Counselors and Cultural isssues

Are culturally sensitive treatment plans possible? Why or Why not? 

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Before I get into this I want to say that I think all of us attempting to be effective counselors should take a second and third language. This will aid in knowing diverse cultures that America is vastly becoming. I for one am in a Spanish 1 class and have signed up for a Jappanese class. I speak both at a limited level but think it will aid in my career to becoming culturally diverse on a limited level. 

That being said, yes I think sensitive treatment plans for different cultures are possible. You just have to work at it. “Therapists should consider the cultural background of clients), with less attention given to how cultural competence can be measured, conceptualized in terms of skills, implemented in practice, and trained in others,” (Sue, (2006), p.238). As we continue in our labors we have certain questions that will arise in the true meaning of cultural competency. Many counselors think if they are just not bias and do not put their true inner thinking on the client that they can be efficient. I tend to disagree with this type of thinking. 

Some questions being asked are as follows:

• What characteristics constitute cultural competency? 
• Is it even possible to know all cultures that may pass through you therapy door?
• When a counselor thinks he or she is culturally competent, is it toward one specific group, i.e., Hispanic, Black, White, and none else? 

These are things to consider. 

Our first level is the provider level, e.g., the counselor role, then we the next which emposses the place we work for, e.g., the agency, are they culturally competent? Then finally we have third level is molar and deals with systems of care within a community. What is offered in the community as far as churches, programs, schools, law enforcement, organizations and the geographics that are served in said community, ( Sue, (2006). Differences are often barriers to effective therapy. 

How does the developmental stage of the client influence the treatment plan? 

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In this field we will document our clients development in the process we have on-going. We will listen and less talking. This will aid in seeing the clients true needs which can only be seen and conceptualized through multiple sessions and rapport building, e.g., trust and a client/therapist relationship. “When the therapist perceives the relationship to be appropriate for the client's continuing development, he or she may accept the role provided by the client,” (Gross, (1981), para 7). 

So as we analyze our client the treatment plan will grow in directions that affect our client in a positive tone. We are bound to never do any harm to our client and always strive for them to better their current situation and life. 

References

Gross, T. P., (1981). "Developmental Counseling and Psychotherapy: Applying the Theories of Piaget, Perry, Kohlberg and Erikson" Dissertations. 2586.

https://scholarworks.wmich.edu/dissertations/2586

Sue, S. (2006). Cultural competency: From philosophy to research and practice. Journal of Community Psychology, 34(2), 237–245. https://doi-org.lopes.idm.oclc.org/10.1002/jcop.20095

Pain in life-My blood is my sister

I have to deal with family members hurting me all my life with this perverse conception of me that no matter what I did in life I was seen as "garbage", e.g., a person that is ok to just throw-away. My father died August 16th at 4:02 PM, and I was tasked with signing all documents based on Oregon law. My grandmother, aunts, and cousins all treated me like shit. I even asked that they extend a courtesy of allowing me to video chat to see my my dad's burial. They all agreed and then refused. They all are nothing to me anymore. They did this for a family member that was in jail, yet not I!

My sister was here for me as well as my husband as I went through a dark time, I am still in it. My only child my son called to gloat that somehow he felt as if I deserved the pain they dished. Even though, I was the one that kept the peace when his dad died and made sure he got something left from his father. I befriended a woman who cheated with my ex-husband to do this in a feeble attempt to make sure he was ok.

Today I speak to no one but my sister. I think other's can learn from this. Life sucks. But we can build our own paradise.

My mother's contibution to my pain is coming. #TwilaEOdom

https://www.facebook.com/Crissy.harris68

How My thinks on Psychology, Mental Illness, & DNA

Once the clinician has collected as much information as possible, his or her second step in the case conceptualization process is to begin organizing the various client data. By studying the clients past, relatives, patterns, and incidents from youth to adulthood we can get enough information to put together a profile of the client's behavior and abnormal actions. According to Schwitzer & Rubin, (2014), “conceptual skills to weave together the different pieces of information about the client’s adjustment, development, distress, or dysfunction into logical groupings that elucidate the person’s larger clinical concerns, the problematic themes underlying the person’s difficulties with life situations or life roles, or critical problems found in the person’s intrapsychic or interpersonal approach to his or her world,” (p. 31).

