Case Study in Applied Social Sciences

Introduction

In many cases, for a given therapy session to be successful, the therapist has to employ a particular modality or theory that is relevant to a given scenario to help guide them through the treatment process. This is to enable the therapist to get good results from their sessions and ensure their clients have recovered. There is a wide range of theories used in to guide therapists during therapy sessions, but this study will focus on two modalities; cognitive behavioural therapy and Gestalt therapy. For guidance to understand Chelsea’s situation and help her during the recovery process, cognitive behavioural therapy and Gestalt theory were used; this was important as they related to every critical factor that she stated.

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Modalities Used in the Study

Cognitive Behavioural Therapy

Cognitive behavioural therapy (CBT) was employed for this study because it is among the most effective treatment conditions for anxiety cases or depression in some cases. Being a psychological treatment condition, it can be used as an antidepressant for various types of depression as it is useful. CBT is a short-term technique. It takes a maximum of 12 sessions where a patient can meet the therapist both once or twice a week and recommendations are usually examined after every treatment (Twomey & O’Reilly, 2017). Given that the patient, Chelsea, travels a lot and is always busy at work, this is a great approach to take as it will take only a few sessions to help her.

Additionally, from the study, Chelsea is worried about getting married and having children of her own which are affecting how she approaches her romantic relationships, as she is more focused on the end product than on how to build the relationship. This is related to the theory because CBT is built on a concept that a person’s thoughts and feelings have an essential role in their behaviour. Therefore it is always necessary for individuals to observe their thoughts as they might affect their behaviour.

Evidently, Chelsea’s thoughts on marriage and starting a family are clouding her judgment and eventually, affect her behaviour. To help her, it is vital to advise her that, she needs to know that good romantic relationship are built over time, and it is vital for her to try her best not to move into any relationships with higher expectations about them leading to marriage. First, she needs to take her time to be able to realise if her partner is willing to spend the rest of his life with her or if he is there for a given period of time.

During this theory’s application, it is crucial to have different strategies to ensure that therapy is successful. First, it is essential to identify some of the pessimistic thoughts Chelsea has. Determining if a client has negative reviews is crucial when trying to help them recover (Epstein & Baucom, 2002). From the study, the first negative thought Chelsea had, was the claim she had last time when happily babysitting a neighbour’s child while she was still a teenager very long time ago. It is essential to help the patient remember the other times she felt happy, including the times she felt slightly comfortable, then advise her to value those moments that made her feel this way. This will help motivate her to keep pushing and understand that she can still be happy.

Second, the therapist will use CBT to advise Chelsea to start practising a new set of skills which she will then use in real situations to achieve full recovery. An example of a skill she can use is to stop spending a lot of her time at work and consider giving more attention to her boyfriend. This will help build the relationship considering that one of her ex-boyfriends claimed that she focused more on her job than him. Additionally, another CBT strategy to use for the therapy is to advise the client to set some goals. Here, the therapist will help Chelsea set her goals through teaching the different ways she will use to identify a plan then work on it from the start to the end product. For example, the therapist can ask her what she really wants from the information she has provided then work on achieving the set target. Lastly, the therapist can advise the patient on the importance of problem-solving and help her work on different problem-solving skills, for example, she needs first to identify the problem then work on a list of different solutions she can employ.

Gestalt Therapy

Being a type of psychotherapy that focuses on personal responsibility and individual responsibility, this type of therapy was employed for the study because the therapist had to discuss the patient’s personal responsibility. It is evident from the case study that the patient is placing herself in a place where she has a lot of personal obligations, which can be reduced or avoided if she gets the required guidance. The main objective of Gestalt therapy is to help individuals understand the importance of their sensations and the environment they are in to enable them to respond fully to various situations (Perls et al., 1972). Through understanding this, the therapist will help Chelsea be aware of how different significant sensations are for a full recovery.

The theory relates to the study in various ways; for instance, Chelsea has a lot of personal responsibilities that are giving her problems, thereby forcing her to go for therapy. An excellent example of this is that Chelsea gave herself the responsibility to look for a man that is ready to marry her and at the same time, work at her demanding job. For this case, the patient needs to work on her personal responsibilities and minimise them so as to ensure she lives a healthy life and let everything work according to plan. Moreover, Chelsea needs to have a plan on how she will reduce her personal responsibilities and make them achievable, in that she can work on each one to enable change.

