Respond to the following classmates post in 100-150 words:
1)In the interview with the adolescent (Adrianne), the therapist (Carrie Alexander) used several steps to assist the patient in identifying her thoughts and getting hold of her behavior when faced with difficult situations. Among the steps followed include identifying and specifying a problem. Through the questions asked at the beginning of the conversation, the therapist was able to determine that the patient was experiencing personal challenges such as not having her own time and conflicts with her parents (Hamann, 2009). Another step that was used is creating awareness of the negative thoughts that are impacting the girl. For instance, as the conversation proceeds, Carrie Alexander helps Adrianne identify the negative ideas that she had built up of not being a good person due to how she is told (Hamann, 2009). As such, knowing her negative thoughts makes her aware of why she feels she is not a good person and creates a foundation to fix the issue. Throughout the process, Adrianne was cooperative and open to responding to the questions as she shared her opinion on the issues she faced.
The model that was used by the therapist is Solution-focused therapy. This model focuses on positive re-enforcement and not the challenges the client is facing. It allows room for improvement as it dedicates itself to finding the solution hence looking at the future (Murray, 2021). The techniques that were used in this model included asking miracle questions, such as when the therapist asked Adrianne what she considers a miracle if she were to wake tomorrow (Hamman, 2009) is considered a miracle for Adrianne. Another technique used is asking coping questions. Alexander uses questions to understand how Adrianne has been handling her stresses. It assist in making the patient feel that they are supported and someone is listening to them. For instance, Adrianne says that she writes her thoughts in her journal (Hamman, 2009). The therapist also uses compliments to acknowledge the potential of the patient hence encouraging her to find solutions that can fit her. Compliments are significant as it helps the patient to keep talking and feel appreciated. The compliments will also eliminate doubt and build self-esteem to the patients if it was damaged.
The most effective technique when using this approach is the use of compliments. Compliments allow the patients to feel that the therapist identifies with their situation. It makes the conversation to be more open and allows the patient to be ready to find the solution to the problem. However, an aspect of this model that might not be effective is asking the coping questions. For some patients, it might be overwhelming to be asked such a question as they might be going through a lot. Hence, they might shut down emotionally, making them unable to proceed with finding a solution to the problem.
For patients who are using substances like alcohol to minimize their stress, the approach will help them weigh the significance of substance use, the reason for using it, the challenges they might experience while using it, and the benefit of not using it (Murray, 2021). Therefore, the model will look at every angle to help the young adult understand whether there is a better option than substance use. As observed, it is purposed to find solutions, and it does not scrutinize. Instead, it assists in knowing what the patient is going through and finding better options for them.
References
Hamann, E. (2009, January 1). Three counseling approaches: One adolescent client. Three Counseling Approaches: One Adolescent Client | Alexander Street, a ProQuest Company. https://search.alexanderstreet.com/preview/work/bibliographic_entity%7Cvideo_work%7C1779036
Murray, H. (2021, January 25). Solution focused brief therapy (SFBT). Solution Focused Brief Therapy (SFBT) | Simply Psychology. https://www.simplypsychology.org/solution-focused-therapy.html
2)Within the Reality Therapy session, clinician Bill McFarland was able to use a number of steps to engage the client ( Hamann, 2009), Adrianne. Bill displayed what is presented by Creed and Kendall (2005) and Karver et al (2008). The authors state that being warm, open, informal, and willing to discuss any adolescent topics of interest leads to better participation and engagement. Glasser (2000) emphasized the importance of the relationship with clients as a prerequisite for helping them “ connect with others in their lives”
The specific therapy model that was selected was Reality Therapy ( Hamann,2009). A technique that was observed in viewing the vignette was the demonstration of empathy. Therapist McFarland was able to convey the notion that Adrianne is a teenager but more “mature” for her current age. McFarland communicated that the client is able to have employment and still maintain her scholastics. McFarland communicated that he was also “impressed” in the manner that the client was able to explain the current situation.
The technique of “Socratic questioning” was also completed by the therapist. Digiuseppe, Linscott, and Jilton (1996) state that asking open-ended questions and utilizing the “Socratic questioning” method allows adolescent patients to share their experiences, views, and concerns. McFarland was able to question Once it was conveyed to the therapist why the client was present, the therapist asked what about the relationship with her parents was specifically giving her issues. McFarland questioned the client about the idea of moving on her and addressed was this a “realistic “idea.
The technique of affirmations was also used by the therapist. After the discussion to what the precipitating issues were discussed, McFarland stated, “You’d like a little more freedom and wanna be treated a little more maturely?” He further communicates that the client communicated that the “big decisions” are being made for her and she does not know how prepared she will be to address them on her own. Affirmations are statements of appreciation related to client effort, internal characteristics, and behavior (Lewis, 2014).