For example, a woman brings in a son (Alex) who has a psychotic break, upon maing a genogram of their family we find out that her brother, sister, dad, and grandmother have all had depression, suicide, and schizophenria diagnoses in the past, It turns out Ms. Costello was familiar with the painful and tragic consequences of mental illness long before Alex’s troubles began.(Mackinnon, (2012). Her son is DNA connected to this illness and now we have information to apply to the treatment plan.

One method to help us new counselors is known as Inverted Pyramid Method of Case Conceptualization

• Taken together, a start-to-finish case conceptualization begins with learning about the client’s concerns
• moves on to meaningfully organizing this information into patterns and themes
• and finishes by explaining the patterns and themes using our choice of theory or theories, (Schwitzer & Rubin, (2014).

References

Mackinnon D. F. (2012). A family tree filled with mental illness: review: a lethal inheritance: a mother uncovers the science behind three generations of mental illness by victoria costello. Cerebrum : the Dana forum on brain science, 2012, 5.

Schwitzer, A. M., & Rubin, L. C. (2014). Diagnosis and treatment planning skills: A popular culture approach (2nd ed.). Los Angeles, CA: Sage Publications. ISBN-13: 9781483349763 Retrieved from https://in.sagepub.com/sites/default/files/upm-binaries/44297_3.pdf

Reply from Classmate:

Re: Topic 3 DQ 1 (Obj. 3.1 and 3.2)

Hi Crystal,

You made some interesting points in your post. I appreciate the example you gave about Alex and exploring his mother's family history. The genetic component of mental illness cannot be ignored during the diagnostic phase of treatment. Sometimes that genetic component makes treatment planning a little easier. The clinician has some foundation, to begin with. It can be very challenging when a client comes to treatment and reports having no family with a history of mental illness. Whether or not this is true, it still leaves the clinician needing to figure out appropriate treatment planning.

Thank you,

Reply back to Classmate: 

I truly think that DNA patterns will show us in the future much more on how we are wired. For example "Diseases like the Black Death have the ability to powerfully shape human demography and human biology," (Pappas, (2014). This is exciting to me because the people that are descendants today still have a DNA change that makes their immune system resistant to certain diseases. My theory is if this can happen to the body, then how much can happen through the brain in a DNA pattern that can cause mental illness. 

The article can be found here if your interested. https://www.scientificamerican.com/article/black-death-survivors-and-their-descendants-went-on-to-live-longer/

I thank you for your reply. 

Reference

Pappas, S. (2014). Live Science. Black Death Survivors and Their Descendants Went On to Live Longer. 

Reply from Professor:

Crystal, thanks for sharing the article with us. It is interesting and your theory is as well! I do believe in the biopsychosocial diathesis stress model in that we are all predisposed to something and the stressors in the environment, including prenatal teratogens, bring out physical and mental disorders in us. Thanks again for your take on this!

Weapons Regulations in America Using the Scientific Method

https://docs.google.com/document/d/1jC_QqXch5u8sCz12T-rT8CHkhD0fnYzANL1ICIdZ32A/edit?usp=sharing

We, as psychologist, have been begging the powers that be to allow us to conduct evaluations, nationwide, on the issue of allowing someone to buy any type of weapon. Mental illness is real. Mental health has been on the back burner for so long that if we do not allow this process we will continue to see sick individuals killing for reasons that are just mentally sick. Any weapon from anywhere should include a psychological background test, first, at all times. #20dead #MurderagainintheUSA

Talking to a 15 year old on Career and Super's Theory

Super’s theory is very complex. Explain the basics of the theory as if you were educating a 15-year-old seeking career advice.

Super’s theory is complex yet explaining this theory to a 15-year-old does not have to be. We all understand that there are stages in life, and this is how I would approach this topic in counseling a teen.

