Effects of Trauma

Part 1

a. Discuss the tools and techniques of psychoanalysis you believe the author may have used to worked with the client and arrive at his conclusions.

The patient chosen is Rebecca. The techniques of psychoanalysis used to work with Rebecca are free association and dream analysis. Free association allowed the author to uncover more information from Rebecca. When she first enters the room, Rebecca places her coat and sits for about five minutes in silence before she states they need to speak about sex (Grosz, 2014). The use of silence and time to allow the client to gather their thoughts and determine what should be discussed is free association. The client is encouraged to speak about what comes to mind without searching for a particular topic (Lindfors et al., 2019). Allowing the free flow of ideas ensures the critical mind does not intervene, and the client can reveal what lies deep in their subconscious. Talking about sex is not something that a person would do so willingly. However, Rebecca was comfortable enough to talk about her night and the satisfaction she received. Though she still had to masturbate, it demonstrated that her sexual behavior could be a defense mechanism. The free association enables the client to experience an emotionally intense and vivid memory during therapy. As was the case with Rebecca, the free association allowed her to recall how Oliver used to keep tapping her waist and seeking her attention all the time (Grosz, 2014). Rebecca had forgotten about those moments because her mother had questioned her. The guilt she felt about letting Oliver use her as a climbing frame, and the subsequent question from her mother caused her guilt.

Dream analysis is the most vital psychoanalytic technique. The repressed ideas will come to light in a dream. Rebecca never recalled how Oliver used to keep touching her and his need for her attention. In the dream, she believed it must have been an old boyfriend touching her waist. The memory of Oliver touching her waist was suppressed, and it was coming to light distortedly. Rebeccas conscious mind would not allow her to recall how Oliver used to touch her and used her as a climbing frame due to how her mother questioned her. Therefore, the repressed memory was not coming to her in an altered way during her dream process. The conscious mind is a sensor and is less vigilant when we sleep, which is why some dreams reveal underlying memories. The analysis of the dream allowed Grosz (2014) to probe further and uncover the underlying meaning of her dream. Rebecca might have forgotten about the event, but her subconscious mind had not, which is why she got the dream. To Rebecca, it was a sex dream where she thought she did not get satisfaction from her husband and her masturbation. Leading to her having the dream. Rebecca misses the insistent demands she got from Oliver, and that is shy she was having the sex dream.

b. Discuss how treatment might look different if the client saw a therapist who used a shorter intervention such as Solution Focused or CBT treatment.

A shorter intervention like Solution Focused Therapy would not have gone on for as long as the intervention had taken. Considering Rebecca had been seeing the author for about a year. Solution Focused Therapy focuses on solutions and not problems. Therefore, for Rebecca, the focus would have been on what she wanted and not what might have happened in her life in the past. While the focus is on solutions, there is always a focus on the clients life experiences and behavioral repertoire. Analysis of the past is done to uncover what is needed to construct a sustainable solution. At the start of the first session, the client is asked to describe what will be different due to their coming to therapy. Goal identification is the first step, and after the goal has been identified, the client and therapist will search through the clients life to uncover when the goal has happened in the past. The idea is to determine what the client did back them and what they can do now to repeat the same. The therapist asks questions probing if there has been a time between making the appointment and coming for the session where something happens, making things better, have you experienced any of this in your case? The answer the client gives determines if there will be follow-up questions. If they say no, the therapist moves on. However, if they respond affirmatively, the therapist will ask about details on when, how, and where things have started improving.

Being a shorter intervention, there is no time for the client to undergo numerous sessions discussing things that have no bearing on a solution. The therapist will focus on the present or future, and the questions they ask will focus on what works. Therefore, clients are encouraged to repeat what works for them to overcome their problems. Focusing on the past takes time because the client might not recall all that happened. In the case of Rebecca, she did not recall how Oliver used to seek her attention all the time. It took her almost a year to remember. With Solution Focused Therapy, there is no time to dwell on the past, trying to uncover forgotten memories. The goal is to get the client back on their feet fast. There would be no dream analysis, and her dream would not have mattered much since it did not offer a solution. Also, her free association would not have taken place. Rebecca would not have been allowed to speak about her sexual events of the previous night if they did not make her feel better. Therefore, even her dream would not have been discussed.

Part 2

1. How have you identified how social welfare and services are mediated by policy and its implementation at the agency level?

There are gaps in the policies implemented to ensure that all persons have a roof over their heads. Teenage homelessness is one such area. While policies ensure adults and homeless families have a place to stay, these places do not accommodate teenagers. Instead, teenagers are pushed towards the child welfare system, which some have run away from due to systemic challenges. Most youths prefer to spend the night on friends couches instead of seeking social support services. The child welfare system works for most children and teenagers. However, some have been through it and might have been abused and prefer to stay clear of it. These teenagers do not have a place to stay and lack support. The agency has identified the issue and is working on ways to modify the policy so that we can have homeless shelters catering to...

…confident will be impactful. Considering the number of families separated due to addiction, we should have better ways of dealing with the vice. Comparing the two theories and how they are used in addiction treatment, we increase the available knowledge in the treatment of addiction. Other social workers can use the information presented to make informed decisions on the best treatment options for their clients. Policy changes can be implemented requiring the implementation of one of the theories over the other due to its treatment effectiveness.

Biopsychosocial Considerations

There is a constellation of factors that contribute to developing an addiction

Bio refers to genetics and biology

Psycho is the psychological component of a person

Social refers to the norms, availability, cultural beliefs, and targeting practices

Putting them all together, we discover numerous factors increase the risk of developing an addiction. Therefore, we should aim at having a holistic conceptualization of addiction as we seek to determine the effectiveness of treatment. There might be universal aspects applicable to all individuals. However, we also have other individual elements, and we should strive to uncover them as we offer treatment. Using ACT and DBT would implement mindfulness strategies to uncover the underlying causes of addiction instead of focusing on the reward system alone.

Potential limitations

There is a significant time commitment required from the client and therapist. Due to the nature of using mindfulness techniques in treatment, DBT and ACT require a considerable time commitment to treat addiction effectively (Amirian et al., 2018). Therefore, there is a possibility that clients might find it hard to maintain the sessions or practice what they have been taught. In addition, the time commitment involves homework the client has to perform at home after the session. Therefore, it might be difficult for clients to complete if they are unprepared or committed.

ACT and DBT are structured, meaning they follow a set of steps. Failure to follow the steps will make the strategy ineffective because a critical step will be missed. Boundaries have to be set and followed for the process to be effective. Clients might find them rigid and make them unwilling to try. Mindfulness is at the center of DBT and ACT. Therefore, the client must be able to practice mindfulness if they are to overcome their addiction. Without practicing mindfulness, it becomes difficult for the client to see things clearly, and they cannot understand the underlying reason for their addiction. Clients who have been escaping their issues through addiction will find it hard to stray mindful of their thoughts, feelings, and behaviors.

Conclusion

Addiction should not be a burden a person has to carry with them all their life. There are treatment methodologies that can assist a client in overcoming their addiction. Therefore, comparing DBT and ACT allows us to uncover the best treatment methodology for a client. One of the theories is expected to be more effective with a particular population. However, both will have similar results in their ability to treat addiction. The use of mindful techniques encourages the client to focus on what lies underneath and the actual cause of their addiction. Without an escape method, the client will be forced to deal with their underlying issue and overcome their addiction. We should not forget the chances that the theories might be ineffective if the client does not commit fully. The structured methodology the theories use necessitates commitment, and some clients might…