The theory being utilized in this case approach is Behavioral Theory. According to Corey, the basic assumptions are that behavior therapy is “based on the scientific method” and sets replicable goals that are agreed on by both client and counselor. Behavior is defined as anything that is “operationally defined”, which includes actions, “cognitions, images, beliefs, and emotions”. This theory deals primarily with the present prevailing issues. There is importance placed on examining the client and the client’s present environment.
The client must actively participate in counseling sessions and in his or her environment by learning “new and adaptive behaviors to replace old and maladaptive behaviors”. It is believed that changes in behavior can potentially guide the client to “an increased level of self- understanding” without the need for “insights into underlying dynamics” and “understanding the origins of a psychological problem”. The treatments will be “tailored to specific problems experienced by the client” and more than one technique can be utilized (2013).
These assumptions relate to the case I am presenting because my client has expressed that he would like to change problematic behaviors. My client is currently experiencing loss of sleep, such as sleeping intermittently or an inability to fall asleep. My client would also like to find ways to cope with his overwhelming anxiety. My client has defined his anxiety as persistent thoughts, which include fearing that people from his past will harm him and his family. My client has expressed interest in learning techniques for developing healthy sleep patterns and new behaviors that manage his anxious thoughts.
My client is seeking counseling because he is experiencing a possible divorce and dealing with a terminal illness and the medical expenses. He stated that he started gambling to pay for his medical expenses and he has recently stopped gambling after his separation from his wife. His current environment includes living alone and separately from his immediate family. The maladaptive behaviors he is experiencing are persistent anxious thoughts and loss of sleep due to these thoughts. My initial conclusions would be that my client and I must routinely ensure that goals are being met.
My client must be active and willing to participate in new techniques. My client will be asked to keep a journal to monitor his sleep patterns and feelings of anxiety. I will use “functional assessment”, specifically the “ABC model”. My client and I will discuss his “situational antecedents (A), behavior (B) and consequences (C)”. Assessment will be unending throughout the course of therapy by “observation and self-monitoring” (Corey, 2013). My client and I will both need to be aware of how his behaviors change throughout our sessions to determine if the techniques we are using are the most effective for his treatment.
The long term goals that my client and I have agreed on would be that my client would like to learn to manage his anxious thoughts. The short term goals would be that he would like to learn new practices that allow him to fall asleep and sleep throughout the night. My client believes that developing healthy sleep patterns will also help him manage his anxiety. One of the techniques my client and I will be using for this case will be progressive deep muscle relaxation. According to Alley, “training involves successively tensing and relaxing the various muscle groups”.
This technique will help my client “identify feelings of tension and generalize the relaxation response to real life situations” (1983). This will help my client when he is experiencing an inability to fall asleep and may benefit him when he is experiencing anxious thoughts. The other technique my client and I will be utilizing will be acceptance-based behavior therapy (ABBT). According to Zargar, Farid, Atef-Vahid, Afshar and Omidi, ABBT is successful in treating generalized anxiety disorder and helps to “develop a more acceptable attitude and willingness” to deal with “internal experiences”.
This technique “could reduce the distress and interference associated with the unpleasant internal experiences” and it will “decrease the negative reactivity and the cycle of anxiety” (2013). By accepting his feelings of anxiety and utilizing the progressive deep muscle relaxation, my client will be able to reduce persistent anxious thoughts and eliminate sleep disturbances. As the counselor, my role is to “be active and directive and to function as consultants and problem solvers”. I must “rely heavily on empirical evidence about the efficacy of techniques they apply” to the client’s presenting problems.
The counselor plays an active role in teaching skills “through provision of instructions, modeling and performance feedback. ” My client’s role in the helping process is to be aware and actively participate. He must be “motivated to change and [is] expected to cooperate in carrying out therapeutic activities” in his environment and in therapy sessions. He will be “encouraged to experiment” and is expected to “continue implementing new behavior once formal treatment has ended” (Corey, 2013). One of my client’s strengths is that he has been a teacher for many years.
I believe this will aid him when learning new adaptive behaviors and applying them to everyday life. I also believe my client will be thorough in completing homework throughout the sessions due to his profession. My client has also expressed that he is open to trying new techniques. He has a positive attitude toward his cancer staying in remission and he has a strong social support system from his in-laws. I believe his positive outlook and social support will aid him in continuing new behaviors after therapy has ended.
The issues I could face may be diversity issues. I will have to be “sensitive to [my client] in a broad sense” and “become more responsive specific issues pertaining to all forms of diversity”. I will need to “conduct a thorough assessment of the interpersonal and cultural dimensions of the problem”. My client will be encouraged and have time in our sessions to talk about any problems that arise due to his new set of “social skills” and how they are impacting his current environments (Corey, 2013).
