Introduction
This social work paper focuses on Magda. Magda is a Polish woman who has been married to Sean for the past ten years. Sean had an accident, and he experiences bouts of depression following the death of her first wife. Sean is also worried about his current disability.
She left an abusive relationship in Poland to seek a good life for her son and herself. Magda started drinking at the age of 16 years old when she moved in with her abusive boyfriend. Magda’s father was alcoholic. She currently works as a marketing manager, provides for the family, and travels to Poland every month to be with her dying mother. Magda is under strain to cope with her roles and kids.
As a result, she has resumed drinking heavily, at least every morning. This paper applies cognitive behavioural theory and crisis intervention to control Magda’s stress, depression, alcoholism, and help her to cope with the crisis in her current situation.
The paper also takes into account the UK’s Health and Care Professions Council (HCPC) guidelines and standards of conduct, performance, and ethics, applicable laws to social workers, anti oppressive, as well as anti discriminatory practice.
Application of Cognitive Behavioural Theory and Crisis Intervention in the Case of Magda
Before the beginning of the therapy, a social worker must operate within the law of the UK with regard to anti-discriminatory, anti-oppressive practices, and observe the HCPC standards on performance, conduct, and ethics and best practices in the field of social work (Ferguson, Jones and Cooper, 2007).
These are inclusive standard, which relate to health care professions in the UK that the HCPC regulates (Health and Care Professions Council, 2012). The HCPC regulations and standards would ensure the safety and protection of Magda. Moreover, they protect clients from discrimination and oppression from social service providers.
They also ensure that a social worker has competency, skills, values, and right behaviours for the profession. The client is a Polish. According to Dominelli, a social worker should recognise feminism theory in the case of Magda (Dominelli, 2002). The social worker must recognise uniqueness of Magda as a woman.
In other words, the care provider should not classify Magda in the general category of other clients (Adams, Dominelli and Payne, 2002). Instead, the social worker must display sufficient sensitivity to Magda as a woman and as a Polish. Brid Featherstone warns that social workers should consider the local contextual situation when providing care to women (Featherstone, 2001).
In this context, they must not consider men as sources of pain, distress, and exploitation that women experience. Hence, a social worker must understand the role of Sean in the case of Magda.
A social worker can apply cognitive behavioural therapy to treat Magda’s alcohol dependency. In this regard, the social worker must focus on two aspects, which include Magda’s functional analysis and skills training.
Functional Analysis of Magda
Magda and the social worker must work together in order to determine thoughts, situations, and feelings of Magda before and after she consumes alcohol. This process would help Magda to identify risks that have led her back to increased drinking and relapse.
The process of functional analysis would also allow Magda to understand why she drinks alcohol. In addition, the social worker would identify what leads to coping difficulties in the client’s life and formulate effective interventions.
Skills training for Magda
Currently, Magda uses alcohol to cope with her job, children, Sean’s pain, and the condition of her dying mother in Poland. At this point, the social worker must recognise the need for professional treatment for Magda. The major aim of cognitive behavioural therapy is to help Magda to learn and relearn how to cope with her current situation.
The role of the social worker is to help Magda to unlearn her old drinking habits. The social worker must also help Magda to learn new habits and skills in order to cope with her life. Therefore, the major aim of the cognitive behavioural therapy is to train Magda to change her thoughts about alcohol consumption. This would help Magda to learn new ways of coping with her current situation in order to avoid drinking.
Cognitive behavioural therapy will also help the social worker to treat comorbid depression and alcoholism. According to a study by Brown and Ramsey, cognitive behavioural therapy is “particularly effective when treating alcohol abuse with a depressive patient” (Brown and Ramsey, 2000).
It is imperative for the social worker to initiate the treatment in early stages. Cognitive behavioural therapy is a non-intrusive intervention. Hence, it will not present any danger to Magda. The application of cognitive behavioural therapy for treating depression will help to reduce depression and manage alcohol. This improves the patient outcome.
The aim of the social worker is to determine why Magda takes alcohol to cope. Moreover, the care provider must also determine effects of alcohol on the overall quality of Magda’s life and the entire family. The social worker must challenge Magda’s beliefs, values, and thoughts that relate to alcohol dependence in order to change her habits and behaviours.
