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Impact of Colonisation on Aboriginal Communities

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Submitted By Brionyl
Words 1761
Pages 8
Title: Assignment 1 Case Formulation
Student Name: Briony Leonard
Student Numbers: U1063496
Examiner: James Brown
Word Count: 1529

Case Introduction The video clip, Feminist Counselling (Mill Valley, CA: Psychotherapy.net, 1997) documents a one to one counselling session between Robin (the client) and her therapist Dr Lenore Walker (Psychotherapy with the Experts). Robin is a 29 year old mother, married, with a two year old son, Cameron. Robin indicated in her initial conversation with Dr Walker that she has attended counselling due to her ‘bond’ that she has developed with her son and how that she feels lost in direction and within herself as an individual. Robin has suggested that she feels that her own self-identity has become less apparent now that she is a mother.
“Where does Robin the individual fit in all of that, because I’m not always going to be a mother’’
As Robin continues her session with Dr Walker, the focus shifts away from her concerns about herself and looks deeper into the relationship she has with her husband Ed, her relationships with her immediate family and also Ed’s family. The focus then shifts back to possible occupational directions for Robin.

Presenting Complaints and Goals Robin initially presents with concern for her self-identity as a person as she discusses that she has solely focused herself on being a mother for the last two years. Robin appears to be lost in her direction as an individual, has a lowered self-esteem and has feelings of being a burden to her husband as she isn’t a financially contributing partner in her marriage. Robin also appears concerned with the pressure to return to work by her partner. Robin discusses some concern about the lack of time she spends alone with her husband, and her husband's beliefs in regards to raising children; “Well you wanted to have Cameron so if we have to go anywhere he comes with us” Robin also voices her concerns regarding Ed’s stereotypical views on the traditional roles that women play. These beliefs appear to be having an impact on Robin’s self-esteem and his behaviour towards her appears to blocking her development and growth as an independent person.
As the conversation continues, Robin discloses her feelings of guilt for not maintaining a clean house, but makes it clear that she is able to vocalise her irritation with her husband; however Robin discloses that she and her husband rarely compromise when it comes to household tasks, family activities or decisions regarding family matters.
Relationship issues with Robin’s mother in law are also existing with Robin voicing that she feels her mother in-law is overbearing, and feels like Ed’s mother has issues with her not being good enough for her son (impacting Robin’s self esteem), as a result Robin, Ed and Cameron do not visit them in Tennessee. (Family break down)

History and Context
Robin grew up in a large family. Her father worked for a large industrial company and also as a pastor for three separate churches. Robin’s family were actively engaged in all aspects of the church. Her childhood was full of activities and she mentions that they were always busy, having to adapt to change on a regular basis.
Robin and her husband Ed met through their local church activities, with Robin doing most of the courting. Their early relationship appeared to be very monotonous, with Robin ultimately discussing with Ed that they either “get married or separate”. It was not long after this discussion that Ed proposed they married shortly after.
During the time before the birth of their first son, Robin was employed in a banking position; she is well educated and holds a bachelor’s degree in business administration. Robin is a self-confessed people pleaser. Robin feels guilty for enjoying staying home with her son Cameron, her social isolation has contributed to poor self-esteem and she states that her Focus of Treatment is to look at how she can re-establish her identity and self-worth.

Assessment and Case Formulation
Robin is seeking to improve her self-worth, self-esteem and rediscover herself as an individual, while defining her role as a wife, mother and contributing citizen in society. Robin’s strengths include her strong faith and link to her church and church community; she has an optimistic view of life and a sense of humour which enables her to see the light side of her problems. Robin is resilient to change; her childhood has provided her with the ability to see the positive opportunities that change can bring and adapt to new situations with ease.
Robin has some positive resources in her network with the church she attends and also the mothers group in which she participates. Her education and banking background also provide her with social and emotional resources, the ability to do several things at once (hold a full time job, maintain a marriage and study). These resources support her ability to challenge herself and to take chances.
Some barriers which may inhibit Robin’s progress could include her husband Ed and his preconceived ideologies of what a woman’s role is within a marriage. Robin’s own trust issues and separation anxiety relating to her son Cameron being left in the care of strangers her also her feelings of her son being a burden on other people (as mentioned at 37:10 minutes in the interview)
There are some indications that Robin is socially isolated (rarely goes out to catch up with friends on her own, attends church on Sundays and once weekly attends a mothers group) and mainly has contact with her husband, mother and the mothers that attend her local church group (in a semi-formal structured activity based gathering). Robin also presents with Relational Problems, in particular intimate partner relationship with her husband Ed, which is having an impact on her mental health – indicators which appear to stem from early childhood – father/mother relationship. Many of these factors indicate that Robin is experiencing a mild degree of stress in her marital and family relations. Robin also displays some traits that could indicate the hypothesis of comorbidity of mild depression (feeling low, low self-esteem, not wanting to maintain every day household duties) and that could indicate mild generalised anxiety disorder (presented with anxious behaviours towards leaving her son with people other than her immediate family).
Another area in which Robin has presented with during her session with Dr Walker includes an indication of V62.29 (Z56.9) Other Problem Related to Employment; her occupational problem (unemployment) is part focus of the clinical attention (DSM IV, Other conditions which may be a focus of clinical attention).
Many of Robin’s concerns and presenting issues could potentially be maintained by the nature of her relationship with her husband, and as a reflection of the relationship between her father and mother she witnessed growing up. Relationship satisfaction can have a direct effect on parenting stress (lower levels of parenting stressors), as well as contributing to the protection of the child – parent relationship where deleterious effects of parental distress can take precedent. (Belsky, Rovine, and Fish, 1989; Goldberg, 1993; Grych and Clark, 1999; Kazui, 1997)