During the therapy session, the therapist will make interventions that are guided by the Gestalt theory mechanism to help the patient fully recover and identify some of the strategies that can be used to fulfil target goals. Firstly, an intervention should be made by the therapist is awareness because it helps patients self-regulate in the environment they are in. For Chelsea’s case, she lacked awareness because she was still preoccupied in her past. This is evident because she states that the only time she was happy was when she was a teenager, and during the time she was a nanny in a remote area. Therefore, it is essential to advise her that she needs to focus more on the present and the future, but less on the past. Gestalt theory focusing more on here and now, a therapist can use this to help patients stop relying on the past as it does not allow individual development.

Secondly, another intervention that can be used is the use of an empty chair. This being a Gestalt therapy, an empty chair can be used in a procedure to ensure a role-taking dialogue mostly between the patient and their personality or others. Usually, two chairs are used where they face each other, and the therapist simply observes the process or takes part by asking questions which the patient is supposed to answer. In this case, Chelsea will be allowed to sit in one chair, and the other will be left empty with an assumption that one of her personalities is seated in it. In this process, the patient is likely to show emotions or conflict; then the therapist will find a way forward. During the session, Chelsea is likely to show some anger issues or feel sad when asked to explain about the last time she thinks she felt happy. This is because she feels that life has not been easy after her previous days of happiness, and she believes that the only way she can be happy again is after having children of her own. The best way to help her solve this can be through advising her that happiness can come from anything and she should not limit herself to having children as the only way to happiness but also try to find other things she loves which will make her feel satisfied afterwards.

The Hypothesis of Key Client Issues

Chelsea has a demanding job that sometimes requires her to work up to 60 hours a week from the case study. Despite this, she states that she enjoys her work because it enables her to interact with individuals who are on a six-figure income, making her feel tremendous but confused at the same time. Moreover, she is worried if that is how she will live for the rest of her life or consider pursuing another career that she is passionate about. Additionally, the client is concerned about how she approaches her romantic relationships because, as she states, none of them has lasted long, which is a concern to her. Moreover, another problem for the client is that she has not been happy for a long time because she felt happy when she was babysitting.

Conclusion

From the discussion, the modality I will choose to use is cognitive behavioural therapy because it is the most relevant for the study as it entails all areas that are covered by Chelsea. Through the use of CBT, the patient is likely to recover because it focuses more on various elements that Chelsea needs to heal. Evidently, by the use of cognitive behavioural therapy, it is easy to help address every issue that Chelsea states as it is more focused on a depressed person and people having problems like the one the client has. Significantly, Gestalt therapy is also relevant for the study because it will help address other areas that cognitive behavioural treatment failed to address. Additionally, the patient’s dilemma on whether she needs to get another job is not discussed by the two modalities because they focused more on the central issues that caused the patient to feel depressed.

References

Epstein, N. B., & Baucom, D. H. (2002). Enhanced cognitive-behavioural therapy for couples: A contextual approach. American Psychological Association. https://www.amazon.com/Enhanced-Cognitive-Behavorial-Therapy-Couples/dp/1557989125.

Peris, F., Hefferline, R. E., & Goodman, P. (1951). Gestalt Therapy, Excitement and Growth in the Human and Personality. http://www.gestalt.org/phgintro.htm

Seligman, L. (2006). Theories of counselling and psychotherapy: Systems, strategies, and skills. Pearson. https://www.pearson.com/us/higher-education/product/Seligman-Theories-of-Counseling-and-Psychotherapy-Systems-Strategies-and-Skills-3rd-Edition/9780135034767.html

Twomey, C., & O’Reilly, G. (2017). Effectiveness of a freely available computerised cognitive behavioural therapy programme (MoodGYM) for depression: Meta-analysis. Australian & New Zealand Journal of Psychiatry, 51(3), 260-269. https://journals.sagepub.com/doi/abs/10.1177/0004867416656258