Crisis Intervention
Crisis intervention involves immediate psychological supports given to patients in a crisis in order to stabilise their biopsychosocial functioning and reduce possibilities of developing psychological trauma (Jackson-Cherry and Erford, 2010). Currently, Magda experiences a crisis because of sudden events in her family. The client faces an intolerable situation, which has exceeded her ability to cope effectively.
In this regard, the social worker will use crisis intervention to enhance Magda’s stabilisation. Crisis intervention is appropriate for Magda’s situation because she can develop trauma at any moment (Roberts, 2006). Although the situation may be temporary, its consequences may last for several months or years based on the effectiveness of treatment and counselling strategies.
Magda has turned to a maladaptive behaviour of depending on alcohol in order to cope with the situation. The client faces unusual stress from different areas of relationships in her life.
The care provider must interrupt the maladaptive behaviour of alcoholism and help the client to return to her normal life before the crisis started. The social worker will use the following stages to treat Magda as provided by Roberts and Ottens (Roberts and Ottens, 2005).
Stage one: biopsychosocial and lethality analysis
The social worker must plan and carry out a thorough assessment of Magda’s “environmental supports and stressors, medical needs and medications, current use of drugs and alcohol, and internal and external coping methods and resources” (Roberts and Ottens, 2005).
Stage two: building rapport and collaborative relationship
The social worker must aim to establish rapport with Magda through respect, genuineness, eye contact, and acceptance. The care provider should not judge, oppress or discriminate Magda based on her gender, nationality, or social status.
Stage three: Identification of the problem
The social worker must focus on the cause of Magda’s crisis and their sources. It is important to understand why Magda requires help now.
Stage four: understanding the client’s feelings and emotions
The social worker should allow Magda to express her feelings and provide an account of her current situation. This process involves “active listening, asking probing questions, reflecting, and challenging some of the responses” (Roberts and Ottens, 2005). However, the social worker must be careful when testing some of the Magda’s answers.
Stage five: generating and exploring alternatives and coping mechanism
Both the social worker and Magda must generate their intervention options. These may include a no-suicide contract and safety of Magda. Magda may not leave home for a temporary housing because of Sean’s condition and the children. This is a collaborative process between Magda and the social worker. In addition, Magda must own these options.
Stage six: Implementation of an action plan
The process involves working with the client in order to restore her normal functions. This is an empowering process, which involves integration of plans to remove the means, negotiating the client’s safety, lessening anxiety, and hospitalisation if necessary.
Stage seven: follow-up
The social worker must conduct follow-ups in order to assess the progress of Magda after treatment and be certain that Magda’s progress is effective (Roberts and Ottens, 2005). The care provider must also assess the post-crisis condition of Magda.
The advantages of the theories as they apply to Magda
Cognitive behavioural therapy
The social worker applied cognitive behavioural theory because of its instructive strategy. Magda can understand the counselling process rationally and develop confidence about her progress with the therapy.
The cognitive behavioural therapy is a short-term strategy for managing alcoholism. In most circumstances, clients only require up to 16 sessions in order to get well. However, Magda may require more than 16 sessions based on her progress and the care provider’s recommendations. Hence, the intervention is cost-effective for the client.
Social workers use cognitive behavioural therapy to make the client to get better, rather than feel well. The social worker solves all the difficult underlying assumptions in order to establish long-term outcomes because the focus of the intervention is on solving the cause of alcoholism.
A social worker comes from the UK while the client is from Poland. Cognitive behavioural therapy relies on universal principles of human behaviours. In this regard, a cross-cultural intervention applies to all clients. Moreover, it focuses on the client rather than trying to compel the social worker’s goals on the client.
A social worker presents a structured cognitive behavioural therapy plan. This reduces any possibilities of turning interventions into ‘chat sessions’. Hence, the structured nature of the intervention allows the social worker and the client to achieve positive outcomes during therapies.
It is possible to conduct scientific studies to determine the effectiveness of cognitive behavioural therapy on Magda because it is based on scientific principles. The social worker follows clearly defined methods to focus on specific issues during therapy sessions.
Finally, the intervention is adaptive. The main principle of cognitive behavioural therapy is that mental processes are responsible for individuals’ behaviours and feelings.
