In the following module/week, respond to at least two classmates threads. In your replies, extend the discussion by analyzing and building upon your peers ideas, asking relevant questions as needed.
Module 1 Will, Respond to
Was Will in denial of depressed mood? Should Wills lack of acceptance of depression as a diagnosis have been confronted more aggressively? Would antidepressant medication have benefited Will?
From my understanding, I can see Will having a depressed mood, though I do not interpret him as being clinically depressed. Will had many things in his life to be devastated by or distressed about including when the tribal members were provided a cash payout and were officially declared no longer being Indians/First nations (Sue, 2014, p. 22). Due to this significant life event, he reported that There were many deaths- they say from disease, but I know better; it was sadness and loss (Sue, 2014, p. 22) Their tribes way of living was completely disrupted, uprooted, and tossed aside by the federal government. Will suppressed these emotions through maladaptive coping via alcohol because he felt after this incident specifically occurred that his identity was lost (Sue, 2014, p.22). He was processing an identity crisis. According to the National Association of Social Work (2017), it is necessary for any provider to ensure they are educated in the culture of the clients they are providing services too. Joseph Stone ensured that he met this competency by providing services and gaining trust from the tribes for 17 years.
I do not feel as if a different form of treatment from the therapist would have been effective. Joseph Stone, a Blackfeet tribal member allowed Will to take charge in his treatment and start wherever he felt comfortable. This began with discussing differences in traditions and ceremonies which ultimately after these discussions appeared to build positive rapport and a strong therapeutic relationship with Will. A more aggressive form of confrontation or aggression towards trying to treat clinical depression would appear to be detrimental to Will. Joseph Stone explains that when a tribal member needs assistance, it is common for them to look towards Native Workers instead of an outside source because most individuals are trained in Euro-American and Westernized methods (Sue, 2014, p. 26). These methods would be detrimental when working with a culture that has had trends of trauma associated with western culture.
It is plausible that medication could have helped Will- though due to his culture I dont believe it would be as effective as his culture strongly feels they are separate from a white man (Sue, 2014, p. 23). According to Nasreen (2018), due to the shortage of mental health services to Indigenous people, western forms of treatment are provided, though ineffective because providers fail to integrate holistic methods; therefore, many either discontinue treatment or do not engage at all (p. 466).
Will throughout his time in treatment did not focus on the grieving part of dying, but the spiritual side of joining his wife in the spirit world. What was more effective than medication for Wills treatment was having a culturally competent practitioner who understood the culture Will was coming from where Will learned from Joseph Stone and Joseph Stone learned from Will. Mr. Stone also learned a specific ceremony that Will requested he conduct after he moved to the spirit world. To have the willingness and ability to carry this duty out is powerful, as well as practicing it prior to his death.
Joseph Stone was able to embody through his relationship with Will Galatians 6:2 Carry each others burdens, and in this way you will fulfill the law(New International Version, 2011). Joseph journeyed alongside Will during his life on this world, learned about his story, and walked the rest of his life with him until he moved on to the spirit world. That was more powerful than any medication Will could have taken.
References
Bible Gateway Passage: Galatians 6 – New international version. (2011). Bible Gateway. https://www.biblegateway.com/passage/?search=Galatians+6&version=NIV
Nasreen, S., Brar, R., Brar, S., Maltby, A., & Wilk, P. (2018). Are Indigenous Determinants of Health Associated with Self-Reported Health Professional-Diagnosed Anxiety Disorders Among Canadian First Nations Adults?: Findings from the 2012 Aboriginal Peoples Survey. Community Mental Health Journal, 54(4), 460-468. http://dx.doi.org.ezproxy.liberty.edu/10.1007/s10597-017-0165-0
National Association of Social Workers. (2017). Code of ethics of the National Association of Social Workers. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
Sue, D. W., Gallardo, M. E., & Neville, H. A. (2014). Case studies in multicultural counseling & therapy. Hoboken, NJ: John Wiley & Sons. ISBN: 9781118487556.
Was the counselors decision to spend time with Will outside of therapy a problem? Was it culturally responsive? Was it unethical?
From a western standpoint, meeting Will outside of therapy could be considered a problem due to the ethical boundaries of dual relationships. According to the National Association of Social Workers (2017), social workers ¦ must not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm. Joseph Stone integrated himself in the First Nations and learned what was culturally appropriate, including discussing tribal traditions and ceremonies. By attending the event outside of therapy, Mr. Stone continued to affirm the positive therapeutic alliance he had built with Will, whereas it could have been seen as disrespectful if he did not attend.
Any form of western approach to trying to treat Will would have been ineffective because of the cultural barriers between First Nations relatives and colliding system issues. Mr. Stone recognized that he needed to do two-eyed seeing, meaning that he saw through First Nations traditions and culture through one eye and Western culture through the other (Hall, 2015, p. 2). By providing culturally competent services with the understanding of both cultures, Mr. Stone was able to make an educated decision of spending time with Will outside of therapy.
