John's Recurrent Depression: A Perfectionist's Undue Burden - Essay Sample

Introduction

The depression that Mr John is currently suffering from is a recurrent one that was initially triggered by the excess university workload due to a lack of assistance from his colleagues because he did not want it. John thought he was a professional in the field of education, so he was trying to be a perfectionist. The condition was also accelerated by unpleasant experiences at work. He felt undervalued, unrecognized, and unappreciated despite his dedication to the university. He, therefore, resorted to drinking as a remedy of curbing the stress he had and preferred his own company, if not that of his few friends whom he rarely spend time with. Even after treatment and taking prescriptions of antidepressants, John fell sick for the second time.

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Many possibilities could have led to the illness of John for the second time. First, John could have resumed work at the university without fully recovering from the previous sickness. Secondly, he could have failed to adhere to the prescription of the antidepressants during the recovery period from his first illness. The third possibility is that Cognitive Behavioral Therapy (CBT) was not the appropriate intervention to ensure his permanent recovery from the initial sickness. Fourthly, the therapist could have administered CBT to John inappropriately; otherwise, he would have been cured. Lastly, the very same staff environment at the university could have triggered his second sickness since he could have begun to experience unpleasant things like before. He now thinks that he should be counselled again to recover fully.

The current counselling to be administered to John has significant concerns on his personal, empowerment, social, and vocational issues, and practitioners of counselling work in their areas of specialization and expertise. These areas could be inclusive of inter and intrapersonal regions about age, employment, marriage and family issues, psychological health, rehabilitation, and adjustments of school or college (Kaeding et al., 2017). The professionals in the field of counselling should be individuals who function within the range of normality. The concerns of John as a client could be related to his situational, adjustment, or development problems that deserve an intervention that is short-termed. The client could, therefore, be stuck and not sick. He may, at times, require information but often solicit for the manner of clarifying and putting into use the information that he already has. Currently, counselling has a place in a setting that is structured since it is a theory. Counsellors refer to a given set of philosophies and operate in a structured environment, like the setting of an office with different families, groups, and individuals.

The theories of counselling psychology that encompass its profession are the Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Approach (CBA), among others. These two theories have both developed and improved over time, from the ancient counselling psychology that was general and mainly focused on the changes of the society depending on the responses of the people (Ternstrom et al., 2017). These theories developed from those ancient ones like humanistic reform and based their legitimacy on the value of human beings. The Theory of Acceptance and Commitment Therapy is a is a behavioural therapy that is characterized by the orientation of the mind, and uses the humanistic and eclectic approach to aid individuals to fight and overcome their problems (Delgadillo et al., 2020). Its origin of development was in the contextualism of function in the Relation Frame Theory (RFT) and gradually developed into providing wholesome assistance to people from all calibres of life. ACT admits that abnormality forms a part of the psyche in people and primarily emphasizes their change via acceptance. The aspect of interventions and techniques in ACT develops flexibility in psychology or plasticity of the mind, which results in positive deeds and choices of life.

According to the theorists, ACT displays many struggles of humankind that result in the Fusion of thoughts, Evaluation of experiences, Avoidance of thoughts and actions, as well as reasoning, all whose acronym is F-E-A-R. Thus, they are fear factors (Williams et al., 2019). ACT, therefore, helps with the reconstruction of the ways that humans think. On the other hand, Cognitive Behavioral Therapy (CBT) is a theory of counselling psychology whose intention is to lower psychological dysfunction and distress. It addresses and explores how the integrated thoughts of the service users' behaviours and feelings contribute to the presentation of the problem. CBT operates under the assumption that behaviours and emotions mediate thinking, faulty cognitions cause psychological dysfunction and distress, and that modifications of wrong behaviours and cognitions alleviate mental dysfunction and suffering (Ternstrom et al., 2017). CBT focuses on modifying and replacing distorted or faulty thoughts, actions, and feelings that exist, with more pleasant and positive ones that facilitate the reduction of the problem that presents itself.

Assessing, intervening, and evaluating stages are involved in the process of implementing the practice of CBT. Assessment entails the joint exploration with the users of the service based on how their feelings, thoughts, and behaviours lead to the occurrence of the presenting problem about intensity, frequency, and duration (Gross et al., 2018). The assessment stage usually applies the model of A-B-C. It calls for the users of service in the exploration of A-the activating occurrence, B-the system of their belief or attitude relating to the event, and C-the consequences as they are in their reactions in terms of emotions or behaviour (Williams et al., 2019). The stage of assessment shows the kind of intervention to be chosen concerning feelings, thoughts, or behaviours that are the intention of change. Interventions of that kind could involve the restructuring of cognition, techniques of relaxing, training of social skills, training of assertion and skills of solving problems, systematic desensitization, as well as modelling, playing of roles, and reinforcement (Delgadillo et al., 2020). The stage of Evaluation acts as the opportunity of coming up with possible changes that have happened in the behaviours and feelings, frequency, intensity, and duration of thoughts and how far the presentation of the problem has reduced into becoming post-intervention from pre-intervention.

