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Clients Description And Functioning Friendly Work Essay

The consumer is a sixteen-year-old BLACK female who is pregnant with her second child. Your client attends junior senior high school. The client lives with her mom, age unknown, who's unemployed.

B. Setting

Peak View Behavioral Health is positioned in Colorado Springs, Colorado. Optimum View Behavioral Health is a "psychiatric medical center dedicated to providing quality treatment to promote development and structure for clients and individuals" (Top View Behavioral Health, 2012). Peak View Behavioral Health snacks adults age range eighteen and more mature and, in January 2013, will start to serve children ages four to seventeen. The hospital's services include severe psychiatric care, partial hospitalization, rigorous outpatient services, substance abuse, twenty-four hour examination and Electroconvulsive Remedy.

C. Reason for Referral

The customer was referred to Each One Teach One, an alternative solution college, by her prior public school primary. The client is pregnant with her second child and has been suspended from the public school. Adolescent motherhood, supposed or not, can have negative effects. Common repercussions of adolescent motherhood include falling out of high school, living in poverty, counting on open public welfare, and experiencing higher levels of psychological distress, as compared to their same age group peers (Stoiber, 2005). The results of the client's pregnancies are mirrored by her situation. She has been described an alternative college and experiences psychological stress which impacts her relationships. The principal was alert to the client's first being pregnant, although no earlier interventions were attempted. The main suspects the client is having difficulty in her home life, although she will not disclose to the main how she became pregnant double.

Client is unhappy about the suspension from public university. Client will not understand why she is being suspended because she seems as though she's not done anything incorrect. Although she is annoyed about the suspension system from her general population school, she does seem thinking about the recommendation to the choice university as evidenced by her acknowledging the recommendation and joining Each One Show One. Among the highlighted advantages in the lives of African People in the usa is their strong educational or success orientation (Boyd-Franklin, 2006). Although the client is experiencing a negative social and economical environment, she appears to be motivated to better herself. The client's mom will not support the referral for client to attend the alternative college. The client's mother encourages your client not to sign up for college and "can get on the Welfare. "

D. Client's Explanation and Functioning

Client is of average elevation and pregnant. Customer attends institution well groomed, e. g, wild hair brushed, teeth brushed, showered, and wears clothes that are clean and well-fitted. Although your client is pregnant, she is able to walk to school and walk along the stairs to her apartment without difficulty. Client took necessary testing safeguards to be tested for People Immunodeficiency Pathogen (HIV) after learning her father passed away from Obtained Immunodeficiency Symptoms (AIDS). Consequently, consumer tested positive for Individual Immunodeficiency Trojan (HIV).

Client does not speak grammatically correct English as evidenced by client stating sentences such as "I is learning, " "I does my work, " and "what that one is?" Although consumer reports she rests in the back of the classroom, does not open a e book and does not participate, client's mathematics teacher reports customer will well in mathematics. Consumer has difficulty reading. The client's mother reports consumer as "stupid" and "not ever amounting to anything. " Consumer recognizes one of her talents as cooking food. Client records auditory and visible hallucinations by means of vampires informing her "you are one folks. " Customer fantasizes about being white, living rich and famous, and being "saved" from her current situation.

E. Physical and Economic Environment

The client's mother is unemployed and will get welfare of an unknown regular amount. Client's mom has custody of client's first child to be able to get aide on that child. Customer attended public institution until suspended and you will be joining Each One Teach One. In the evenings, customer cooks and cleans for the household. Client details her mother's day as a "beached whale resting on the couch. " Client states her mom "eats, watch T. V. , eats, watch T. V. "

The client and mother reside in a two bedroom apartment, rent unidentified, in Harlem. Client describes the neighborhood as the "ghetto" and used with "split mind. " The client's apartment building is sprayed with graffiti. Americans imagine the ghetto as "where the black people live" representing an unhealthy, susceptible to crime, drug-infected and violent part of the location (Anderson, 2012). The client defines her neighborhood as the ghetto due to medicine activity and criminal offense.

