Different mental health disorders are influenced by one’s lifestyle, experience, and social situation. From the case study handled by Faber and Lee (2020), it could be seen that there are many different sociocultural factors that contributed to the depression and anxiety of the client. Many of the factors come from the background and life experiences of the patient. The first factor is the socioeconomic status of the woman. As was noted in the characteristics of the client, she had a low income due to the fact that she was self-employed, worked part-time, and had no stable salary. Social assistance was the main income source for the patient. It was also noted that she had no higher education degree as she completed only high school. That might also affect her employment chances and thus her financial situation. Low socioeconomic status may impact depression and anxiety levels as it affects one’s access to different services and enjoyable activities. It may also influence the level of satisfaction with life and the level of self-esteem.
The next sociocultural factor is the refugee status of the client. Moving to another place and adapting to the new life conditions is not an easy process. One may face many difficulties such as finding a new job, supportive surroundings or getting used to the new culture. It was also noted in the characteristics of the client that she is a single woman that is raising a four-year child on her own. She had no support from her family, and overall she had low social support. That is a noteworthy factor because, firstly, a lack of supportive surroundings and limited interaction with other people may contribute to the development of depression and anxiety. Secondly, especially when it comes to raising a child, which requires a lot of responsibility, a young woman needs support, both psychological and material.
Another sociocultural factor that contributes to the development of anxiety and depression in the woman is her experience with a physically abusive partner. It was mentioned in the client characteristics that her partner with whom the client lived in Canada was an abuser. In addition, the woman had several traumatic experiences in the past, such as sexual abuse and intimate violence. Even though the case study preferred not to focus on the traumas from the patient’s history, it is important to take the past traumas into consideration.
If the traumas are not cured properly, they may influence the mental condition of the person who is present. As the case study mentions, women are very vulnerable to sexual abuse and violence. De La Rue and Ortega (2019) confirm that women that were exposed to abuse and violence tend to be vulnerable to different stress disorders, depression, anxiety, and specific issues related to mental health. The clinician in the case study addressed the sociocultural factors when providing therapy and preparing tasks. For example, there were some cases when the patient had no opportunity to come to the therapy because of the transportation issue or childcare. The therapist then handled a brief check of her home tasks and organized a session via phone.
The healthcare provider applies such tools as cognitive error and cognitive restructuring while working with the patient. Cognitive errors are related to one’s way of thinking that is based on negative bias, which is usually inaccurate. Cognitive restructuring refers to a technique that is applied in order to transform one’s way of thinking. First, in order to modify the client’s behavior, the therapist first became familiar with the kind of negative thoughts a client has experienced on a daily basis. Thus, the therapist did not impose his own assumptions regarding the effect of sociocultural factors on the client but instead asked the client directly. She replied that the main negative thought that was often coming to her mind was her being a bad mother. The patient noted that when having negative thoughts, she often isolated herself, thus producing avoidant behavior.
The therapist concluded that the client, because of having negative experiences that were repetitive, had developed cognitive errors. The clinician then gave the woman an opportunity to analyze her negative thoughts by herself. She was asked to review her records and figure out the most common negative thoughts that she had. The client then had a chance to reflect on the results and think of the possible alternative thoughts. After that, the health care provider started to implement a cognitive restructuring method in order to help the client get rid of the avoidant behavior. Relying on this technique, the health care professional taught the patient to cope with the negative bias by reminding herself of the sources of these thoughts and assessing their validity.
With the help of the therapist, the woman improved her situation with her depression and anxiety. She learned how to work with the negative attitudes toward herself. Thanks to the special tasks that were provided by the doctor, the client realized that often her judgments about her being a bad mother were not true. I think that the contributory factor to the successful outcomes of the clinical case was the empathy of the health care provider. They took into account the socioeconomic situation of the client when working with her.
However, the therapist did not rely on the traumatic history of the client when using the cognitive restructuring technique. Instead, they focused on the current problems that the woman had and worked on the problems that were bothering her in the present. The medical professional assisted the patient is responsible for the case stages. For instance, in the fourth session, in order to handle a thought record, they helped to complete the record. The patient had an opportunity to feel the support that she lacked for a long time.
With the contribution of the therapist, the client was able to determine positive thoughts about herself, which is crucial for a person suffering from depression and anxiety. Establishing alternative thoughts allowed her to reduce the effect of negative emotions. At the end of the therapy, the client admitted that she enjoyed the process. I think that the fact that the therapist allowed her to notice the negative thoughts on her own and reflect on that problem raised the awareness of the client. With the help of the therapist, the patient obtained several important insights about herself. She not only listened to the advice of the professionals but contributed to the process of healing in many ways. I believe this is one of the significant factors that facilitated the successful outcomes of the clinical case. The woman realized that she was not as bad at motherhood as she always thought she was. She was motivated and experienced more joy in life by the end of the therapy sessions.
Reference
De La Rue, L., & Ortega, L. (2019). Intersectional trauma-responsive care: A framework for humanizing care for justice involved girls and women of color. Journal of Aggression, Maltreatment & Trauma, 28(4), 502–517.
Faber, J., & Lee, E. (2020). Cognitive-behavioral therapy for a refugee mother with depression and anxiety. Clinical Case Studies, 19(4), 239-257.