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Person-Centered Approach on Xavier Example

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CLIENT

The subject is a 32-year-old African American, heterosexual, Christian male, that has been a widower for approximately for 1 year. His education includes high school, and a certified nursing assistant for 11 years. Xavier began his struggle with depression when a series of events happened in his life. First, his son passed away a few hours after birth, two years later his mother passed away from cancer, and, finally, his wife died a few months later with breast cancer. To add more to his plate, he had been laid off in the year before his hospitalization.

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Xavier had demonstrated suicidal thoughts and actions. The admission to the hospital was because he went to the hospital and held a knife to his neck threatening to kill himself. Before, this climax of an event of hospitalization he had become homeless due to the loss of his job. Upon receiving shelter from a friend, he became homeless again due to a foreclosure on his friend’s home. His depression grew and his suicidal thoughts as his situation seemed to worsen. His first attempt of suicide was spoiled by a bystander who saved him from a moving train.

Xavier was hospitalized for the first time after this incident and treated for depression. Being that he was homeless they contacted a family member who was willing to take him in. However, this family member expected sexual favors from him for the help and he was assaulted. Once again, Xavier found himself homeless, broke and ashamed. Because, of his beliefs about taking medication and doing it on his own he did not medicate himself. After the train incident he was hospitalized again and was diagnosed with major depressive disorder, recurrent severe without psychotic features and gender identity issues due to his believes that he should not take the medications.

ASSESSMENTS

Xavier is a middle aged African American male who suffers from major depressive disorder, invisibility syndrome, racial socialization issues, sexual assault and suicidal tendencies. Because, of his ethnicity Xavier feels that it is not okay to have a mental health need and to be dealing with depression. Xavier’s childhood was in a one parent household where he was a caregiver to his brothers in the absence of his mother. His mother worked and went to school to provide for them which made left him to be the “strong man” of the house. His mother also would make stereotypical remarks to him about his phasic, stemming from a conversation about the sports that he wanted to participate in. Xavier wanted to do skiing and running to which, his mother stated, “Black men play basketball or football”.

HISTORY

Xavier will benefit from person centered therapy due to his issues with his cultural factors of treating his depression disorder, views on gender socialization and his sexual assault he endured. Only 7% of African American men will develop depression in their lifetime (Black Mental Health Alliance for Education and Consultation, Inc., 2003). This also states that it can also be because of the lack of screening in African American Males and treatment services accessible. “Although models articulating general and gender socialization have existed for some time (e.g., Baumrind, 1971; Darling & Steinberg, 1993; Eccles, 1983, 1993; Maccoby, 1992), only recently have theoretical models been developed to understand the process by which parent R/E socialization influences R/E identity development (e.g., Hughes, Witherspoon, Rivas-Drake, & West-Bey, 2009; Murry, Berkel, Brody, Miller, & Chen, 2009).’ A 2017 Centers for Disease Control and Prevention report asserts that 1 in 6 men has experienced some form of contact sexual violence during their lifetime, with 14 percent of men experiencing sexual assault before the age of 18. In 2016 Terry Crews a famous African American Actor came out about an agent who sexually assaulted him. He was made fun of and even called homosexual because of his claims. According to an article in Huffington Post, “Strong Black Men Are Victims of Assault, Too”, in order to survive in American society, black males are all ages are conditioned to be “strong Black men.”

THEORETICAL ORIENTATION

The theoretical orientation that I will be using is person-centered approach. Person-centered will allow Xavier to process and discover his own solutions to his issues and problems. This will help him to learn coping skills that will help him as an individual for problems as they occur in the future. Because of his gender identity issue, I feel that it will be essential for our relationship that he trust me and knows that I am not going to be in judgement of him but rather listen to what he must say. I will be acknowledging his experiences and being compassionate as I facilitate the sessions. The self-discovery process that will take place will be beneficial today as well as the future.

Carl Rodgers in the 1950s, American psychologist created person-centered therapy. He was a former mister who studied clinical psychology at Columbia University. At that time professionals were looking for practical methods for helping children and adults with psychological, emotional and “social adjustment” problems (Kirchenbaum, 2009). At Rochester Guidance Center he was the director of the Child Study Department of Rochester Society of the Prevention of Cruelty to Children (2018). He first introduced his “non-directive” method in ahis book Counseling and Psychotherapy in 1942. Surprisingly, it was because of a challenge that his students made to him in 1940 at University of Ohio.

