WOMEN VETERANS WITH PTSD 13
Application:Case of William Final Project
Application:Case of William Final Project
Culturaldiversity characterizes the world we currently live in. Many hundredsof years ago, physical barriers and long distances separatedcommunities from each other. In present world, individuals fromdifferent communities and geographical regions now mingle freely witheach other(Sue & Sue, 2003). Because of this intermingling,multicultural identities and experiences have become a commoncomponent in the lives of many individuals. The cultural diversity inthe modern world has had a significant impact on the counselingpractice. Counselors have to deal with clients presenting complexconcerns with regard to issues surrounding their belonging,acceptance, and identity. Assessment of a client’s identity hasbecome quite difficult for counseling professions. This is due to themixing and overlapping of multiple identities (Cornish et al., 2010).In this paper, I discuss the case of William Thompson and how hismulticultural identities influence the assessment, diagnosis, andtreatment process to include how to best navigate these influences.
TheMulticultural Identities Expressed by William Thompson
Peopleidentify themselves in numerous ways like the individual self, therelational self and the collective self. The individual selfhasto do with one’s personal traits. Besides, the relational selfinvolvesthe relationship a person shares with significant others. On theother hand, a person’s collective selfinvolvesthe person’s membership into a certain social group. Another way inwhich people identify themselves is through their culture. Accordingto Joerchel (2006), cultural identity has to do with how a personshares with a certain section of the population knowledge oftradition or practices and ideas. Multiculturalism arises when anindividual becomes extensively exposed to two or more knowledgetraditions. This exposure allows them to identify themselves withmore than one culture. The idea of an individual being able toidentify with two or more cultures is quite interesting. This isbecause it reflects the ability of human beings to transcend nationaland regional differences.
Adler(2002) points out that the emergence of individuals with multiplecultural identities has been made possible complex interactions. Theinteractions can be broadly categorized into economic, political,social and education interactions. This is the case with WilliamThompson. William’s multicultural identity arises due to thecomplex educational, social and political interactions he experiencedcurrently and in the past. William Thompson is an African-Americanmale. The description automatically identifies him with both theAmerican and African cultures. Furthermore, he is married to aKorean-American lady.Therefore, he identifies with the Korean culture to some extent. William has a military history, where he served as a captain and tookpart in the Iraq War. As a result, he is also familiar with militaryculture. William’s sister-in-law,Rosita, is a Colombian. Zora and Mario, William’s niece and nephewrespectively, are multi-racial. William is also an uncle to Rosita’sand Henry’s adopted child, Jia, who is a Chinese. In summary,William’s family relationships have resulted in an interaction ofmore than one culture (Adler, 2002).
Ingeneral, a large number of individuals are able to identify with morethan one cultural group. This means that the world has become amulticultural place where people easily share their traditions,values and beliefs. Joerchel (2006) states that metropolitan regionshave formed an important place where people from different culturesget to meet and establish multicultural relationships. In his study,which sought to investigate multicultural identities among London’sinner city children, Joerchel reported that parents from twodifferent cultures raise most of these children, as is the case withthe Thompson’s family. The development of multicultural identitiesis facilitated by the metropolitan life. The metropolitan life bringspeople from diverse cultures together just like in the case ofWilliam Thomson. Reitz et al. (2008) also point out the role ofimmigration and visible minority status inthe formationof multicultural individuals. Individuals who migrate to othercountries often bring back with the knowledge of the popular culturesin their host countries. The individuals therefore identify with boththeir foreign and home cultures. Cultural groups considered aminorityare often brought together through their shared minority status. Thislead to individuals with multicultural identities like WilliamThomson a black American married to Korean American wife (Jennipheret al., 2010).
TheSocial Context for William’s Multiple Layers of Identity
Socialfactors that have led to the increased number of individuals withmulticultural identities include intermarriages, friendships andimmigration. Social places such as schools, parks and restaurantsgive an opportunity for people from diverse cultural backgrounds tomeet and even establish lifelong relationships such as marriages. Inthe current world, people from different cultural backgrounds areintermarrying and establishing long-term friendships with each other(Yampolskyet al., 2013).It is no longer a big deal for a white American man to marry anAfrican woman. Apart from that, people who move into foreigncountries are often forced to adapt to the prevailing culture intheir host countries, thereby adopting multicultural identities.
