Identification of knowledge and purpose for referral
Stan is a 35-year-old male adult who was recommended for specialized alcohol abuse therapeutic assistance. Stan has been accused of driving under the influence of alcohol several times. Stan nevertheless maintains that he is not an alcohol abuser, despite the facts raised in the court of law against him. The contributing variables include: inadequate expertise in stress management, irresponsibility and ignorance of the legislation. Sources of Information
Background information was obtained from Stan autobiography and an interview. The information was obtained from the educational reports, medical reports and the court of law. This information appears to be from a reliable source and valid.
Current status of Stan behavior was obtained from observation while testing and from Evidence Based Therapy (EBT) standard procedures. The validity of his performance on most tests was deemed to be accurate due to his cooperation and motivation to heal and attain his goals after five years.
Stan has a long conflicting and struggling life with his emotional, behavioral and physiological life. His emotional struggles entail depression, inferiority complex, feeling worthless, fear of rejection, social anxiety, and fear of criticism. These emotional struggles are the main cause for Stan behavioral struggles which include: addiction, unsatisfactory relationship, unassertiveness and afraid to connect with other people especially ladies. Furthermore, this also results to physiological struggles like headache, poor eating habits and dizziness. The most pressing concern at this time is his emotional struggles.
Medical and Development History:
Pregnancy and birth history. Medical reports reveal Stan mother was 22 and his father was 25 at the time of his birth. There were no complications of pregnancy or delivery, and he was born through normal birth. His birth weight was normal.
Developmental History: Stan experienced a normal childhood but at adolescence his behavior altered. Stan preschool reports express a happy, eager, lively and loving child, however his high school reports show a struggling adolescent with rough life of substance abuse, addiction, rebellion and dessert.
Stan former psychological reports reveal a boy with behavioral and emotional struggles. Moreover, the cases of intrapersonal antagonism and inferior complexity are also revealed.
Stan experienced a balanced physiological health, thus termed healthy life without cases of lifestyle associated diseases.
Family and Social History
Stan grew up in a family characterized with domestic violence. His mother and father always fought, and abused each other. As if not enough, they took it took on their first born son, Stan. Not only did they fight but they also had poor parenting skills. Stan autobiography and interview revealed he experienced a rough childhood. He was not love and appreciated by his parents.
Summary of Previous Evaluations
Stan has a history of two psychological assessments to determine the source of his behavior and emotion difficulties during his high school and rehabilitation facility life. A series of psychological therapy standard procedures were conducted. The test revealed, that Stan experienced a rough and tough childhood that led to his behavior and emotional difficulties. The results also suggested, Stan behavior was a key tool for him to gain his parent attention and affection from his siblings. Furthermore, poor parenting skills from his parents also played a role in modelling Stan behavior. However, there was no clear indication of the reason behind Stan emotional and behavioral difficulties in his high school. This left a stone unturned, hence the problem was never solved or corrected.Behavior
Stan is determined and smart, mature adult, who is eager to overcome his challenges in life. His case registered many specific and interrelated psychological disorders, luckily they were identified, isolated and corrected through assessment standard procedures and therapy.
First the therapy session entailed identification and isolation of Stan psychological disorders. Stan disorders were broadly categorized into three categories: Behavioral, Emotional and Cognitively disorders (Corey, p262).
Behaviorally; Stan is defensive, overprotective, shy, uses alcohol excessive, avoids people, alienated, lying and alone always.
Emotionally; Stan has a number of problems, some of which include fear of rejection and criticism, inferiority complex, feeling worthless and stupid, depression and social anxiety.
Cognitively; Stan behaves like a normal person however his fallacies and beliefs are very different. Not only are his fallacies and beliefs different but also they are governed with categorical imperatives whose engagement are dangerous thinking and thoughts thus negative humiliation of himself. Stan is undecided, unassertive, has a negative unsatisfactory relationship with his parents, has few friends, and is afraid to connect and interact with women. Moreover, he fears intimacy and feels social inferior.
Stan first learned the relaxation procedures, and then all procedures were explained to him to obtain his informed consent authorization for the therapy medication.
