Using the case study provided, demonstrate how you would work with the client using therapeutic strategies from your text. You must use three different therapeutic models with the client.
For each therapeutic approach you select for your paper:
Case Study: Karen
Karen is a 30-year-old Asian-American who works as a banker. She is struggling with value conflicts pertaining to her religion, culture, and gender-role expectations. Throughout her life, Karen has identified herself as a "good Catholic" who has not questioned much of her upbringing. She has never really seen herself as an independent woman; in many ways she feels like a child, one who is strongly seeking approval and directions from those whom she considers authorities. Karen tells you that in her culture she was taught to respect and honor her parents, teachers, priests, and other elders. Karen feels overwhelmed by the demands of life. Despite receiving several promotions at work, she feels disappointed in herself and fears she has not met her parents' expectations. Karen is questioning whether she has chosen the right career path. She feels a woman with her personality may not be considered for further advancement at the bank.
Karen is the second of three siblings. As a child, she felt she had to compete for her parents' attention. In high school, her older brother was a highly accomplished athlete and her younger sister was quite popular and well liked. Karen, who was an average student, often felt she was in her siblings' shadow. While her parents never stated they were disappointed in her, Karen routinely felt like the least successful person in the family. She also believed that her mother overly stressed the importance of marrying a successful individual while simultaneously encouraging Karen to be independent and to excel at whatever she attempted. If Karen or her siblings expressed a lack of interest in certain school or family activities, her mother would use guilt to motivate them.
Whenever Karen tries to assert her own will, if it differs from the expectations of any authority figure, she experiences guilt and self-doubt. She went to Catholic schools, including college, and she has followed the morals and teachings of her church very closely. She has not been married, nor has she even had a long-tenn relationship with a man. Karen would like to get married and start a family, but she believes she can not find a partner who meets her criteria for a mate. Karen has not had sexual intercourse, not because she has not wanted to, but because she is afraid that she could not live with herself and her guilt. She feels very restricted by the codes she lives by, and in many ways she sees them as rigid and unrealistic. Yet she is frightened of breaking away from what she was taught, even though she is seriously questioning much of its validity and is aware that her views on morality are growing more and more divergent from those that she at one time accepted.
Basically, Karen asks: "What if I am wrong? Who am I to decide what is moral and immoral? I've always been taught that morals are clear-cut and do not allow for individual conveniences. I find it difficult to accept many of the teachings of my church, but I'm not able to really leave behind those notions that I don't accept. What if there is a hell, and I'll be damned forever if I follow my own path? What if I discover that I 'go wild' and then lose any measure of self-respect? Will I be able to live with my guilt if I don't follow the morality I've been taught?"
Karen is also struggling with the impact of cultural restraints on her view of what it means to be a woman. Generally, she sees herself as being dependent, unassertive, fearful of those in authority, emotionally reserved, socially inhibited, and unable to make decisions about her life. Although she thinks that she would like to be more assertive and would like to feel freer to be herself around people, she is highly self-conscious and whenever she considers acting against her upbringing, she can hear her mother's voice scolding her and telling her how she should and should not behave. She wishes she could be different in some important respects, but she wonders if she is strong enough to swim against what she has learned from her culture, her parents, and her church.
Karen says she would like to learn how to frust herself and, in essence, have the courage to know her convictions and live by them. At the same time, she feels unable to act on her values for fear that she will be wrong.
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