Client’s Background
Addressing the needs of diverse clients currently represents one of the core challenges for healthcare services. The customer in question, Mr. XY, is an adult Hispanic male, which suggests that a cross-cultural framework for addressing the patient’s needs is required. Furthermore, the patient suffers from complete blindness, which adds to the complexity of the rehabilitation process. The patient requires active counseling and guidance, as well as the provision of the necessary tools and resources for supporting his rehabilitation process. Specifically, opportunities for independent living will have to be provided along with options for meaningful employment.
Diagnosis
A further assessment of the patient’s current status has indicated that he suffers from several health issues, including physical and mental ones. Specifically, total blindness is presently defined as the complete inability to perceive form and light (Jackson et al., 2019). In turn, the phenomenon of IDDM (insulin-dependent diabetic mellitus) is typically defined as a condition that prevents the pancreas from producing the amount of insulin needed for the blood to be absorbed into cells (Jackson et al., 2019).
The specified condition implies that the patient must be provided with an opportunity to self-monitor the amount of blood glucose in his body (Jackson et al., 2019). Specifically, behavior modifications involving increased responsibility for insulin intake, as well as the modification to the patient’s diet to minimize the development of comorbid issues, such as heart disease, will have to be introduced (Jackson et al., 2019).
In turn, mental health issues must be addressed accordingly as well. Specifically, depression and anxiety will need to be approached with the help of a closer focus on building a support system rooted in the patient’s family and community and deploying therapeutic approaches such as applied relaxation. Furthermore, the patient will have to be provided with extensive opportunities for clinician-patient communication to reduce anxiety. Finally, managing depression with the help of appropriate medications must be considered. Specifically, Sertraline will have to be considered.
Objectives of Treatment
It is crucial to ensure that the core objectives of treatment include active communication and collaboration between the patient and the healthcare provider. Thus, the treatment process will be aligned with the set standards and requirements. Furthermore, the Rogerian techniques will be included into the therapy process to ensure its efficacy. Namely, core boundaries will have to be set to create an appropriate therapeutic environment. Additionally, the therapist will have to deploy active listening techniques to ensure that the patients’ needs, preferences, and concerns could be incorporated into the therapy process. In addition, as a therapist, one must provide guidance to the client, implying that Mr. Xy should be encouraged to develop resilience and the relevant strategies for addressing his anxiety. Another crucial component of the Rogerian technique demands that the therapist should not be judgmental or actively making decisions for the client (Jackson et al., 2019). Therefore, Mr. XY should be encouraged to build a management strategy independently with the assistance of the therapist.
Furthermore, concentrating on the patient’s responses and being genuine must be the core components of the process. Most importantly, the therapist must make it obvious to Mr. XY that negative emotions should be embraced and accepted to manage them in the future. Adopting a proper tone of voice should also be deemed as a necessary step, which in the case in point implies speaking in a measured and empathetic manner. Finally, according to the Rogerian principles, the therapist will have to advise another healthcare expert if the therapy fails.
Similarly, the motivational interviewing approach should be utilized to identify the patient’s core needs. Specifically, the precontemplation, contemplation, preparation, action, and maintenance steps will have to be taken to ensure that the client is ready to accept change. Remarkably, at the specified stage, the Hawthorne effect can be observed, implying that some patients may improve by receiving enough attention (Jackson et al., 2019). However, the specified change does not suggest that the treatment must be terminated.
Assessment
The assessment will involve the identification of the current blindness issue, as well as the evaluation of the physical and mental health status, in general. Namely, the absence of vision will have to be checked using the strategies such as the clinical low vision evaluation and functional vision assessment (Jackson et al., 2019). In addition, the learning media assessment technique will have to be implemented. In addition, the assistive technology assessment instrument will be integrated into the process of evaluating whether the patient has complete blindness. Finally, the patient will be introduced to purposeful skills that will allow him to make his core tasks easier.
In the process, the emphasis on the therapeutic alliance as the active collaboration between the patient and the therapist will be placed. Specifically, after the rapport is established, active listening will be used to obtain crucial information about the patient’s core problem, as well as the relevant factors including the patient’s relationships with family members and his cultural background. Combined with educational and occupational history, the specified data will inform the therapist about the approaches to be taken to implement patient education and introduce Mr. XY to core therapeutic and medication-related options. Additionally, opportunities for the patient to receive family support will be examined. Finally, a mental status exam will be applied to evaluate the extent of the patient’s current anxiety and depression. Finally, co-occurring conditions, primarily, IDDM, will be evaluated to chart the further course of treatment.
Clinician Characteristics
It is crucial that the clinician and the client agree on the core objectives of the treatment. Afterward, the Rogerian framework involving a patient-oriented approach will be utilized. Namely, the focus on empathy and consistent support of the patient, as well as active listening and unconditional positive regard, must be introduced into the therapy framework.
Location of Treatment
Since the patient’s current health status cannot be defined as critical, namely, since the patient does not require immediate assistance, the outpatient treatment framework will be applied. Specifically, counseling sessions with a therapist will be scheduled in the manner that suits Mr. XXY best. For this purpose, Zoom will be used as the default communication tool. The session will last 45-60 minutes and include active communication between the patient and the therapist, as well as the relevant activities that will allow Mr. XY to develop the required resilience and meditation techniques needed to alleviate his anxiety. The necessity to conduct Zoom sessions is driven primarily by the need to align with the Covid-19 protocol and the necessity to maintain the safety of all parties involved.