Treatment Plan The treatment plan is built around the presenting concerns/ problems that Robin has raised and Dr Lenore has elicited during the counselling session. The Treatment plan for Robin aims to strengthen her family relationships and increase her self-esteem, self-confidence and communication skills.
Working with Robin to set short and long term goals to address mild depressive thoughts, mild generalized anxiety traits and to increase her ability to communicate her feelings with her husband Ed, this reducing marital stress.
Problem/Symptom: Mild depression as manifested by poor self-esteem, lack of self-identity
Long term goal/objective: Symptoms of depression will be significantly reduced and will no longer interfere with Robin’s functioning. Robin will develop and use positive self-talk.
Robin will develop a positive self-image
Short Term Goals: 1. Robin will become involved in at least one activity fortnightly that is independent from her immediate family 2. Robin will learn to use positive self-talk 3. Robin will
Intervention: Have Robin write 5 positive things about herself (as an individual, not mother or wife)
Problem/Symptom: Mild generalised anxiety disorder as manifested by the inability to leave her son with others, other than her immediate family.

Long term goals/objectives: Symptoms of anxiety will be significantly reduced and no longer interfere with Robin’s functioning and ability to have time to herself.

Short Term Goals 1. Robin to discuss with her friend from church swapping duties to accommodate care. 2. Robin to leave Cameron in the care of her friend once weekly for 2 hours
Intervention: Have Robin write 4 positive reasons for leaving Cameron in the care of her friend.

Problem/Symptom: Relational concerns and mild family conflict as manifested by poor communication between Robin and her husband.

Long term goals/Objectives: Reduce family conflict and increase positive family interactions. Robin will learn skills to cope with stress in an adaptive manner

Short Term Goals 1. Robin will learn healthy communication skills 2. Robin will share positive feelings with others ( namely Ed, her husband) 3. Improve the dysfunctional interpersonal relationship with her husband. Intervention: Have Robin share her positive feelings in therapy sessions.

References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Belsky, J., Rovine, M., and Fish, M. (1989). The developing family system. In M.R Gunnarand and E. Thelen (Eds.), Systems and development: The Minnesota Symposium on Child Psychology, Vol. 22 (pp, 119-166). Hillsdale, NJ: Lawrence Erlbaum Goldberg, W.A. (1993). Marital quality, parental personality and spousal agreement about perceptions and expectations for children. Merrill-Palmer Quarterly, 36, 531-556 Grych, J.H and Clark, R. (1999) Maternal employment and development of the father-infant relationship in the first year. Developmental Psychology, 35, 893 -903 Kazui, M. (1997). The influence of cultural expectations on the mother-child relationship in Japan. Journal of Applied developmental psychology.18, 485-496. Hutchinson, Michael et al (2008).The Clinician’s Guide to Writing Treatment Plans and Progress Notes (5th ed.).Page 13 Perkinson, R.R. (2011). Chemical Dependency Counseling: A Practical Guide: A Practical Guide. SAGE Publications. 5, 75.

Walker, L.(1997) in Psychotherapy with the Experts, 15,Mill Valley, CA: Psychotherapy.net, 48 mins

--------------------------------------------
[ 1 ]. Hutchinson, Michael et al The Clinician’s Guide to Writing Treatment Plans and Progress Notes, page 13, 2008
[ 2 ]. Perkinson,2011, Chapter 5, The Treatment Plan, page 75

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