The idea is that a client has the capacity to understand those aspects of his life, those that cause him pain, and can reorganize themselves in the direction of self-actualization to bring them internal comfort to a degree. The psychologist creates the atmosphere that will foster the client to find their strength and to achieve their own potential.

“Person-centered therapy uses a non-authoritative approach that allows clients to take more of a lead in discussions so that, in the process, they will discover their own solutions. The therapist acts as a compassionate facilitator, listening without judgment and acknowledging the client’s experience without moving the conversation in another direction (Hazler, Richard J., 2016).” Carl Rogers, in the 1950s created person-centered approach which helps people move toward their full potential. The therapist must be open, genuine, and value the client as a person because this is important to help the client accept and understand their own feelings. The goal is to help them connect with their sense of worth and their inner values. “According to Rogers, there are six conditions necessary to enable real change. These are:

  1. There is psychological contact between the client and the counsellor.
  2. The client is emotionally upset, in a state of incongruence.
  3. The counsellor is genuine and aware of their own feelings (congruent).
  4. The counsellor has unconditional positive regard for the client.
  5. The counsellor has empathic understanding of the client and their internal frame of reference, and looks to communicate this experience with the client.
  6. The client recognizes that the counsellor has unconditional positive regard for them and an understanding of their difficulties.

Out of these, the following three are known as the 'core' or 'active' conditions:

  1. Congruence - the counsellor must be completely genuine.
  2. Unconditional positive regard - the counsellor must be non-judgmental and valuing of the client.
  3. Empathy - the counsellor must strive to understand the client's experience. (person-centered therapy (n.d.))”.

The therapist is an aid or sounding board for the client to bounce off and to come to the realization that they are in control of their own healing. A true understanding of their situation and the steps that will help them achieve their goals. A self-actualization process that will give them the tools to manage their problems in the here and now. This will also help them in the future as other issues may arise.

TREATMENT GOALS

With Xavier his treatment plan specifically will include for his intervention side, individual therapy that will help Xavier learn and implement coping skills and to help him identify, process and resolve feelings and concerns. We will develop a safety plan to help him, problem solving and relaxation techniques and help to identify and modulate emotions. Another plan will be developed to help replace negative, maladaptive thoughts that Xavier is experiencing.

Short term goals to help Xavier would be to help with his coping mechanism so that he does not continue to have suicidal thoughts. He will need to focus on the issue of what he feels a black man should do about their feelings of suicide and getting help for it. During each session I will instruct Xavier to choose a topic of what the session should be centered on. We will determine how often we should meet and the duration of the treatment. We will work through the issues of stress, anxiety, low self-esteem, his interpersonal relationships, his physical and sexual abuse and how he can begin to get back to work and being more productive in his life.

Long term goals are to get him back to work. Client will identify five effective coping strategies in dealing with stressful situations. Xavier will also identify and chart what triggers his anxiety and depression to help write his coping strategies. Long term goal of Xavier significantly reduces his depression and anxiety so that it does not inter with his functioning in life.

OBSTACLES

When dealing with Xavier has a therapist there will be obstacles to overcome. His deep seeded believes from his childhood stemming from his mother being a “strong black woman” and his believes that he should be a “strong black male”. Because, of these beliefs it will be little more difficult for him to come to the self-realization that he should take his medication. Also, the fact that an African American male who has been sexually assaulted is lesser of a man, will be an issue that will be addressed.

INTERVENTIONS

Xavier may need intervention help because of his Major Depressive Disorder when he it comes to dealing with his sexual assault. Often, a traumatic event in a person’s life can worsen the effects of the depression. As his person-centered therapist I will use these skills to aid him in his crisis should this occur. “Sensitive listening, hearing, and understanding are essential at this point. Being heard and understood helps ground people in crises, helps to calm them during turmoil, and enables them to think more clearly and make better decisions” (Corey, 2013, pp. 7-4e).

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