William’ssocial context for his multiple layers of identity includes hisrelationship with Luli Kim, his wife, his military life, his life asan African-American and the relationship he shares with hissister-in-lawand his brother’s children. Having been raised in a black Americanfamily, we can conclude that William is quite familiar with the blackAmerican culture. William’s wife, Luli, is American-Korean, afactor that makes William also identify with the American Koreanculture. The complex relationship William shares with the rest of thefamily is another interesting social context that has resulted in hismultiple layers of identity(Macdonald, 2009). His sister-in-lawis Colombian while his nephew and one niece are multi-racial. Theeldest niece is Chinese. It is also interesting to note that thisfamily stays together. Given their diverse cultural backgrounds, wecan assume that the family members have learntto embrace each other’s cultural backgrounds and thus identify withmore than one culture. William spent some time in the military,whose culture is quite different from the civil culture. He isfamiliar with both the military and civil life and can thus identifywith fellow veterans and the rest of the civilians.
IdentityFactors to Consider When Working With William
Anumber of factors that a psychologist working with him needs to takeinto consideration shape William’s identity. These factors includehis family, his hobbiesand interests, the community in which he lives, his previous andpresent job, and his friends (Adler, 2002). The family plays one ofthe most important roles in shaping an individual’s identity. Afamily made up of people from diverse multicultural backgroundsusually has its members subscribing to multiple cultural identities. The different practices and norms shared by such a family often shapethe way the family members perceive the world and relate with eachother. The nature of support the family members provide to each otheralso shapes their identity. A family member who fails to receivesupport from the rest of the family would most likely not identifyhimself with the family (Alarcon,2009).In William’s case, his family has a diverse cultural background andhas proved to be supportive despite the challenges he is currentlyencountering. As such, the relationship between the client and hisfamily would need to be taken into consideration in the current case.
Anindividual’s hobbies and interests influence his or her personalidentity. As a psychologist, one should take into consideration theactivities that a client likes most. This may offer an avenuethrough which the client might open up about his feelings. Hobbiesand interests can tell a lot about an individual. In William’scase, his interests include intense physical activities, specificallysoccer and Marathon. He points out that running is the most peacefultime of his day. His other hobbies include collecting art pieces andlistening to jazz music. A person’s identity is also shaped by thekind of people related to the person. Most people have friends withwhom they share the same interests and ideas (Macdonald, 2009).Taking into consideration William’s friends will be an importantway through which the psychologist can learn more about William.Another identity factor that the psychologist will need to take intoconsideration in William’s case is his previous and currentprofession. The type of job or career an individual chooses
HowThe Complexities and Various Layers of William’s MultipleMulticultural Identities Might Affect the Primary Areas ofAssessment, Diagnosis, And Treatment
Franciset al. (2016) pointout that all health practitioners need to take into considerationissues of culture when assessing, diagnosing and treating patients. The cultural alignment of patients has been found to have asignificant impact on the outcomes of the assessment, diagnosis andtreatment processes. As a result, most healthcarepractitioners, including psychologists, are required to be culturallycompetent a factor that helps the deal with patients from diversecultures more effectively (Alarcon, 2009). Dealing with multiculturalindividuals such as William can be quite a daunting task forpsychologists. Multicultural individuals have the advantage ofswitching between cultural frames in response to the changingcultural demands of the environment.In William’s case, hisinterpretive biases during the assessment process may be affected bythe presence of cultural cues within the environment in which theassessment is being done. Inturn,this might affect how he perceives the whole assessment anddiagnostic procedures and whether he will adhere to the recommendedtreatment regimen.
Multiplesocio-cultural backgrounds have a direct impact on the patients’values, beliefs, perspectives and behavior about their health andwell-being. In William’s case, the above factors may result indifferences in expectations of care, understanding of the assessmentand management processes and adherence to medication. A patient’scultural background also affects how they communicate with healthcarepractitioners. William has been exposed to numerous cultures.He therefore,may switch between different cultural frames to another whencommunicating with the psychologists(Macdonald, 2009). However,his ease to cultural switchmight make it difficult for the psychologist to understand him,resulting to poor diagnosis and treatment approaches.
TheTheoretical Approach in William’s Case
Toaccess and engage with William during the counseling process, aperson-centered approach would be the most appropriate theoreticalapproach to use.Alarcon(2009) argues that thisapproach focuses on how the patient perceives himself or herself asopposed to what the psychologist can tell about unconscious ideas.The approach sees individuals as having the ability to develop totheir full potential. However, life experiences end up distortingone’s ability to reach their full potential. In the caseof William, it is quite clear that his experiences in Iraq haveplayed a significant role in preventing him from attaining his fullpotential both in his marriage and in his career. When using thisapproach, the psychotherapist aims understanding client’sexperiences from the client’s point of view. Developed by CarlRogers in the 1960’s, the person-centeredapproach can enable real change to be achieved when the counselor andthe client establish psychological contact (Hays & Erford, 2010).Additionally, the client has to be emotionally distressed and thecounselor has to be congruent. Apart from that, the approach can onlybe effective when the counselor is emphatic and non-judgmental.
