Capstone: Intervention Planning Phase, Capstone Project Example

An intervention planning phrase is an inviting collaboration between a case manager and a client. A discussion on client’s self-perception is the phrase of cognitive behavioral intervention process in which the client is to assess its blindspots at the root of dysfunctional thinking, emotional expression, and behaviors (Egan, 2010). This is up to the point to where a client fails to see available resources to identify the present problems and or manage the soluble problems in an escalating situation(s). The blindspot mechanisms that Hecke (2007) explicated the most common problems that most people get themselves into trouble—- A trouble that does not have always have the intention or an infliction reason upon themselves. Such blindspot mechanisms are: The situational cues, lack of self-awareness, lack of exploring biases on both sides, and or seeing coincidences as causes.

Although, a client will not reasonate the nature of dysfunctional thinking himself or herself without therapist’s open questions about thoughts. The leads of open questions on thoughts enable clients to clarify and explore their thoughts thoroughly and more deeply about their life-altering concerns. Instead, case managers, unnecessarily, do not purposely to limit the nature of clients’ responses to a ‘yes,’ ‘no,’ or one- or two-word answer, even though the clients may prefer to respond that way (Hill, 2009). A case manager or a therapist’s open questions can be used in either phrases or queries, and probes. For example, ask a client a series of open questions such as, ‘How do you think about that?’— ‘What were you thinking when you said that?’—‘Tell me more about your thoughts about that?’ than to discourage a way that may disrupt the catharsis probing questions in which it may affect clients’ willingness to express freely from perceived thoughts. Another self-perception mechanism of concern, the emotional expression, which is the second physiological disposition affecting the overall intervention process. Furthermore, clients whose characteristics of fears, worries, and depression are often deliberating and stressful and tolerant. In some clients, they believed that being worry protect against, and prepare them for preventing the incoming negatives. While, on other hand, also believing that worry will result in negative consequences, such as illness or insanity, and that worrying must be controlled or eliminated (Wells, 2000, 2004).

Simply by saying, ‘stop’ to a client who is worry or obsessed with something will have a little effect to the positive outcome during the intervention process. Because, in general, worry is generally experienced in abstract or linguistic form, further ‘neutralizing’ emotional content and inhibiting habituation, since the emotional or arousal component of “worry schemas” is not activated during the process of worrying (Wells, 2000). Across the cognitive/behavioral intervention literatures, suggested that a helper is highly recommend to show a character of empathy behavior toward a client to fill the void. Thus, it is important for both parties to turn their monologues into an accomplishment. It is no stranger for some helpers that do not have the empathy characteristics. Because of numerous of factors, name the one of the factor that is commonly seen in therapists is the lack of environmental/biological exposure limitations to a variety of broaden ‘walks of life’ including gender change, age longevity, and attentive child rearing. In other words, clients cannot help themselves to stop worry about whatever is bothering them and that a case manager is to give clients an empathic attitude towards to clients’ worries and fears (Egan, 2010).

Thereby, maladaptive behaviors extend worries, fears, and anxiety together, in some people. In which, open questions sometime affect a client to be less responsive to the questions asked by a case manager. That is, for some of the behaviors must have some form of comfort before begin to share information. For example, a client who always chooses a chair that faced by the window and faced away from a case manager to tell a story. As such, case manager shall be flexible as in ways of which the client is comfortable to express freely while he or she is in distraught state of mind. A pattern can be change overtime when the client is familiarized with how a case manager can allow him or her to take the control of the session.

From the aspects of client’s self-perceptions and its blindspot mechanisms, a therapist is challenging the client to reassess all of the angles into segmental parts and deal with contents individually. Then, moving the client to choose which part of the angle mechanical problem that needs to be eliminated from personal perspective, before the client is able to convert the ways of which helps her to see things differently with therapist’s assistance. Finally, specific skills to help a client to challenge their blind spots and move to new perspectives are: seeing things more clearly, getting the picture, getting insights, developing new perspectives, spelling out implications; and, transforming perceptions, developing new frames of reference, looking for meaning, shifting perceptions, seeing the bigger picture, developing different angles, seeing things in context, context breaking, rethinking, getting a more objective view, interpreting, overcoming blind spots, second-level learning, double-loop learning (Argyris, 1999).

Goals and Objective Outcomes

A systematic intervention plan for Toya is designed to focus on her feelings, beliefs, and interactional patterns and interactional relationships with her partner and teenaged child. A combination strategy of analytical and synthetic thinking that takes account of the impact of a presentable problem and all of the components of the problem together. It is much easier if there is an additional method of thinking like the analytical thinking, for instance, is concerned with breaking down a concept into its components parts, whereas synthetic thinking is the process of combining components to make a complete whole (Egan, 2010).

Next, Toya is to learn how to enmesh her personal/parenting behaviors to the negative responses in the most difficult situations. This step of intervention process has the tendency for the clients to focus on re-evaluate the systematic model in which evaluates a method of assessing personal effectiveness in terms of an interacting model of a social unit that is capable of achieving a goal. Thus, it is concerned with assessing the availability of resources by personal knowledge in order to reach an optimum level of resolving situational problems, rather than for the person to assess the effectiveness of others in achieving the social goals.