After the completion of the disorder identification and isolation stage in Stan Case, we had to set goals aiming specific areas he would like to make changes. Furthermore, this helped Stan to understand the reason for his behavior unlike the previous therapy session.
Stan was then educated and taught about therapy sessions and his work to help him achieve his goals.
First Stan, treatment involved Stan translating and converting his general goals into concrete, measurable and tangible goals.
For instance; when he said I want to feel better about myself, the therapy would help to redefine the goal into a more specific one: I want to get rid of inferiority complex
Stan desire to work without alcohol, the therapy procedures suggested that he keep a record of when he drinks and the events lead to drinking.
We drafted concrete goals based on positive spots, and not the negative goals. When he would propose to get rid of something, the therapy procedures encouraged Stan to acquire another set of skills to fill up the gap after. After acquiring the set of skills, the session would encourage him to develop the skills and use them wisely.
Stan was afraid that he would not last long at construction site where he is currently working because of poor communication and interaction skills. The therapy approaches introduced behavioral skills training. This approach considered demonstrating a set of skills that he could use directly and confidently. These procedures include modeling, role playing, coaching, guided practices and behavior rehearsal.
When Stan did not want to feel apologetic for his existence. The therapy introduced behavioral skills that entailed Stan talking to his boss and coworkers. This procedure involved demonstration of specific skills that Stan used to communicate with his boss and coworkers. Some skills compacted a follow up procedures like guided practices, coaching, role playing and imitation.
Imaginative exposure and systematic desensitization were working appropriate with Stan fear of not succeeding. Another, technique that was working correct were homework assignments and their feedback. This also helped to instill sense of responsibility in Stan.
The goal of the therapy was to help Stan modify the behaviors that were born out of his feelings of guilty and anxiety. Through learning more appropriate coping behavior, eliminating unrealistic anxiety and guilty, and acquiring better adaptive responses.
Approaches and Techniques Applied
Based on Stan interrelated psychological disorders, the therapy involved a series of borrowed psychological concepts to help correct these disorders. The therapy mainly focused on Evidence Based Therapy which simply cared for Behavioral and Cognitive therapy to treat Stan. Unlike the previous therapy, Stan present therapy was done in stages and applied a lot of sophisticated concepts and ideas to wipe his interrelated disorders. In most cases, combination of two or more concepts from the Albert Ellis Rational Emotive Behavior therapy (REBT) a form of cognitive therapy, Aaron Beck concept in treating depression disorders and Meichenbaum cognitive therapy concept of Stress Inoculation therapy (Corey, 263).
Stan cognitive therapy was based on his thoughts, emotions and behavior. It was clear that specific thoughts determined Stan feelings and behavior. Therefore, the negative, self-undermining and unrealistic thoughts triggered a lot of discomfort and stress in him. According to Stan record, psychological distress is the key factor for his negative interpretations and behavioral thinking.
Furthermore, Stan behavioral characteristics also shared a lot of similarities with cognitive assumptions. First, were abnormalities in Stan thinking cognition, the cognition caused various distortions in his seeing, thinking and interpretation of things; and lastly was his interaction with the world is defined with mental representation of it.
Thus application of Ellis concept about cognition distortion suggested was through irrational thinking and Beck proposed it was the cognitive triad.
Albert Ellis Rational Behavior Therapy concept application on Stan Case:
Albert Rational Behavior Therapy is a type of cognitive therapy that focuses on resolving emotional and behavioral problems. The therapy goal was to alter and eradicate Stan irrational beliefs into rational ones.
The therapy standard initial step was the identification Stan general and irrational beliefs, and then subsequently persuades him to challenge these false thoughts in realty testing. The therapy revealed Stan had many basic irrational assumptions that often triggered his psychological distress thus unhealthy behavioral acts. Some of these irrational assumptions were; he frequently assumed himself as an irrational failure in almost everything he did. He constantly seeks for approval and repeatedly feel rejected.
This led to the application of Ellis ABC MODEL, to aid in cognitive therapy about Stan irrational beliefs. The models involves a series of three steps which include: Activating Event, Belief identification and Consequences (Corey, 293). Stan adherence to Ellis Rational Emotive Behavior therapy was better, it helped to cure his anxieties and mild fears.