Crisis Intervention
The core advantage of crisis intervention is prevention of trauma and promotion of the patient’s health. Magda experiences stressful life and situations from various relationships in her life. Existing studies demonstrate that a lack of coping skills and stress correlate strongly with mental problems.
In most cases, such clients have received care services through admission or outpatient services. However, hospitalisation has not been the best strategy for managing a crisis because it is expensive, ineffective, and does not control the crisis.
The intervention averts a situation from developing into trauma. The social worker must prevent Magda’s situation from becoming a threat to her mental status. They must avoid unnecessary hospitalisation. Crisis intervention is a flexible procedure, which can allow the social worker to help Magda at any time or place, by the use of telephone, or even visiting Magda’s place of work.
The social worker uses a crisis intervention to concentrate on the ‘here and now’. This is a deliberate strategy to avoid long-term processes in managing a crisis, which requires immediate attention. Magda requires a short-term intervention. The social worker must empower Magda by helping her to solve the problem and acquire coping skills. This would lead to Magda’s self-reliant.
The disadvantages of the theories as they apply to Magda
Cognitive behavioural therapy
Magda may find it difficult to follow the steps involved in the treatment of her alcohol dependence because intervention relies on the power the client to change. Cognitive behavioural therapy requires the commitment and involvement of both the client and the care provider in order to be effective.
Cognitive behavioural therapy is a structured program. The detailed nature of the intervention might not be effective if Magda has learning challenges, or if she has some underlying psychological health problems.
Some critics of the cognitive behavioural therapy claim that the therapy only focuses on current and specific issues. As a result, it fails to address underlying problems, which are responsible for the client’s alcoholism. For instance, it will not explore the unhappy childhood of Magda and her past abusive relationships, which led to her drinking problems.
Crisis Intervention
In some cases, a social worker may fail to recognise that a crisis intervention works within social systems (Sheppard, 2008). In other words, it is appropriate to include the family of Magda in the intervention process because it is a social system she relates with closely (Bridgett and Polak, 2003).
Magda has unresolved and unexpressed emotions from her childhood and past marriage. This can result in tension and make the process potent during the first meetings.
The social worker must recognise the need for medication if required. It is not suitable for the care provider to regard the medical treatment as contraindication of the meeting. Instead, intervention medications are appropriate and supplementary to meetings.
In some instances, there are incongruities in verbal and non-verbal behaviours of the patient. For instance, what Magda might say may be at odd with her physical appearance or behaviours. Generally, alcoholics tend to deny their status. An open communication may overcome such discrepancies.
Reflection on the suitability or otherwise of chosen theories in relation to Magda
Several studies have documented the suitability and effectiveness of cognitive behavioural therapy in managing comorbid depression and alcoholism (Cilente, 2010). Cognitive behavioural therapy is suitable for Magda because it will empower her to initiate changes, which are within her control.
The social worker guides the client to recognise the cause of her alcoholism and start new skills of coping with her current situation (Healey, 2005). Moreover, the therapy aims to help the client to avoid circumstances that trigger the use of alcohol for coping.
During various stages of the therapy, the social worker may conduct an evaluation to determine if the client has learned or forgotten coping strategies. The feedback allows the social worker to adjust the therapy and intervention appropriately.
Both cognitive behavioural therapy and crisis intervention are flexible. Hence, the social worker can adjust interventions to meet various needs of Magda. The flexible nature of these interventions also allows the social worker to conduct treatment sessions anywhere. In addition, the social worker can perform both treatments in a short-term and give the client an opportunity to practice new coping skills.
Crisis intervention will prevent Magda from developing trauma because of early intervention to manage the current crisis. It will help to avert any emergencies and hospitalisation of the patient. The social worker chose a crisis intervention because alcoholics rarely admit their behaviours.
This provides an opportunity for the social worker to recognise the problem. For this reason, the social worker may use crisis intervention to understand the underlying causes of alcohol consumption in the case of Magda.
The structured characteristics of these interventions ensure that the client and the social worker do not spend several sessions in irrelevant issues. Instead, they allow the social workers and the client to focus on defining the problem and generating the best alternatives for interventions.
The social worker must provide guidance and procedures that Magda requires in order to develop new coping skills. This would guarantee high chances of success.
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