Then, Toya is to learn how to rectify her narrative habits, and understand each narrative dialogue that can influence ones’ thinking of how it upsets her, and how Toya want to change her daughter Avery thinking to think positive and have a thought of a positive outlook of a subject that is ambiguous and belligerent. This strategy is called the parent effectiveness training, a set of principals providing guidance for prosocial interaction between a parent and a child related to discipline, communication, and responsible relationships. A balance is maintained between the child’s feelings, needs, and those of the parents.

Including, the operant conditioning defense mechanisms such as the antecedents, behaviors, and consequences to change a child behavior at home, at school, and in other settings. The goals are to help the parent and the child to develop prosocial behaviors and decrease oppositional, aggressive, and antisocial behaviors into the positive behaviors like respect, integrity, and acceptance of rejection, and mutual in complex situations.

Research Findings

Coiro and associates (2012) evaluated 60 women with children excluding the mental and physical disabilities had contend medical and cognitive behavioral therapy treatments elsewhere and no women had obtained dual treatments at the community center. For the reason why women could not obtain treatment at the community center is unknown. The study aimed for mothers to be treated for depression of their children’s behavior problems and adaptive skills. Also, the study examined whether the treatments are effective at the remission period at 6 and 12 month follow ups.

According to the DSM-IV-TR (2000) mothers and children may be diagnosed as Dysthymic Disorder coded 300.4 with presentable depressed mood most of the day or for more days than not during 12 to 24 month of initial diagnoses. However, they both differ in the duration of having the symptoms with low self-esteem, insomnia or hypersomnia and or having low energy and fatigue. In children, they could live without the Dysthymic symptoms within two months to 12 months. But at a time when there is an episode, a prominent presence of poor concentration or difficulty with making decisions, feelings of hopeless, low interest and self-criticism, often seeing herself or himself as an uninteresting, or incapable to perform daily activities. After two years of the Dysthymic Disorder, it could superimpose to Major Depressive Disorder. In some children, they also may be diagnosed as an additional mental disorder such as Attention-Deficit/ Hyperactivity Disorder, Conduct Disorder, Oppositional Defiant Disorder, and Disruptive Behavior Disorder. Of these disorders, they are accounted for societal norms that have ambiguous symptoms like impairing, affecting social, familial, and scholastic adjustments; and, may resist the willingness to conform to other demands; and, often children initiate aggressive behavior and react aggressively to others. Thus, investigators conducted several tests to explore the effect of low-income women from racial ethnic group on depression treatment modalities and rate the responses from the Hamilton Depression Rating Scale (HDRS) based on mothers’ self-reporting reports.

All of the psychological tests [i.e., Behavior Assessment System for children (BASC), Behavioral Symptoms Index (BSI), and BASC Adaptive Skills Composite (ASC)] were evaluated on the parental sustainability abilities in the prosocial content in the context of interaction with children. The results showed that mothers’ depression remitted had significantly fewer behavior problems than the children of mothers whose depression had not remitted, at both six-and 12-month follow-ups, with an overall difference of 4.2 on the Behavioral Symptoms Index (BSI). Although, the depression symptoms did not concluded in improved child outcomes. Investigators argued that the population sample in the study was incompliant to begin with and that the study could not achieved a stronger response from, medication versus CBT. Other investigators reported that in a study that contained a larger sample of women with depression symptoms might be more compliant in achieving stronger response in reference to the medication and psychotherapy (Coiro, et al., 2012).

Conclusively, the case study of Toya and her child Avery have several cognitive behavioral approaches to practice the learning aspects of self-fulfillment and interpersonal relationships between the parent and the child and the community. Case managers maintain their adherence with the intervention process and its procedures in which supports the individuals involving in the case to reframe the situational picture into a different view of perceiving things. In particular, Toya the mother of Avery is taking a lot of toll on herself on parenting skills and reinforcement skills for Avery to demonstrate interpersonality to all of the authority figures around Avery. However, the case study is limited to the understanding of how her child is having issues at school while Toya could not figure out the real problems by herself. Thus, an intervention planning on series of theoretical orientation and philosophical approaches are needed for such cases like Toya’s case.

References

American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4^th ed. Text Revision. Washington, DC; American Psychiatric Association.

Argyris, C. (1999). On organizational learning, 2^nd ed. Cambridge, MA; Blackwell.

Coiro, M., Riley, A., Broitman, M. & Miranda, J. (2012) Effects on Children of Treating Their Mother’s Depression: Results of a 12-Month Follow-Up. Psychiatric Services in Advance. American Psychiatric Association

Egan, G. (2010) Facilitate Client Self-Challenge: From New Perspectives to New Behavior. The Skilled Helper: A Problem-Management and Opportunity-Development Approach to Helping. Belmont, CA; 8:222-242

Hecke, M. (2007). Blind spots: Why smart people do dumb things. Amherst, NY: Prometheus.

Hill, C. (2009) Helping Skills: Facilitating Exploration, Insight, and Action, 3^rd ed. Washington, DC; American Psychological Association.

Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. New York: Wiley.

Wells, A. (2004). A cognitive model of GAD: Metacognitive and pathological worry. In R.G. Heimberg, C.L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 164-186). New York: Guilford Press.