The Assessment of John’s Second-Time Sickness From the Cognitive Behavioral Therapy Intervention

According to the case study of John, who is a young overworked and undervalued lecturer at the local university, the ultimate therapeutic remedy that could see his problem solved permanently could be sourced from the application of ACT in his second time counselling rather than the application of CBT that has failed in ensuring permanent healing of John during his first treatment. The Acceptance and Commitment Therapy could be of great help to John because his problem revolves around the F-E-A-R factors. He is experiencing a fusion of thoughts in the sense that he is a professional in the field of education. A factor that makes him think that he is a perfectionist and does not need the help of his senior colleagues with his everyday workload. He resorts to drinking as a way of relieving himself from the daily workload fatigue. He also thinks he is not recognized and appreciated for his everyday hard word work. ACT is appropriate for John because it relates to the Evaluation of experiences that could see John counselled for the weird experiences that he goes through every day. He experienced unworthiness among his colleagues while at work. Avoidance of actions and thoughts is another aspect of F-E-A-R that could see John counselled about his daily haunting thoughts at the environment of work. The feeling of being inferior is also an aspect of F-E-A-R. Applying ACT in his counselling would also help in rectifying the contrary reasoning about his work environment. He reasons that he is a perfectionist who does not need the help of his colleagues; thus, he ever feels no change in the system of the local university.

Cognitive Behavioral Therapy (CBT) could not help burying John's depression for good, despite being employed on him for the first time as a therapeutic intervention. Applying CBT for the second time in the encounter of counselling, John, would not guarantee his permanent recovery since it could not aid his full recovery in his first treatment. There can, however, be doubts that the therapeutic psychologist that applied it to him was either unexperienced or did not apply the technique appropriately. CBT on clients bases on the assumption that emotions and behaviours are by thinking, dysfunction, and distress. Thoughts psychologically facilitate it, and that the alleviation of psychological dysfunction and suffering is through modifying faulty thoughts and behaviours (Gross et al., 2081). John's depression is with a lot of views based on how he thinks that he is a young, hardworking, dedicated, and a perfectionist whose efforts are undervalued by his colleagues. CBT addresses this problem in its first assumption, though it could not help in healing him. He is also experiencing negative thoughts about the university. It is the same way it was when he was going for early treatment. Thus, making the faulty cognitions that have contributed to his psychological dysfunction and distress, according to the second assumption of CBT. The third assumption of CBT is also portrayed in John's story as his job-related stress leads him into drinking a lot and preferring his lonely company, his continued depression. The better part of CBT, therefore, addresses the problems that John has, yet it could not guarantee his full recovery. Thus, CBT is the wrong therapeutic choice to be involved in the counselling of John for his second-time recovery.

From the history of John, it is, therefore, quite evident that he is suffering from the problem of Job Stress. The illness has symptoms of loneliness, fatigue, and at times characterized by autism and improperness of being an introvert. It is also characterized by negative thoughts about others, emotions like fear, and may lead to behaviours like drinking or too much sleep. Job Stress may also lead to overworking and, at times, inappropriate quietness, or even suicide. It could also cause health effects like obesity, hypertension, or heart attack due to a lack of outdoor activities like exercise.

Diagnosis and Critical Evaluation of the Acceptance and Commitment Therapy in the Psychological Counselling of John

Acceptance and Commitment Therapy would effectively help in remedying John's psychological disequilibrium, which is the disorder of Job Stress. ACT involves the employment of counselling skills pegged with the self-observation, moment awareness by the client's receptiveness and openness, acceptance of emotions and thoughts, as well as diffusion of ideas, which involves the development of feelings and thoughts in a manner that reflects accurate awareness. The main cause of John's condition is his working environment and any other aspect that is related to his job. The main problem to focus on to ensure his full healing is primarily his job and every aspect of it since it is the source of his stress. The application of ACT as a therapeutic intervention in counselling John will work best towards coaching him about the art of working together to prevent him from overworking. It will reduce his job stress. For him to work together successfully with his colleagues, he should make friends with them and ever feel free to ask for their a...