The response from Adrianne was positive. The client appeared to be quite engaged in the questions and the dialogue that was presented to her. The client appeared to be comfortable with the self-disclosure of information to better assist the therapeutic process. The client also offered her opinion of the current situation and the outlook that she has for the future. All of the information was able to be presented in the presentation due to the knowledge of the techniques displayed by the therapist.
Glasser (1965; 2000) Describe most behavior as being a combination of choice and control, and behavioral patterns can be altered through conscious decision making. McFarland was able to give the opportunity to Adrianne in relation to what she thought the issues were currently and what resolutions may be presented to assist the current situation. The manner that the questions were asked and answered allowed for a sense of “trust” to develop. The “trust” could be concluded by the manner that more information continued to be offered to the therapist. Adrianne even offered the solutions and her explanation to what the issues could present to her and her development, in the future. Glasser (1965, 1998, 2000) also communicates that there needs to be a sense of responsibility by the person seeking help for the plan of action to work. This responsibility is shown in the ability for Adrianne to supply ideas and solutions to the present concern. The ideas and solutions were presented to the therapist in a “mature” manner. It continues to be conveyed that the therapist should focus on the factors which are under the control of the person (Glasser, 1965;1998;2000). McFarland speaks about the age of the client and her current life status of work and school. The therapist speaks of the issue of “dating” that the client has currently, with the parents being the focus of the clients complaints. McFarland also addresses the notion of the client moving out on her own. The idea of how the client will afford this decision, is also embraced.
Some adolescents may present an occurrence of co-occurring disorders or comorbidity. Nunez (accessed March 15, 2022) states that Glasser communicated that medication is never required to treat mental health conditions. Nunez further relays that Reality Therapy doesn’t aim to understand past conflicts, unlike traditional form of therapy. These ideas could pose as an obstacle to some adolescents seeking assistance through this modality.
Erickson (2011) and Pociluyjo (1995;2002) reminds us that at times, normal adolescent behavior can appear to suggest a SUD or mental disorder, leading the counselor or clinician to “imagine a DSM 5 diagnosis” where none really exists. Reality Therapy with the use of the “Socratic Questions” method will be able to assist in the screening of a substance use disorder. Pociluyko ( 1995;2002) also relays that chemically addicted adolescents will usually have problems related to and unrelated to substance use, and need stable adults with whom they can discuss those many concerns and solve problems. This adult can be the qualified Reality Therapy therapist. The National Institute on Drug Abuse (2014) offers that behavioral therapies are effective for treating substance use disorders and help build motivation to change abstinence, teaching coping skills, and learning positive activities. The inclusion of Reality Therapy by a qualified clinical staff will be able to apply the techniques and skills to assist the adolescent client in the implementation of these listed skills.
References
Creed, T., & Kendall, P. (2005). Therapist alliance-building behavior within a cognitive-behavioral treatment for anxiety in youth. Journal of Consulting and Clinical Psychology, 73(3), 498-505.
Digiuseppe, R., Linscott, J., & Jilton, R. (1996). Developing the therapeutic alliance in child-adolescent psychotherapy. Applied & Preventive Psychology, 5(2), 85-100.
Erickson, C.K. (2011). Addiction Essentials: the Go to guide for clinicians and patients. New York: W.W. Norton
Glasser, W. (1965). Reality therapy: A new approach to psychiatry. New York: Harper & Row.
Glasser, W. (1998). Choice theory. New York: Harper-Collins.
Glasser, W. (2000). Counseling with choice theory: The new reality therapy. New York: Harper-Collins.
Glasser,W. ( 2000). Reality therapy in action. New York. NY: HarperCollins.
Hamann, E., ( 2009). Three Counseling Approaches: One Adolescent Client. Alexandria, VA. Microtraining Associates.
Karver, M. S., Shirk, S., Handelsman, J., Fields, S., Gudmundsen, G., McMakin, D., & Crisp, H. (2008). Relationship processes in youth psychotherapy: Measuring alliance, alliance-building behaviors, and client involvement. Journal of Emotional and Behavioral Disorders, 16(1), 15-28.
Lewis , T., ( 2014). Substance Abuse and addiction Treatment; Practicial Application of Counseling Theory. Pearson Education Inc.
National Institute on Drug Abuse. (2014). Principles of Adolescent Substance Use Disorder Treatment: A research based guide. Available Online.
Nunez, K. Reality Therapy Techniques, Benefits, and Limitations (healthline.com). Accessed on March 15, 2022
Pociluyko, P.J. (1995; 2002). Adolescent Treatment Series. Clinical Viewpoint Series. The Substance Abuse Newsletter. Washington, DC: Pace Publications