Hypothetical Example:

Your 15 now and you can see that your thoughts and dreams have changed since far back as you had conscience thought’s that you can remember. When you were, 5 what was important to you then, may seem trivial now that your almost an adult. Donald Super’s theory is showing how all people move through life and the only thing you can count on is “thing’s change”. Right now, you most likely have developed what interest you and you’re in what Donald Super called the “exploration” stage. The first being growth is usually around 4-13, and you understand the need to succeed in school and are setting up your own personal identity as you navigate the world around you. In this exploration stage you have a clue of what your doing well and might want to transfer that into an occupation. Later, in life your expectation’s might change due to your personal surrounding, e.g., marriage, kids, or difficulties with current occupation. This is where change will occur and again it is a constant and quite possibly the only aspect in life that you depend on. In essence, the career you chose now may not be the career you become to desire most.

Donald Super talks about establishment being between the ages of 25-44 years, where you might be in your career choice and be striving for a promotion in this field and maybe even going back to school to obtain the requirements needed to land that big promotion. Trust me, we all go through this phase and it is how we handle it whether or not it will be a satisfactory outcome. Basically, once you feel like you have mastered that position you will seek more responsibility and money to continue shaping the world you have built. Donald Super was defining these stages based on a normal life perspective. There are so many things that will happen in life that sometimes goals get thwarted. But it does not mean the ultimate goal cannot be achieved. There just might be a couple exits on the highway of life we end up taking at one time or another.

Donald Super talks about this next stage he called “Maintenance (45-65) is the period of continual adjustment, which includes the career development tasks of holding on, keeping up, and innovating,” (Career Research (n.d.) para 8). At this stage you will working to hold on to that home you bought, getting ready to send kids off to college, making sure your 401k is on point and that is a subject we will get into as well as you choose the occupation you want to venture into first. You see, when Donald Super came up with these stages in the 1950’s; that was back in the days where people chose a profession that they would stay in for life. That simply is just not the case today. In this stage you might open your own business, decide on an entire different career but one thig will stay the same and that is “change”.

This brings us to the golden years… Donald called this Disengagement (over 65). I know it may seem like  a long way off, but trust me, you will blink and be there fast. This stage is the need to just chill out and reap the benefits of all of your hard-earned work. Many people relocate to Florida or to an island if they have managed their funds correctly. I suggest taking a finance course to all young adults to get a feel of how to handle your money and make good decisions as you go through the ever-changing life that you will and already have embarked on.

Reference

Career Research (n.d.). Super’s Career Development Theory. Retrieved http://career.iresearchnet.com/career-development/supers-career-development-theory/

Psychology class...

Given the commonality of blended families, how do you decide who should be included in family therapy?

·         Social Class position

·         Sexual orientation in the family and amongst its members

·         Religion inside the family; taking in to mind there might be different views

·         Identifiable race and ethnic identity ( I see my self as bi-racial some see me as Black or Hispanic and addressing me as such is not ok). Just ask when in doubt, people respect honesty before blatant guessing and assuming. This character will aid in finding out who should be involved from the blended family.

·         Individual assessment in family therapy.

According to Goldenberg, Stanton, and Goldenberg 2016, “The evolving view of cultural diversity recognizes that members of racial and ethnic groups retain their cultural identities while sharing common elements with the dominant American culture (Axelson, 1999 as cited in text on p. 64).  Simply inquiring is the best way to go in my opinion. Families that are in second and third marriages; a therapist may make the decision not to include old exes that are not in the current family dynamics and may cause  more issues than help.

What ethical considerations need to be made when determining who to involve in therapy?

The therapist's primary responsibilities are to protect the rights and to promote the welfare of his or her clients. The first is to consider the client that is seeking help for the family, ask the client to bring in who they want to be a part of the therapy. Have all sign an agreement on the  goals that are needed, and what and how much they want to share in family therapy. Allow the chance to walk away to all members if they feel uncomfortable. Out-right denying a family member access can be considered rude and pose ethical issues such as the client feels slighted, e.g., what family member not asked to attend by counselor. The loss of trust between the family and counselor could occur from decisions not made by the client.

Confidentiality is a big ethical concern because people divulge secrets in one setting and not in others. Communication between the family and counselor is important at this stage so all boundaries are clear and concise. So basically,

1.      Determine a policy that is compatible with his or her method of conducting therapy.

2.      Relay this to the family.

3.      Be clear about the method, using language the entire family can understand.

Informed consent and the right to refuse therapy is an issue and any family member has this right if not mandated by a legal order.

What are some ways in which confidentiality and third-party reimbursement challenges may be navigated?