F. Current Public Functioning

1. Family Situation. The client and mother stay in apartment jointly. The client's mom has custody of the client's first created child and promises that child for welfare purposes, although the child actually lives with client's grandmother. The client's dad previously lived in the house with consumer and mother prior to moving out. Client's romance with her mother is volatile. The client's mother reported she "should have aborted her. " Client cooks for her mother, cleans the home, and runs chores for her mom when needed. Client fantasizes of attempting to be on the cover of your magazine or in a music video recording.

Client has current and past history of erotic and physical abuse. Consumer was raped by her father. The client's first child, and the second child she is pregnant with, are products of rape by the client's father. The client's mother is aware of the rape of your client by her daddy but blames your client for "taking my man. " The client's mom also blames your client for client's daddy moving out of our home. The client's mother also accepted to sexually abusing client, stating "who was heading to please me. " Consumer has also experienced physical misuse as a result of her mom. The client's mother has slapped her and thrown a frying pan towards her head. The client's mom is verbally abusive dialling client brands such as "bitch, " "whore, " "best for nothing" and "stupid. "

2. Current Intimate/Emotional Relationship. Client reviews never possessing a boyfriend but needs she had a "light epidermis sweetheart with nice scalp. "

3. Occupational/University Situation. Consumer has been suspended from general population school and described Each One Train One, an alternative solution school, scheduled to her second pregnancy. Client enjoys mathematics and does well in mathematics, as reported by her math teacher. Client has difficulty reading and analyzed at a second level reading level. Customer has difficulty with her peers as evidenced by client's physical aggression towards peers, i. e. , slapping, punching, and cursing at her peers. Consumer has obedient relationships towards professors and main as evidenced by pursuing directions without defiance.

4. Other Sociable Relationships and Sociable Tasks and Satisfaction. Client reports never possessing a boyfriend and does not have any friends. Client takes pleasure in being a mother but struggles to be a mother to her first child due to her own mom not allowing her child to are in their home due to child's developmental impairment. Client has expressed attempting to get her child again. Client does not currently show up at a cathedral but fantasizes of participating in the church choir. For years, African Americans have used spirituality and religious beliefs as an essential instrument for success (Boyd-Franklin, 2006). One role of the BLACK church is to do something as a refuge, as a sanctuary within an quite often unfriendly world (Boyd-Franklin, 2010). Although customer does not presently attend church, in her fantasies, she finds the cathedral as a safe place from her negative and hostile environment.

5. Medical/Psychological. Client is pregnant with her second child. Client's first being pregnant resulted in a female with developmental disabilities. At time of client's recommendation to Each One Coach One, client had not yet seen a doctor for her second pregnancy. Customer found out from her mother her father passed away from Helps and client examined positive for HIV. Client's mother refuses to be analyzed for HIV because she thinks she has not contracted the disease because she and client's dad did not embark on anal sex.

6. LEGALITIES. Client does not have any legal issues at the moment.

G. Personal and GENEALOGY relevant to current focus

Client was created in November 1971 in Harlem. Mother reported customer would rest in the foundation with her and the client's dad. Client was container fed as a child, as client's dad would drink the breast dairy from client's mother's breasts. The client's mother reported consumer was three years old during her first sexual misuse by her daddy. Customer has experienced erotic mistreatment by her father and mother, and physical and verbal misuse from her mother. Folks who are of lower economical status are more likely to experience traumatic occurrences, and African People in america are more likely to be of lower socioeconomic position (Gapen et al. , 2011). Client's mom reports there is no alcohol or chemical use in the house.

II. Assessment

Psychological Functioning

The client's intellectual working reaches a average level as evidenced by grammatically incorrect language another level reading level. In conditions of the client's psychological performing, her ego functions are reasonably jeopardized. The ego's capability to unify and combine mental procedures is named ego functions (Berzoff, Flanagan, & Hertz, 2011). Reality assessment is the ego's potential to identify and trust physical and interpersonal reality. The main aspect of this function is the ability to inform the difference between inside reality and exterior simple fact (Berzoff, Flanagan, & Hertz, 2011). The client's function of simple fact testing is jeopardized sometimes, as evidenced by auditory and visual hallucinations and retreats to her "fantasy world. " The client's ego function of managing impulses is also jeopardized, as evidenced by aggressiveness towards peers.

