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counselors practice and learn how to properly handle each client's situation. Clients have a variety of issues that they are dealing with at any given time and sometimes need help. Clients may seek help from a counselor, allowing the counselor to help that person manage their particular areas of concern. Case studies are valuable to any counselor and require much thought and careful consideration.
In the case of Tony Cepin, who is a 45-year-old Hispanic male, we are able to evaluate a unique case study, in which Tony, a nontraditional student, has various issues going on in his life in which he needs help. His presenting problems are that he feels as if he is too old, he has little of a support system, has difficulties finishing tasks, suspects ADD diagnosis, has conflicts with his spouse and immediate family, and often overspends money. We can look at Tony's case in different aspects when analyzing Tony's case and how Tony can be helped. In this paper Tony's case can be analyzed by using three different methods, they are: Gestalt theory and therapy, Behavioral theory and therapy, and Cognitive-Behavior theory and therapy.
First of all, we will analyze Tony's case using Gestalt theory and therapy. In the Gestalt approach, we can relate several issues to Tony's case. For example, according to Fritz Perls, who was a theorist of the Gestalt theory, nothing exists except the "now" (Corey, 225). The past is gone and the future has not yet arrived therefore, only the present is significant. One of the main contributions of the Gestalt approach is that there is an emphasis on learning to appreciate and fully experiencing the present. In Tony's case, he seems to be living in the past and future a lot. In counseling, it may be a good idea to help him make contact with the present moment. Any time Tony starts to talk about the past and future, as it seems that he is stuck in, he can be helped to move back into the present. Also, there can be a concentration on asking Tony "what" and "how" questions, rather than concentrating on "why" questions, in order to promote "now" awareness (Corey, 226). In therapy, if Tony begins to talk about sadness, pain, or confusion, the counselor can make an attempt to have him experience that sadness, pain or confusion now. On another note, Gestalt therapists do care about the past and if it seems to be significantly affecting Tony today, the counselor may make every attempt to deal with it bringing it into the present as much as possible.
Another concept in the Gestalt approach that could be used with Tony is dealing with unfinished business or unexpressed feelings such as resentment, rage, hatred, pain, anxiety, grief, guilt and abandonment. Tony has expressed feelings of unfinished business or unexpressed feelings in his case. In particular, he expresses resentment toward his parents for those years when his parents moved him back to Puerto Rico from New York City to be with his grandmother. He claimed to feel very alone and had to grow up fast without his parents and his siblings, leaving him with a distant relationship with them now. These feelings that Tony was experiencing in the past can come into the present because they are in a sense unfinished business. Because these feelings have not been fully experienced in awareness, they linger in the background and are many times carried into present life. This in turn may cause problems and interfere with relationships, making them unhealthy. Unfinished business persists in a person until it is dealt with. Gestalt therapists emphasize that if feelings are unexpressed, they will tend to result in a physical symptom or blockage in the body.
Tony may have felt that he came to an impasse, or a stuck point, in his life where he believed that he could not support himself and came to the point where he needed to ask for someone's help, in this case a counselor and his family. Support from others has been lacking in Tony's life; however, Tony may not realize that support from others is not necessarily a genuine source of nourishment for the self. In Tony's life, it seemed to become a replacement for self-support, which was unhealthy. At the moment of impasse, in the Gestalt approach, clients attempt to maneuver their environment by playing roles of weakness, helplessness, stupidity, and foolishness. The therapists task will be to help Tony get through the impasse so that growth is possible. The counselor will assist Tony by helping him to experience situations that will encourage him to fully experience his condition of being stuck. After completely experiencing the impasse, Tony will be better able to get in contact with his future frustrations. He will also be more willing to change if he accepts whatever is, rather than wishing he were different, for example the issue where he feels he is too old.
On another note, when Tony is confronted about this unfinished business, he may show avoidance toward the unfinished business. If this happens, the counselor may encourage him to express his negative and angry feelings in therapy. By Tony experiencing these feelings in therapy, it will make it possible to dispose of any unfinished business that may be interfering with his present life. Tony can then move on toward health and integration.
Different techniques in relation to the Gestalt approach of therapy can be used with Tony, such as the "staying with the feeling" technique, where when a client refers to a feeling or a mood at a key moment, the therapist urges the client to stay with the feeling. By facing or confronting the feelings, the client will endure the pain necessary for unblocking and making way for new levels of growth. Another technique that can be used with Tony is "playing the projection," in which Tony will be able to see clearly in others the very things that he does not want to see and accept within himself. The counselor will ask Tony to "try on for size" certain statements he may make about others, for example, maybe his wife or his mother.
A central theme in regards to the Gestalt approach is to help the client to move more fully into self-support, such as in Tony's case. He will be encouraged to expand on awareness and experience all of his feelings more fully. Tony will work on any unfinished business that he points out he may have in order to avoid any blockages, emotionally and physically.
Secondly, we can analyze Tony's case using another approach, which is the Behavioral theory and therapy. In the Behavioral approach, we can relate several issues to Tony's case. For example, Tony's counselor or therapist can help him by focusing on helping him define to the specific areas where he would like to make changes in his life. Then he and his counselor may talk about how the therapy sessions can help him to reach his goals. Early on in treatment, the counselor may help Tony to translate some of his general goals into concrete and measurable ones. For example, when Tony says that he wants to establish a better relationship with his extended family, the counselor may ask him specifically how he wants to do that or what are some specific things that he would like to see happen between he and his extended family in order to better their relationships.
Systematic desensitization is a technique that can also be used with Tony, in relation to the Behavioral approach. This is an appropriate technique in helping Tony to deal with his fear of failure, when it comes to school and life in general. Tony will learn relaxation procedures during the sessions and then he will be able to practice them daily at home. He can then list his specific fears relating to failure. He will then be instructed to imagine a pleasant scene and begin a desensitization process beginning with his lesser fear and working up to the anxiety associated with his greatest fear.
On another note, in using the Behavioral approach, this approach does not place importance on his past, except to the extent necessary to modify his faulty learning. The counselor will not explore his childhood experiences but instead will work directly with his present behaviors that have caused him difficulties. Insight is not seen as important in this approach, nor is having him experience or reexperience his feelings. The assumption is that if he can learn more appropriate coping behaviors, eliminate unrealistic anxiety and acquire more healthy adaptive responses. His presenting symptoms will decrease and he will experience a greater degree of satisfaction.
The major goal of the Behavioral approach is the identification of specific goals at the beginning of therapy. The counselor then helps guide the client in achieving his/her goals. Behavioral therapists or counselors will typically assume an active and directive role. The client will generally determine what behavior will…[continue]
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