghanistan in 2014. William served in the United States Army for six years, He enlisted in 2010 and exited the military on an honorable discharge February 10, 2016. During William service, he achieved the rank of Sergeant and served in two combat deployments. William has no known drug allergies but said that he refuses to medication which is why he is here to see Grace Counselors instead of the VA. William loves to shoot guns, exercise and play the video game call of duty. William has been having anger outbreaks and cry spells since he left the service just four months ago. His wife, who escorted him to the church said that they are constantly fighting over stupid things and that he treats her like he’s her soldier. William keeps trying to explain himself but he says his wife doesn’t listen. He’s not treating her like a soldier he 's just trying to point out some things and he doesn’t feel respected therefore he feels the needs to raise his voice and through a tantrum.
With solution-focused therapy, the client is the professional. We know that people overcome great adversity daily and often this occurs without any psychotherapy. Often the client just needs to be guided in the right direction. “We cannot change our past; we can change our goals. Better goals can break us out of stuck places and can lead us into a more fulfilling future” (Norcross, p. 408). The value of goal setting is something that has been discussed in every class I have taken since beginning the masters of arts in counseling (MAC) program. “This process of goal setting and action planning is not something we do to people, but rather with them. The assessment process, as well as the working agreements we strike with our clients, should reflect high degrees of
According to Andrew’s medical records from U.S Department of Veterans Hospital, he was diagnosed with traumatic war neurosis, which is currently known as Post-Traumatic Stress Disorder (PTSD). During his evaluation, his symptoms were nightmares, irritability, increased startle responsiveness, and a tendency to angry outbursts. Considering the limited knowledge and education of PTSD, he was not prescribed any psychotic medication for treatment. Along with PTSD, Andrew had abused alcohol on a daily basis. He had a pattern of consuming four to six drinks every evening and engaged in alcohol binges most weekends. However, Andrew has been sober for almost two years. In addition, his medical records also indicated
Solution-Focused Therapy is different than most typical types of therapies. It is a simple all-purpose approach (George, Iveson, & Ratner, 2015), with a wide range of applicability; it is a form of brief therapy that emphasizes cognition and behavior. As such, the therapy required to assist in solution-generating change could take as little as one session. Appointments are made one at a time, assuming one more is all that is necessary. Planning out a treatment plan with this in mind, the format is more geared towards three to five visits, at around forty-five minutes each, beginning to end, and indeed, typically, three sessions is all that is necessary. Some therapists feel that if progress is not made by the third visit, it is a poor fit for the client’s situation, and would require an alternate form of therapy (George, Iveson, & Ratner, 2015). When progress does occur, the length between session visits increase.
Jason has three goals he would like to achieve while he is in treatment. The first goal is to strengthen his long term sobriety skills. The objective scores for this goal are to list triggers (person, places, and things) that come before a relapse, also to complete a ten page autobiography and process that with his primary therapist. His second goal is to reduce the level of depression he has. The objective scores are to list five ways a higher power can help reduce depression, and make a gratitude list with at least ten items, and then process them with his primary therapist. The third goal Jason would like to achieve is to obtain a positive support network. The objective scores for this goal are to meet with a twelve step program individual and discuss support for recovery, also to obtain at least ten phone numbers of people that have long term sobriety. While in treatment Jason has a few modalities which are; individual sessions two times a week, family therapy two times a week, and process and didactic groups two times a
The participant is a 49 year old African American male who began using substances at the age of 13. He was diagnosed with severe alcohol, cocaine, and opioid use. The participant has been incarcerated over the past 32 years. He was recently paroled after completing eight years of a sixteen year sentence in the Illinois Department of Corrections for burglary and theft. The participant is on medications to treat HIV/AIDS and has been diagnosed with Major Depressive Disorder. He was referred to Healthcare Alternative Systems residential program through TASC as a condition of his probation.
Given the restrictions imposed by health insurance requirements, short-term therapies are now the treatments of choice for many therapists and patients. Short-term therapies may be best described as “time-limited psychotherapy.” However, research has found increasing evidence of the effectiveness of such time-limited approaches as interpersonal psychotherapy (IPT), cognitive behavioral therapy (CBT), and solution-focused therapy (SFT).
Goals aid the clinician in monitoring the client’s progress, in addition to determining if the client’s strategies and intervention approaches should be adjusted. The involvement of the client and the family can lead to increased participation with treatment. Therefore, goals that are measurable, visualizable, and benchmarks help to make sure that the clinician, the client’s family are all aware of what the client is doing in therapy and how they can help the client reach his or her goals the clinicians the ability to regularly follow up with the client and the family (Haftel, 2014, p.1).
Treatment is delivered by a primary therapist who conducts both individual and group sessions. His/her tasks entail coordinating the delivery of the program, scheduling and maintaining patient retention in the program. Whenever possible, the co-leader, chosen by the therapist, who has observed at least 6 months of recovery is involved. The co-leader serves as a peer supporter who can share his or her own recovery experiences. The therapist, therefore, maintains control of the group, facilitates the session within a positive environment and ensures the delivery of its educational element. Therapists specifically avoid allowing confrontational or extremely emotional environment. Thus, encouraging input from patients
Psychiatric studies that were part of this study include Beck Depression Inventory, Hamilton Anxiety Rating Scale, and SCL-90-R questionnaires. The Beck Depression Inventory questionnaire measures the severity of depression and screens patients who require intervention. BDI scores minimal depression from 0-13, mild depression from 14-19, moderate depression from 20-28, with severe depression scoring lying within the 29-63 range (Beck AT. Depression: Causes and Treatment. Philadelphia: University of Pennsylvania Press, 2006). HARS provides an overall measure of global anxiety that is psychiatric and somatic symptomatically. Scoring ranges from 0-56 with a score over 14 indicating high levels of anxiety (Bagby RM, Ryder AG, Schuller DR, Marshall MB. "The Hamilton Depression Rating Scale: has the gold standard become a lead weight?" Am J Psychiatry 2004; 161(12):2163-77). SCL-90-R questionnaire presented
Clarification and agreement around the client’s goals represents a starting point for collaborative exploration of multiple ways in which these goals can be attained. Goal setting offers a platform for both therapist and client to resolve any differences through collaborative dialogue which reflects their mutual intentions and understandings (Clark, 1996) Goals can be defined as immediate, those which help to achieve longer term goals, goals to be worked on in therapy and long term or life goals (Hanley, Sefi & Ersahin, 2016) A client may formulate life goals including non-specific, contradictory, avoidant, unattainable or no life goals, which can then be broken down into therapeutic goals and the therapist will have her own goals as well