The ego's try to maintain a precise level of positive self-worth in the face of nerve-racking or aggravating circumstances is self-esteem legislation (Berzoff, Flanagan, & Herzt, 2011). The client's self-esteem could be defined as low scheduled to physical, intimate, and verbal abuse. The client's low self-esteem can be seen through her fantasies of wanting to be someone else, e. g White, famous. Body's defence mechanism guard the do it yourself from danger, real or recognized (Berzoff, Flanagan, & Hertz, 2011). In conditions of body's defence mechanism, the client's body's defence mechanism could be labeled as immature. The client's immature protection of dissociation, in which a painful memory space is detached from the sensation, is evidenced by the client's fantasies of herself leading another type of life (Berzoff, Flanagan, & Hertz, 2011).

B. Emotional Functioning

Between nine and twelve months old children begin to develop Internal Working Models to characterize emotions and expectations resulting from interactions and communication between baby and caregiver (Riggs, 2010). In keeping with the notion emotional abuse negatively impacts Internal Working Models and the capability to regulate affect, research suggests emotional maltreatment places children at risk for poor self-concept and disorders of psychological legislation and impulse control (Riggs, 2010). With regards to the client's emotional functioning, her limited range of emotional appearance and poor impulse control are showed by her use of hostility and anger towards peers. The client's negative coping reactions is seen through her fantasies, as she cannot verbally communicate how she actually is feeling.

According to attachment theory, insecure connection styles are being used because they are adaptive in relation to the behavioral replies of their connection figure (Riggs, 2010). One type of insecure attachment design is disorganized connection. Disorganized connection can be connected to child abuse, lack of image resolution to injury or damage by parent, and maternal terrifying action and psychopathology (Riggs, 2010). The client's attachment design can be grouped as disorganized due to her experience of sexual abuse, by her mother and father, and physical maltreatment, by her mother. The client's disorganized attachment may also be related to her mother's insufficient support in regards to her sexual mistreatment by her dad, i. e. , blaming the client for the mistreatment. Evidence of client's insecure attachment in early childhood can also be seen, presently, through client's dismissiveness, i. e. , that she takes care of her mother despite the mistreatment, low self-concept (Berzoff, Flanagan, & Hertz, 2011).

C. Public/Behavioral Functioning

Attachment insecurity, due to emotionally abusive parenting, adds to poor social functioning. In early attachment relationships, children begin to develop the skills had a need to build future public relationships, such as self-awareness, empathy, negotiation, and turmoil quality. The security of attachment influences many regions of interpersonal romantic relationships, including performance in peer organizations, reciprocity in associations, empathy, problem solving, conflict image resolution, and establishing close and close romantic relationships with peers (Riggs, 2010). The client's interpersonal isolation, as evidenced by her insufficient peer group, demonstrates the client's insecure attachment with caregivers. The client's lack of distrust in peers and people is displayed through client's intense behaviors.

D. Environmental Issues and Constraints Impacting the Situation

The customer lives in a area in which she'd consider the "ghetto. " Consumer lives with her mother, although the relationship is unstable. Children with a very insecure attachment to their mothers are much more likely than other children to reside in high-risk young families and conditions (Kwako, Knoll, Putnam, & Trickett, 2010). Your client has experienced sexual, physical, and verbal maltreatment from her caregivers. DARK-COLORED young families experience higher rates of poverty than groups of other races. Living in poverty increases the risk of exposure to trauma and stress is found more often in DARK-COLORED populations (Graves, Kaslow, & Frabutt, 2010). The client's turbulent home environment, unsafe community, and insufficient social works with and resources exacerbates client's distrust in others, social isolation, and negative self-concept.

E. Determination and Determination to Services

The client's mom does not support client participating school and would prefer to client take welfare services. Despite the client's mother's insufficient support, your client is motivated to attend school to keep her education and be a positive mother for her children.