Aaron Beck Cognitive Triad Concept application in Stan Case:
Beck concept suggested Stan dysfunctional thoughts to be challenged, try out new interpretations and provision of new alternative ways of thinking to Stan. The concept help to stream out the automatic negative thoughts which frequently made Stan to feel very depressed. Unlike, other approaches Beck concept had a vast of homework assignments for Stan to work. Hence, he experienced more interactions with the real world.
Beck concept and approach was helped to provide more insights on Stan mechanism that lead to generation of depression. The mechanism of depression generation in Stan were The Cognitive triad of negative automatic thinking, errors in logic due to poor and faulty information processing and Negative self-schemas ( Corey, 289).
The cognitive triad revealed, Stan had three fallacies and beliefs all negative (Negative view for himself that he is always on the receiving end and he has never done something good with his life, Negative view of the future i.e. pessimistic that he would lose his job and lastly Negative view of the world, Stan often thought he is existence was not worth in the world) leading to impairment in perception, memory and problem solving thus a he become depressed and obsessed with negative thoughts.
The negative self-schemas concept showed that Stan depression was triggered due to his traumatizing childhood.
The error in logic concept registered that Stan depression and anxiety psychological disorder was because of self-selective abstraction and magnification of undesirable events.
Stan showed a lot of enthusiasm and vigor while under this approach concepts. It played a key role in healing Stan wild depression and social anxiety.
Meichenbaum Approach and Concept Application in Stan Case:
Meinchenbaun cognitive behavioral therapy exploited the use of Stan stories and narration for therapeutic approach. In this approach, Stan autobiography and narration were used to accentuate his strength, skills, and personality. Stan was argued to forgive others and even himself. The therapy procedure involved constructive-narrative perspective approach to array for Stan developmental level in emotional and behavioral backgrounds.
Contemporary Behavior Therapy
Contemporary behavior therapy is a form of Evidence Based Therapy, which was applied in treating Stan psychological disorders (Corey, p 235). The therapy involved four main areas to help improve Stan behavior. The therapy session determined by the Emotional based therapy and unlike other forms of psychological therapy, contemporary behavior therapy, played a key role in helping Stan understanding and endorsing the once previous unclear goals into tangible plans. Furthermore, the therapy made Stan to understand how to interact with the environment and people.
The therapy entails a lot of guided practices, coaching and homework assignments which were later graded. The techniques applied here include:
Classical conditioning- teaching and learning as skills a pair, Stan seem to enjoy these session and they helped to improve his confidence.
Operant conditioning- Stan was taught behavior as influenced by consequences. For example, when Stan did not control his drinking then he would hurt those around him something which he did not want.
Social cognitive theory- social approach in learning, Stan had to interact with a dozen of people and visit places with people once a week.
Cognitive behavior theory which involved Stan learning and endorsing cognitive dimensions of behaviors. The skills learnt during this sessions were: social skill training, stress management training acceptance based practices, and mindfulness (Corey, p238.)
Stan was given a homework assignments to interact with his boss and coworkers. He performed averagely.
With time Stan understood the importance of mindfulness and stress management training played a key role in eliminating Stan alcohol addiction problem.
Stan is a 35 year old male adult, who was referred for professional psychological help on alcohol addiction. He experienced a lot of difficulties with his emotions and behavior in the society. Previous evaluation of psychological and cognitive capabilities were in vain at high school and in the rehabilitation facility.
Stan performed above average in his cognitive and behavioral therapy. Moreover, it was noted that he had grasped a lot of skills concerning his emotions and behavior control. He had also mastered an outstanding ability of reasoning with logic and accountability for his actions.
He demonstrates positive attributes and qualities like optimisms, mindfulness, eager to learn and help, well-structured social interaction and value of life.
However, his alcohol addiction problem is to be eliminated slowly because of the physiological detriments that may occur as advised by his physician.
Gerald Corey. Manual for Theory and Practice of Counseling and Psychotherapy. 1st ed., Monterey, Calif., Brooks/Cole Pub. Co., 1985.