AdditionalQuestions You Would Ask William to Further Support Your Assessmentand Diagnosis of His Presenting Concerns
Asmentioned earlier, counseling does not involve taking samples andconducting laboratory tests. It instead relies on the communicationbetween the client and the counselor for the right diagnosis to bemade. Questioning the client is an important way through which acounselor can know more about the underlying issues contributing to aclient’s problems (Cornish et al., 2010).. In William’s case, thedifficulty in establishing rapport would necessitate asking morequestions. These questions would enable the client to talk about hisproblems more openly. The questions include:
Who do you presumes to be the most important in your life?
What do you consider to the three of your biggest accomplishments in your life so far?
What do you think makes your current problem worse? Have you ever tried other approaches such as reading a book and other activities apart from alcohol?
Have you set any goals for your marriage and career life?
Do you believe in change and do you fear or like it? What positive changes do you think can be beneficial to both your marriage and career?
What do you hope to achieve at the end of this session?
HowWilliam’s PTSD Diagnosis Might Influence His Identities
Accordingto (Reitzet al., 2009),Post-Traumatic Stress disorder often comes about after an individualexperiences a traumatic or dangerous event. In William’s case, hisexperiences in Iraq have immensely contributed to the disorder.Patientswith PTSD usually require family support despite provision ofmedication and psychotherapy (Yampolskyet al., 2013)InWilliam’s case, his immediate family can assist in his recovery byencouraging him to share his memories of the harrowing events heexperienced in Iraq. Since the family members will be obliged tooffer William the necessary support, his multicultural identity islikely to be enhanced. The closer connection he will establish withthe family members and sharing of his experiences with them will helpenhance his multicultural identities.
TheRole of Spirituality and/or Religion as It Relates to William’sIdentities
Manyscholars have sought to investigate the role that spirituality andreligion playin shaping identity (Oppong, 2013). The possibility that religion andidentity are positively correlated is very high as evidencedby these studies. King (2010) argues that religion provides an idealsetting where identity exploration and commitment can take place. Hepoints out that the sense of identity is promoted in a religiouscontext and this sense of identity goes beyond the self and includesthe promotion of social good. William is a catholic and prior to thewar, he was a very active member of the church. However, hisparticipation in church activities has gone down since his returnfrom the war. Nevertheless, his affiliation with the Catholic Churchneeds to be taken into consideration during the whole assessment,diagnosis and treatment processes. Different religions and spiritualgroups have varying opinions about various medical procedures(Macdonald, 2009). Failure to take into consideration these beliefsmay undermine the assessment, diagnosis and treatment proceduresthereby resulting in undesired patient outcomes.
TheMulticultural Theories That Support the Therapeutic Approach to BeUsed When Working With William
Givenhis multicultural background, a multicultural counseling, therapywould be used when working with William. Hartman (2016) claims thatsince the traditional counseling theories were developed for thewhite middle and upper-classindividuals, they may not be appropriate for individuals withmultiple cultural identities. Hays and Eford (2010) point out thatmulticultural theory and counseling encompasses many theories thattake into consideration the important role cultural contexts play toimpactthe outcomes of counseling. The ecological model of multiracialdevelopment is an example of the theory that supports themulticultural counseling and therapy. According to Root (2003), themodel points out that, multiracial identity development has fivepositive outcomes. The first outcome is that people are always readyto identify as a race they are ascribed by others. The secondargument the theory makes is that people are always able to identifywith all their racial groups. However, if they choose, they can onlyidentify with one group (Root, 2003).Another theory that supports themulticultural counseling therapy is the Systems Theory Framework.This theory views clients within the context of their lives and asactive agents who can influence their surrounding contexts (McMahon &Patton, 1999).
APAEthical Codes As They Relate To Multicultural Competency andProfessional Interactions with William
TheAPA had adopted numerous guidelines and code of ethics since itsestablishment in 1892. These codes and guidelines aim at governinghow psychological professionals interact with their clients (Alarcon,2009).The APA came up with the Multicultural Guidelines due to the risingneed to consider the impact of race, cultureand ethnicity in psychological theories and therapies. Under theguidelines, psychologists are required to recognize that they arecultural beings that might have views and attitudes. The altitudesand views can negatively affect how they interact and perceiveclients from different cultural backgrounds. Additionally, theguidelines require psychologists to varying levels ofmulticulturalism among different individuals. Psychologists are alsorequired to apply culturally appropriate skills (King, 2010). In thecourse of interaction with William, adhering to these guidelines helpestablish a positive relationship. Similarly, acknowledging thecultural differences that may exist between the psychologist and theclient help avoid embarrassments and questions that might offend theclient.
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