Date of the interviews
The two interviews took place on 6th October 2012 and 16th October respectively. The first interview was done in order to analyze the client’s problem and then establish a path for dealing with the issue. The second session was a follow up on the early progress of the intervention. Successful outcomes were reported in both instances.
Patient information
Javier is a 39 year-old, Hispanic male who, prior to the two sessions, had never seen a psychology professional. It only dawned on him that he could get psychological assistance for his problem through suggestions from friends. He has been married for eleven years and has two children of school-going age. Javier works in Chicago as a mechanical engineer, and has a bachelor’s degree.
The problem
In the first interview, Javier explained that he was having trouble at work as he could not concentrate and felt constantly fatigued. His productivity went down, and this had not gone unnoticed by his supervisors. Javier’s colleagues also detected the change in behavior, and suggested psychotherapy. His only source of income would be in danger if this pattern of disengagement persisted. Additionally, he dreaded time at home because he was now the primary caregiver. It was necessary to do so after his wife, Nina, was diagnosed with breast cancer. He didn’t spend as much time as he should with his children and was distant from Nina. Javier also felt trapped because he had lost control of almost every part of his life. As a result, he started smoking again, yet this was a habit that he had quit seven years ago.
During the second interview, it was evident that Javier was not feeling as downtrodden as he appeared in the first interview. His level of engagement at work was improving, but the situation at home was not where he wanted it to be. Javier still stated concerns about communication issues and his smoking habit.
Theoretical orientation
Cognitive Behavior Therapy (CBT) is an approach used to treat a myriad of psychological conditions, including stress or depression among patients. Each cognitive therapy session should be precise and result-oriented. Normally, most therapists prefer having an hour-long session once a week, for 16 weeks. For great outcomes, one ought to have training in CBT and possibly some experience on the same. In this approach, one must focus on identifying negative thought triggers. Cognitive behavior therapists believe that the way patients react depends on the way they think. Therefore, by developing the right thought patterns, a client can reverse some of the issues that led to his current psychological problem.
One must apply a structured strategy to challenge the patient’s beliefs and then work with them to create new beliefs and behavior systems. The main goal is to teach patients how to react to undesirable situations. They must realize that although they have no control over their surroundings, they can control how they react to them. Rationality is also a vital component of this form of therapy. Patients need to base their reactions on facts rather than imaginary conceptions. They need to be ready to do practical work on matters that they discussed in therapy. Psychotherapists should develop a collaborative relationship with the patient in order to enhance positive outcomes. In essence, the therapist should not prescribe actions to patients, but should teach them how to act.
Reflective summary
In the first interview, it was evident that the client was in a low mood. He did not care much for his appearance as there was a big stain on his shirt. Additionally, Javier felt fatigued and immediately slouched on the couch. He often seemed detached and I had to ask him questions more than once for him to give appropriate responses. Therefore, his body language corresponded to his verbal expressions. When Javier described his symptoms, there were some clear sources of stress in his life; the most obvious was his wife’s illness. However, in line with cognitive behavior therapy principles, one must work with the patient in order to establish these triggers of stress. After asking Javier what he thought was the main trigger, he replied that it was the unavailability of his spouse. All his problems started after she was diagnosed with breast cancer.
Javier also pointed out that the quality of his marital relationship had deteriorated. Instead of focusing on the unchangeable condition of cancer as the cause of his problem, it was wiser to dwell on things that he could change. It became evident that his communication patterns with Nina had contributed to this problem so he needed to work on them. The client also noted that he was under increased strain to assume the role of primary caregiver. Javier had to prepare food for the children, feed Nina when home and cater to her health needs. He explained that these responsibilities were overwhelming. After asking Javier about how he could work around the many care giving tasks, he suggested the use of a hired helper.
Additionally, the client was anxious about becoming a single father after the death of his wife. After asking Javier about how he could deal with these challenges, he stated that he needed to accept the fact and prepare for it. It was decided that the issue of smoking was a cover for Javier’s fears, stresses and insecurities. If we dealt with them, then he would slowly refrain from the habit. This case was symptomatic of depression as Javier reported having issues with sleep. Fatigue is was also an important indicator of the condition. DSM IV criteria indicate that a depressed person should report decreased interest in work. He or she may have a depressed mood and will report feelings of worthlessness. High levels of indecisiveness and a reduced ability to concentrate also prove that depression exists. Javier had all these qualities, so treatment approaches included challenging negative thinking and making lifestyle adjustments. He joined a Zumba class and promised to identify these negative-thought triggers.
In the second interview, Javier appeared more engaged as he had practiced some of the things discussed. For instance, he had already hired a helper and joined the dance class. He was adjusting to the Zumba class since it takes time to learn the routines. He made a list of some sources of negative thoughts and suggested ways in which he could challenge those thoughts. However, he did not report very positive outcomes about his marital relationship. It was clear that he had reservations about talking openly to his wife about his doubts and fears. Communication was still a big problem, and he needed to challenge it. Nonetheless, Javier still slipped into periods of disengagement and depression. This indicates that he is yet to challenge the negative thoughts he experiences. It is also necessary to address his anxieties about a future without his terminally-ill wife.