References
Hall, L., Dell, C. A., Fornssler, B., Hopkins, C., Mushquash, C., & Rowan, M. (2015). Research as Cultural Renewal: Applying Two-Eyed Seeing in a Research Project about Cultural Interventions in First Nations Addictions Treatment. International indigenous policy journal, 6(2), 115. https://doi.org/10.18584/iipj.2015.6.2.4
National Association of Social Workers. (2017). Code of ethics of the National Association of Social Workers. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
2nd Response
In the following module/week, respond to at least two classmates threads. In your replies, extend the discussion by analyzing and building upon your peers ideas, asking relevant questions as needed.
Module 1: Donna
I chose to discuss Donnas case study, a 17-year-old Cambodian American (Asian descent) female presented to therapy to address her aggressive and defiant behaviors in school for getting into numerous fights and multiple suspensions. This case spoke to me, as one of the aspects of counseling that I want to focus on is adolescent behavioral health. As a quick synopsis of Donnas case: lived with her lesbian mother, a single-parent household, and had no real connection with her mother or father, failing school, risky sexual behaviors, defiant/aggressive behaviors, a troubled teen. Donna had challenges with identifying where she fits in, acceptance.
Q1. What types of countertransference might you have when working with someone similar to Donna.
-When Donna initially started therapy, she was apprehensive and challenging. She could not understand how her behaviors could contribute to much of the dynamics occurring in her life. She boasted on her defiant behaviors and promiscuity as if they could be a badge of honor. Although some may view the attitudes as closed-off, rebellious, and carefree, counseling a client similar to Donna, during the session, the types of countertransferences I might have are either concordant or complementary. The emotions of sympathy and compassion are natural and would be my initial reaction. I identify with the clients feelings and life dynamics because of my past; I know the hurt. Because I can automatically relate to the pain, I would unconsciously identify it as a defensive mechanism, assuming a silent cry for help. However, possibly allowing some of my clients stories to trigger personal emotions from my past, I would be exampling the concordant type of countertransference. An example of complementary countertransference would be me as a mother of daughters or the passion for empowering troubled young women, seeing my client as one of those significant persons/people vs. the individual client. Countertransference signs of being aware during sessions would be offering advice; imposing my experiences, and listening to respond vs. listening to understand my clients message is inadvertently trying to convey.
Freud was against countertransference as something to be avoided during treatment sessions, leading to an unsuccessful session and risks for unclear boundary lines. However, in todays time, countertransference could be a technique used to treat my client better. Countertransference can have both positive and negative effects on the counseling process. If you use your own feelings as a way of understanding yourself, your client, and the relationship between the two of you, these feelings can be a positive and healing force. Countertransference becomes problematic when it is not acknowledged, understood, monitored, and managed (Corey, 2018).
2. What are some of the ways in which Donna departs from the model minority myth?
– Unfortunately, people are often pre-judged based on their demographics. These stereotypical views or myths of a person based on ethnicity does not allow individuality and can be dangerous in counseling and therapy. In my opinion, the Therapist, if not careful, can pre-judge, not seeing the clients initial struggles for trying to make one fit into a cultural mold.
Donnas case, as an Asian American, her culture is viewed as the model culture. As the writer points out in Donna’s case study review, the Asian culture exemplifies academically sound, most adjusting, self-respectful/prideful, and hard-working. It captures the family dynamic as a traditional one with both parents in the home. (Sue et al., 2014). Donna defies that myth in various ways:
1. Myth- academically sound: Donnas grades are failing, noted as an academic failure.
2. Myth-hard working: Donna believed that she could independently take care of herself through doing small-time modeling.
3. Myth- most adjusting of societal issues: Donna could not accept her mothers lesbianism
4. Myth- self respectful/prideful- Donna exhibited low self-awareness or self-respect as she continually bragged on her sexual escapades with both males and females; participating in risky sexual behaviors
5. Myth- family dynamics- Donna was the product of a single-parent home with little to no connection with her father.
Sadly, the misconceptions of cultures lead to mental health and depression issues, especially in Asian adolescents. One of the leading causes of mental health struggles among Asian American students is the pressure to adhere to the traditional values that prevent them from expressing their social and psychological difficulties (Cress & Ikeda, 2003 as cited in Panelo, 2010).
As a Christian counselor, its important to remember that we are all created in Gods image, fearfully and wonderfully made, emulating his principles. More importantly, as a reminder from the biblical verse 1 Samuel 16:7, But the LORD said unto Samuel, Look not on his countenance, or on the height of his stature; because I have refused him: for the LORD seeth not as man seeth; for man looketh on the outward appearance, but the LORD looketh on the heart. (King James Bible, 2017).
References
Corey, Gerald. The Art of Integrative Counseling, American Counseling Association, 2018. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/liberty/detail.action?docID=5491630.
Cress, C. M., & Ikeda, E. K. (2003). Distress under duress: The relationship between campus climate and depression in Asian college students. NASPA Journal, 40(2), 74-97
King James Bible. (2017). King James Bible Online. https://www.kingjamesbibleonline.org/ (Original work published 1769).
Panelo, Nathan (2010) The Model Minority: Asian American Students and the Relationships Between Acculturation to Western Values, Family Pressures and Mental Health Concerns. The Vermont Connection, 31(16). https://scholarworks.uvm.edu/cgi/viewcontent.cgi?article=1101&context=tvc
Sue et al. (2014) Case Studies in Multicultural Counseling and Therapy. John Wiley & Sons.