F. Worker's Understanding of Client's Presenting Situation/Problem

The customer is a sixteen year old, African-American teenage mom of two. Your client has experienced severe youth sexual injury by her mother and father. The client's two pregnancies are results of erotic misuse from the client's dad. The client lacks mental support from her mom and is often ridiculed by her mother in conditions of her appearance, intellectual performing and overall being. Emotional maltreatment in the connection relationship significantly escalates the likelihood of expanding insecure attachment, which is proven to be linked to low empathy and reciprocity, hostility or aggression and impulsivity, exploitation or ridicule by peers, interpersonal withdrawal or exclusion from group activities, and standard habits of un-relatedness and isolation (Riggs, 2010).

The customer lacks any kind of communal support from peers and, quite often, connections with peers lead to hostile confrontation. Client's distrust in peers and people is evidenced by insufficient nurturing human relationships. Up up to now, client hasn't seen community resources. Earlier experience with racism frequently prevents African People in the usa from accessing assistance and/or services from organizations which historically have safeguarded Caucasians (Graves, Kaslow, & Frabutt, 2010). Client's mom is distrusting of community companies which may lead to client's inability to gain access to support.

According to attachment theory, a child forms representational models, i. e. , internal working models, of attachment information, of the do it yourself, and of self-in-relation to others based on their relationship with principal caregivers. When a child's caregiver responds in a very sensitive, loving, and constant manner, an operating model of "other" as loving, reliable, and supportive is internalized. Alternatively, experiencing emotional abuse and disregard may instill harming beliefs about the self applied, e. g. , "I am stupid, " "I am not worthy of attention, " which may cause maladaptive types of home, other, and self in-relation to others. Instead of developing a working style of the self applied as worthy of love and attention, negative types of the do it yourself as worthless, incompetent, or powerless may direct result (Wright, Crawford, & Castillo, 2009). Due to the client's mother's unpredictable and inconsistent caregiving habits, client is rolling out a low concept of do it yourself, as evidenced by the client's emotions of unworthiness to obtain or accept any type of relationships.

Although your client has experienced severe youth trauma, insecure parts with caregivers, and family and community instability, your client appears to be moderately resilient. Resilience identifies habits of positive version during or pursuing major adversity or risk (Lopez & Snyder, 2011). Confronted with two pregnancies, unsupportive and abusive caregivers, and insufficient social support, your client continues to be motivated to go after her education, regain guardianship of her first child, and become a caring and loving mom to her children.

III. Evidenced Structured Practice Search

This author started the search using the Yahoo Scholar search engine with the term 'psychodynamic treatment for feminine African American children of sexual maltreatment. ' This search yielded articles related to interventions for drug abuse. The same key phrase was used again but the term treatment was exchanged for the word treatment. This search yielded articles on cognitive behavioral interventions. This creator then transferred to using the internet search engine PsyhInfo. Conditions including psychodynamic treatment, psychodynamic involvement, DARK-COLORED, adolescent and erotic abuse were again interchanged to aide in the search. This author then added the term 'sexual misuse survivor' to the search. This search started to produce interventions related to psychodynamic interventions. This writer started finding articles related to psychodynamic organizations as a psychodynamic intervention.

Continuing to use the PsychInfo internet search engine, this publisher then used search conditions psychodynamic groups, adolescents, sexual abuse survivor and African American. This author was able to produce articles related to psychodynamic groupings. This publisher then transferred to using the School of Southern California Library to keep the search. This publisher again used the terms psychodynamic groups, adolescents, sexual maltreatment survivor and African American to yield further articles in regards to psychodynamic organizations. This author was able to collect six articles in regards to psychodynamic group involvement. Overall, this author found it extremely difficult to acquire, in the literature, psychodynamic interventions specific to DARK-COLORED adolescents who have experienced sexual abuse.