The insurance companies are a big one. The client must agree to what information that is shared and unless this is a legal manner or refers to abuse of family members, e.g., children, or suicide, or murder, we must have permission to relay certain data. Only data that pertains to keeping the third party up to par with treatment is warranted. For example, if an insurance company wants to know information about sessions the information asked for must be placed in writing and presented to the client for signature and approval or disapproval.

Title X is an issue and HIPPA makes provisions for this that all counselors should be aware of. According to English, et al, 2017, “The HIPAA Privacy Rule also contains important confidentiality protections of particular relevance for Title X providers,” (p.1.)

Another third-party issue is if the client has a family member paying for their sessions and wants to know information. If the patient is a minor this can present issues. If it is an adult consent is needed.

References:

English, A., Summers, R., Lewis, J., Coleman, C., (2016). Confidentiality, Third-Party Billing, & the Health Insurance Claims Process: Implications for Title X. Retrieved from https://www.confidentialandcovered.com/file/ConfidentialandCovered_WhitePaper.pdf

Goldenberg, I., Stanton, M., & Goldenberg, H. (2016). Family therapy: An overview (9th ed.). Boston, MA: Cengage. ISBN-13: 9781305092969 http://www.gcumedia.com/digital-  resources/cengage/2016/family-therapy_an-overview_ebook_9e.php

Grandparents and counseling- raising the grandkids

Grandparenting can be highly rewarding. Many grandparents, though, unexpectedly become guardians and raise small children. How might this responsibility affect their normal course of adult development? What components might require transitions?

In many cultures inside western society grandparents have become the parents of their children’s children. For example, the crack epidemic brought to the Black communities by the CIA rendered many fixed income Black grandparents to raise these kids because their moms and dads were in the streets smoking the glass pipe. This was in the 80’s, and I witnessed it personally. The CIA issue you can research on how this happened. The CIA wanted to Congress to give them money for weapons to give to a certain country and when refused, they found the cash in cocaine in which was funneled in the to the USA in the poorest neighborhoods.  For more information on this visit this university cite: http://wordpress.philau.edu/thevoice/2016/12/crack-the-cia-and-media-all-complicit-in-destroying-black-communities/

But I digress; In 2005, 2.5 million children were living with grandparents who were responsible for their care. By 2015, that number had risen to 2.9 million. Child welfare officials say drug addiction, especially to opioids, is behind much of the rise in the number of grandparents raising their grandchildren, just as it was during the crack cocaine epidemic of the 1980s and ’90s. An estimated 2.4 million people were addicted to opioids at last count, (PBS, 2016).

The ability to relax and enjoy their golden years was taken away. Vacations were not available anymore, food was hard to come by and the stress of a 65-year-old raising a 13-year-old is devastating and can lead to early death, due to stress. The development of the children is affected because of the huge generational gap where different thought’s and practices change. Technology in the grandparent’s house will usually not be as it would with their parents simply because this age group does not see the appurtenance of a child having access to the internet.

Many components will change as these “grand-families” take on this endeavor of raising children 3 to 4 generations behind them. Their schedules, the need to be in close contact with schools, the need to understand the attire these kids will wear and when to put the breaks on, and the correct discipline to put forward when facing issues the grandparents are not familiar with.

 How would a professional counselor encourage these older guardians in their new roles?

Counselors can do the following to aid the grandparents in raising their grandchildren and offer these resources:

·         HelpGuide.org is a nonprofit site that gives grandparents resources, tools and ideas on how to get help and make the most of raising grandchildren.

·         USA.gov is a site that can aid them in getting financial help for the grandparents. Many are on fixed incomes and this site is a life-saver.

·         Daily Strength is an online community with a special online support group for grandparents who are the primary caregivers of their grandchildren. This can also help them technology they need to bond with the grandchildren.

Many other cites are available but most of all the counselor can let them know that you do not need to be perfect, listen to the kids, talk with them and make family time count. Quality time is important for children and both can grow into these new roles together. Also, let the grandparents know it is ok to feel like throwing the towel in! We all get that way at times and it normal.

 Reference:

PBS, 2016. How drug addiction led to more grandparents raising grandchildren. Retrieved from https://www.pbs.org/newshour/nation/drug-adChild