3005PSY Counselling Theory and Practice
The rationale for assignment: This assignment will start you on your journey to becoming counseling professional. The ability to apply theory to counseling practice is an essential skill. Without theory, your micro- skills will have no direction. Counselors must also consistently assess for the presence of suicide risk, and follow ethical guidelines.
Part A: Description of Client and Presenting Problem
Choose one of the specified characters from one of the following movies:
- Skeleton Twins (client “Maggie” played by Kriste n Wiig )
- Young Adult (client “Mavis” played by Charlize Theron)
Briefly describe the client and their presenting problem. This description should include a summary of the relevant demographic information of the client (e.g., gender, age, relationship status, employment, number of children, living circumstances ). This can be estimated if specific details are unknown. The presenting problem should also be outlined. When outlining the problem :
- Provide a brief summary of the reasons that the client has come for treatment (you can choose at which point in the movie the client has come to see you; regardless on the timing you choose, you can still use information from any part of the movie)
- Discuss the current symptoms /issues, the history of the problem ( i.e., when the symptoms began), and the impact of these symptoms on the client’s functioning or well -being (i.e., the ways in which their relationship/job/quality of life etc . are being or have been affected by what is happening )
In this section, your writing must be free from judgment and your personal values, even if you strongly disagree with the clients’ attitudes or behaviors. Counselors should not allow their personal feelings or beliefs to impact on their empathy for the client.
Part B: Case Conceptualisation
Conceptualize the client from one of the following theoretical perspectives:
- Cognitive and/or Behavioural (CBT, CT [including schema therapy] or BT )
- Person- Centred
- Acceptance and Commitment Therapy (ACT)
- Interpersonal Therapy (IPT)
- Contemporary Psychodynamic (NOT Freudian)
Your conceptualization must cover the Four P’s: Predisposing, Precipitating, Perpetuating and Protective factors :
- Predisposing factors: the background to the problem
- What factors in the client’s history have made them susceptible/vulnerable to developing this problem?
- Predisposing factors will vary across theoretical frameworks (e.g., a psychodynamic /IPT approach may emphasize attachment style, whereas a cognitive approach will emphasize the development of core beliefs/schemas)
- You must also explain HOW and WHY this is a predisposing factor. For example, if low self -esteem is a predisposing factor, you would explain why the client has low -self -esteem (e.g., due to negative criticism by a parental figure) and how it acts as a predisposing factor (e.g., therefore the client has developed negative automatic thoughts about their worth )
- Precipitating factors: why has the client come to therapy now?
- What were the most recent triggers for the problem?
- It is likely that different theories might identify the same triggers, but with different concepts and language. For example, the loss of a parent from a psychodynamic perspective may represent the loss of an attachment figure, whereas from a behavioral perspective may represent the loss of a significant reinforcer. Typical precipitating factors might include a crisis, physical illness, major stressor or life event, grief, role transition, relationship breakdown, etc.
- Perpetuating factors: factors that maintain or exacerbate a problem; perhaps why the client does not get ‘better’ without treatment
- This will differ according to theory – behaviorists may look at avoidance or reinforcers for a problem; cognitive therapists may consider ongoing negative automatic thoughts
- Protective factors: What strengths/resources does the client have?
- These may explain why the problem is not worse than it is or may be factors that enhancing the client’s recovery
- These commonly include good social support, financial security, sense of humor, warm interpersonal style, intelligence, etc
- Protective factors tend to be more generic than theory -specific
IMPORTANT: The conceptualization needs to be internally consistent. For example, a CBT conceptualization should NOT contain any psychodynamic concepts or terminology.
Part C: Treatment Plan
Using your chosen theoretical approach, develop a treatment plan for the client. Your treatment plan must then follow logically from the above conceptualization. In your plan:
- Specify which factors of the conceptualization are going to be targeted (e.g., “cognitive therapy will address the client’s negative automatic thoughts”)
- Outline which techniques will be used to do this ( e.g., “the client will be encouraged to complete a Dysfunctional Thoughts Record to identify their negative automatic thoughts” )
It is important that the treatment plan does not address any factors that have not already been raised in the conceptualization. For example, your plan should not include assertiveness training if you have not first identified the lack of assertiveness as an issue in the conceptualization. You do not need to construct a detailed session-by-session treatment plan; just discuss what the main components of treatment will be, based on the conceptualization, and which techniques will be used to do this.
Note that in the marking criteria the case conceptualization is worth twice as many marks as the treatment plan, so it is best to focus your attention and effort on the case conceptualization, with fewer words dedicated to your summary of the treatment approach.
Part D: Ethical Issue
Identify ONE potential ethical issue that may be relevant when working with this client. Explain why this is potentially an ethical issue.
Part E: Suicide Risk
Conduct a Suicide Risk Assessment for this client. Assess the client’s suicide risk (low, medium or high), and explain the rationale for your assessment (e.g., “I have evaluated the client’s suicide risk as low, based on….”). Outline one strategy that you could use to manage this level of identified risk.
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