IV. Treatment Plan

In the first years of child years, the family is in charge of the attention and development of the child. In healthy people, children learn they can depend of their environment to provide emotional security and physical safe practices. Children then gain habits which allow them to nurture their own mental and physical health clear of parents or caregivers. Illness also can develop early on in life. Children who live in households with characteristics such as family conflict, i. e. , frequent episodes of anger or hostility, and lack of nurturing, i. e. , human relationships which are wintry, unsupportive, and neglectful, can have negative consequences on mental and physical health (Repetti, Taylor, & Seeman, 2002). Alas, credited to client's exposure to an abusive and un-nurturing environment, she's developed poor mental health, as seen by her moderate level of defense mechanisms, poor self-concept and insufficient support.

Due to the client's insecure connection with caregivers, which includes led to insufficient support and untrusting dynamics to others, the involvement used will be psychodynamic group psychotherapy. Due to client's early age, client could be more well suited for time limited psychodynamic group psychotherapy, which occurs between twelve and thirty lessons (Smart, 2009). The format used for psychodynamic group psychotherapy is verbal. The basis of the group ought to be to feel and speak, rather than work. Since it is a psychodynamic therapy, the therapist should await the group interactions to occur readily and then comment when appropriate (Good, 2009). During the procedure for psychodynamic group psychotherapy, the therapist will try out not to establish agendas but follow the suggestions of the group. The perception is the group process will eventually lead to the most psychologically charged topics if permitted to carry on without interruption. The therapist in the psychodynamic group psychotherapy program will focus on the group and individual members based how the session starts (Rutan, 1992).

The implementation of the psychodynamic group psychotherapy intervention is community based mostly, therefore the consumer should gain access to community organizations to utilize the treatment treatment. As previously observed, the client has not reached community resources so far. Another hurdle the client must overcome in order to maximize maximum results from the psychodynamic group psychotherapy treatment is a proper match to therapist leading the group and contribution. Because customer is untrusting of other others it may be difficult to activate consumer in group psychotherapy process. A therapist who creates an environment of approval, understanding and trust, and provides empathy and responsiveness will have a better potential for keeping and engaging challenging associates (Gans & Counselman, 2010).

The goal of psychodynamic group psychotherapy is to make aware parts of the unconscious which bring about negative distortions in present day perceptions (Rutan, 1992). Furthermore, goals of treatment are to aid in overcoming level of resistance to experiencing, expressing and understanding emotion. The psychodynamic group psychotherapy model allows for resolving the tension between suppression of emotions and explosiveness. The group format also permits members to interact to control and contain thoughts (Wise, 2009). This aspect of psychodynamic group psychotherapy will be good for client, as she's difficulty expressing her feelings, as evidenced by hostility towards peers. Although your client will gain mental regulation skills through the psychodynamic group psychotherapy intervention, this will never be her main treatment goal.

Psychodynamic group psychotherapy is also another way for individuals to have interaction within a system of relationships. This is beneficial due to many presenting problems having a relational framework. Allowing individuals to have interaction and then mirror gives the specific the chance to use the group as a place to observe and change patterns (Smart, 2009). Your client has portrayed a desire to have safe, nurturing and adoring romantic relationships with others, but scheduled to low self-concept will not feel worth such relationships. The client's goal for psychodynamic group psychotherapy is to increase variety of quality connections from zero to at least two by the conclusion of the group classes. The client's romantic relationships will be assessed by her own self-report, as well as therapist observations of her relationships and romantic relationships with fellow customers of the group and development of social skills.

The catalyst for change in psychodynamic group psychotherapy includes change by imitation, i. e, learning by observing others, id, i. e. , unconsciously dealing with characteristics or characteristics of others, and internalization. The healing process grows using confrontation, explanation, interpretation and working through (Good, 2009). Also, other healing aspects that happen to be attended to include support, self-revelation, learning, and self-understanding, with social learning as the utmost important (Smart, 2009). As the client is rolling out negative internal working models, due to insecure connection with caregivers, i. e. mother and father, the connections with others in the group environment may begin to aid client in expanding higher self-concept and more nurturing connections.