The core intervention to be considered in the case under analysis is the Rogerian approach. Implying a completely patient-centered approach, the proposed therapeutic strategy will allow for the most effective therapist-patient communication and the maximum efficacy of the treatment. Namely, the suggested technique will help shape the therapeutic process so that it could reflect Mr. XY’s culture-specific needs. Namely, the focus on family involvement as one of the core values in Hispanic culture will be facilitated with the introduction of the Rogerian model (Jackson et al., 2019).
Specifically, the model in question will involve identifying the boundaries as the means of introducing clear focus to the therapeutic approach, and determining the unique characteristics of the patient that may require particular attention. Namely, a culturally sensitive approach involving a profound understanding of Hispanic culture, particularly, the importance of familial relationships, must be applied. Specifically, Mr. XY will have to be introduced to the idea of enhancing the rapport with his family members to ensure that the required support is facilitated. Additionally, active listening techniques will have to be applied to determine the factors that contribute to the client’s anxiety and depression. Furthermore, Mr. XY will be encouraged to accept and reconcile with his negative emotions regarding the issues that cause him to experience anxiety. Finally, the strategy for addressing the current mental health issues will be identified, with the active focus being placed on meditation and the related strategies.
Interventions
The core intervention to be considered in the case under analysis is the Rogerian approach. Implying a completely patient-centered approach, the proposed therapeutic strategy will allow for the most effective therapist-patient communication and the maximum efficacy of the treatment. Namely, the suggested technique will help shape the therapeutic process so that it could reflect Mr. XY’s culture-specific needs. Namely, the focus on family involvement as one of the core values in Hispanic culture will be facilitated with the introduction of the Rogerian model (Jackson et al., 2019).
Specifically, the model in question will involve identifying the boundaries as the means of introducing clear focus to the therapeutic approach, and determining the unique characteristics of the patient that may require particular attention. Namely, a culturally sensitive approach involving a profound understanding of Hispanic culture, particularly the importance of familial relationships, must be applied. Specifically, Mr. XY will have to be introduced to the idea of enhancing the rapport with his family members to ensure that the required support is facilitated. Additionally, active listening techniques will have to be applied to determine the factors that contribute to the client’s anxiety and depression. Furthermore, Mr. XY will be encouraged to accept and reconcile with his negative emotions regarding the issues that cause him to experience anxiety. Finally, the strategy for addressing the current mental health issues will be identified, with the active focus being placed on meditation and the related strategies.
Emphasis
It is crucial that the emphasis be placed on several aspects of the patient’s background. Namely, culture-specific issues will have to be addressed accordingly. Particularly, the fact that Hispanic people are predisposed to a greater range of health risks than White people, should be taken into account (Jackson et al., 2019). Similarly, the range and variety of the risks in question is large, which should also be incorporated into the therapy framework (Jackson et al., 2019). Most importantly, the fact that Hispanic people are at a significantly higher risk of death from diabetes than White patients must be taken into consideration when shaping the therapeutic approach. Specifically, the focus on the patient’s diabetes issue and the further active education of Mr. XY, must be regarded as the core goals of the process.
Numbers and Timing
To ensure that all goals are achieved and that the patient’s needs are properly met, the number and duration of session must be identified accordingly. It is currently suggested that at least 6 sessions should be conducted with the patient. The specified number of sessions will allow establishing the necessary rapport with the patient and ensuring that his core needs are identified. Moreover, the specified number of sessions will be sufficient for the patient to reconcile with his emotions and determine the strategy for addressing his current anxiety issues. Specifically, techniques linked to meditation will be acquired.
Medications needed (if any)
In addition to the proposed therapy treatment, medications will be prescribed to the patient in order to assist him in managing his depression and anxiety. Furthermore, the essential co-occurring health issues will have to be prevented. For this purpose, medication such as Xanax should be prescribed.
Additionally, the patient must be informed about the core side effects to be observed when taking the medication in question. Namely, Selective Serotonin Reuptake Inhibitors (SSRIs) such as Prozac (fluoxetine) will have to be prescribed. 20 mg per day is advised as the optimal dose; however, in case the medication process is too strong or, on the contrary, does not have the required effect, the dose will be adjusted accordingly.
Prognosis
While there are reasons to believe that the proposed solution will allow improving Mr. XY’s quality of life to a substantial extent, one will have to admit that the majority of positive effects of the therapy depends largely on the client’s participation and the extent to which the disorders have progressed. Therefore, it is crucial that the patient is offered the necessary support and assistance. Specifically it is expected that the patient will develop the skills needed to navigate the local setting, and that he will acquire the skills for handling his current anxiety levels. Most importantly, the extent of the patient’s depression is expected to be reduced to the point where Mr. XY will regain the ability to properly function. Overall, the current prognosis is quite positive given the range of opportunities for recovery and reintegration into the community.
Reference
Jackson, S. E., Hackett, R. A., Pardhan, S., Smith, L., & Steptoe, A. (2019). Association of perceived discrimination with emotional well-being in older adults with visual impairment. JAMA ophthalmology, 137(7), 825-832.