critically evaluate client Lois using either a reality or family systems approach. Make sure you address:
The strengths and limitations to using this approach with this client
The specific cultural/gender/age issues that need to be attended to with this client
The ethical or legal issues that need to be attended to with this client
The overall therapeutic goal with this client
How you would proceed with this client:
How would you begin?
What would be the goals of therapy?
What specific strategies and/or techniques might you use?
* Please include an introduction and a summary conclusion
Reality therapy is being selected to evaluate the case of Lois, a Hispanic female who presents in therapy with several problems including a history of substance abuse. Reality therapy is focused on helping clients to make alternate choices to replace destructive behaviors. Lois has developed a psychological dependence on others around her, and is now experiencing feelings of abandonment, hopelessness and despair in response to event changes in her life. Reality Therapy emphasizes choice-making in which the clients make value judgments and become responsible for their own behavior. The assumption is held that change is not possible if the client does not examine his or her behavior and recognize the destructive pattern.
(a) Critically evaluate client Lois using either a reality or family systems approach.
Reality therapy holds that individuals must assume responsibility in efforts to meet their needs. The basic premise underlying reality therapy is that individuals must learn to face reality, and understand that the key to happiness is through the acceptance of that responsibility. Using reality therapy with Lois will help her to understand that her failure to take responsibility is contributing to her destructive behavior (e.g., her substance abuse, her willingness to submit to her husband's abuse, etc.). Lois is experiencing several symptoms resulting from psychological dependence. As examples, she feels a sense of despair and loneliness as her daughter goes off to college, and her mother has been diagnosed with dementia. She is being verbally abused by her husband, and she accepts this abuse by making excuses that it is okay, because he is allowing her mother and daughter to live with them. Reality therapy will help Lois to take responsibility for her own life, and not depend on others for her satisfaction in life. In addition, the therapy will show her how to respond to her husband's abuse. Lois will be taught that she has control over this behavior, and during the therapy will be asked to examine whether her behavior is satisfying her needs (i.e. her happiness).
One potential limitation in using reality therapy with Lois is that it only deals with the conscious behaviors. As Corey (2005) describes a limitation in reality therapy, it fails to address repressed conflicts. Since, Lois has had a long history of substance abuse, it is possible that her problems involve ...
This soluton discusses a specific case study from the perspective of Reality Therapy
The Family Systems Approach: Client Evaluation
Name: Lois R. Gender: Female Age: 41
Ethnicity: Hispanic Religion: Catholic
Relationship Status: Married
Description of Presenting Issue:
Lois heard you give a talk on abuse and called for an appointment the next day. She said your talk made her realize that she may be experiencing abuse, and she would like your help in improving her behavior so that her husband won't be so angry with her. Lois has been married to her second husband for three years. When she married, she brought her mother and teenage daughter to live with her new husband. Lois expresses great gratitude toward her husband for allowing her to bring her family with her into his home, and states that he deserves to have the best possible wife because he is so good to her.
Since childhood, Lois has always looked to others to help her and make decisions for her. She cannot tolerate being alone and feels overwhelmed and without direction when she is alone. The focus of her life has always been pleasing and caring for others, asking them to tell her what to do because she feels unable to determine her own direction.
Two major changes occurred in Lois's life a few months after she married. Her daughter left for college and her mother was diagnosed with dementia. Since then, Lois has felt very sad and lonely. Although she has continued her daily activities and responsibilities, she reports having little energy, having even more than her usual difficulty in making even simple decisions, feeling hopeless, and having little interest in eating. Her husband has responded to this by yelling at both Lois and her mother and demanding that they change. Lois has tried to appease him, but his anger has only escalated and she is now afraid that he might hit her.
Occupation History: Lois is currently a homemaker and caretaker to her mother.
Education History: Lois completed high school and two years of college. She wanted to complete her college education, but was unable to due to financial hardship.
Medical History: Lois did not report any medical problems, but she appears to have a curvature of the spine.
Family History: Lois has two sisters, age 44 and 49. Lois's father passed away when she was 11 as a result of a massive heart attack.
Alcohol/Substance Use: During high school, Lois tried a variety of prescription medications and illegal substances (marijuana). She became a heavy drinker during her mid twenties, consuming upwards of 6+ drinks per evening, 5 times per week. At age 29, Lois joined Alcoholics Anonymous. She remains active and sober in the program, attending one meeting per week.
Critically evaluate the client using either a reality or family systems approach. Make sure you address:
- The strengths and limitations to using this approach with this client
- The specific cultural/gender/age issues that need to be attended to with this client
- The ethical or legal issues that need to be attended to with this client
- The overall therapeutic goal with this client
- How you would proceed with this client:
- How would you begin?
- What would be the goals of therapy?
- What specific strategies and/or techniques might you use?