V. Discussion, Research and Rationale for Interventions Chosen

Psychodynamic group psychotherapy was chosen as the intervention for your client anticipated to her connection with sexual maltreatment by caregivers. Time limited, as well as ongoing psychodynamic group psychotherapy has been effective in dealing with women with a brief history of sexual misuse, due to the chance for the individual to reduce the emotions of isolation, guilt, and pity. An individual is able to effectively sort out feelings when the individual can share their experience in a therapeutic environment comprised of compassion and popularity. The psychodynamic group psychotherapy process has an individual having the ability to add a new subject experience without devaluation or ridicule, while at the same time abandoning previous parts which were from the original event and feelings (Nusbaum, 2000).

When an individual is abused, the individual tends to identify with the unloving, competitive, and immoral characteristics of the superego rather than the gentle, adoring and protective characteristics. The individual may interpret the caregivers inability to nurture and protect properly as an indicator they are really unworthy and unlovable (Nusbaum, 2010). Proof these characteristics can be seen in the client's low self-concept and thoughts of unworthiness to possess any kind of relationship. Within the psychodynamic group psychotherapy process, the group can demonstrate appropriate levels of protectiveness, love and concern to its participants. Negative thoughts often experienced by people with sexual abuse can frequently be eased through disclosure of the distressing experience. The group may then provide corrective superego functions by not allowing its users to blame themselves for the knowledge, which might have been inevitable rather than their problem (Nusbaum, 2000).

Psychodynamic group psychotherapy also deepens the alliance between group people and facilitates the development of relationships that can be observed and analyzed in the context of interpersonal anxieties and roadblocks. Furthermore, in psychodynamic group psychotherapy individuals can identify interpersonal conflicts and work through primary defense set ups which can be run by doubts of trusting. Additionally, because mistreatment and neglect have a tendency to appear in dysfunctional young families, by successfully working through psychological discord the psychodynamic group offers the ability for social learning and development of public skills, which are usually not modeled in dysfunctional homes (Nusbaum, 2000).

This author struggles to put into practice the psychodynamic group psychotherapy intervention with your client but can visualize how the treatment would unfold with your client. Within the first consultations this creator would try to make a trusting, nurturing and protected climate where consumer would feel she could take part in the group process and talk about personal experience. Relating to psychodynamic theory, personality is created developmentally. In such a model each stage of development builds on the prior level and each level affects the following one. It's important to notice in the healing process, flaws in preceding developmental phases can be corrected if that stage can be recalled, relieved and be affectively re-experienced and corrected in the here and today (Rutan, 1992). It'll be pivotal for the client's treatment on her behalf to share feelings, emotions and earlier experiences in order facilitate positive transformation.

This creator would predict the client would be difficult to activate initially due to her mistrust in others and thoughts of unworthiness. After regular nurturing, recognizing, trusting and safe experience in the psychodynamic group, this writer would see the client begin to engage in the group process. After the client begins to talk about personal experiences, thoughts and thoughts this author would start using a specific involvement, the here and now. The here and now technique would allow this author to use the client's previous experience to comprehend and explain situations when she unconsciously repeats days gone by or misperceives the present based on what she has learned in the past (Rutan, 1992). This system allows self-learning and self-understanding when it comes to how her past abuse and neglect as afflicted her current human relationships.

This author needs transference will probably surface in the therapeutic process with your client. Transference can be defined as the misrepresentation of present subject relationships on the basis of early object connections (Rutan, 1992). Transference will be beneficial in the therapeutic process with your client. It will allow for this author to assemble information and explore the nature of early romantic relationships predicated on the characteristics the client transfers to this creator (Rutan, 1992).

Through the psychodynamic group psychotherapy process the client's main goal will to be to create quality, nurturing and trusting connections. Relationships are important in creating personality, creating psychopathology, and treating psychiatric symptoms. As individuals develop in the psychodynamic group they can be forming important romantic relationships and, while doing so, every part with their character is growing. Individuals reveal their defense mechanisms and transferences while, in turn, receiving opinions from the therapist and other people. There may well not be another healing process where a lot data is open to a person about themselves as with psychodynamic group psychotherapy (Rutan, 1992).

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