Ideal Psychotherapy for Childhood Abuse in Adults

¶ … Social Work Practice Within Aboriginal

Building attached case study Lisa, describe discuss social work practice approach aboriginal innovative practice modalities a cultural context. This assignment refining approach practice integrating theories practices learned required readings.

ABORIGINAL AND INNOVATIVE SOCIAL WORK PRACTICE APPROACH

Concepts in Social Work Practice within Aboriginal and Cultural Framework

In trying to attend to a client's challenges in psychology, it is imperative to provide an environment that is sufficiently safe where a client can talk and explore their problems (Brave Heart, 2004). This measure is adequate for many clients but not sufficient for all especially so when it comes to cases involving aboriginal persons. For the aboriginal clients, an understanding of adaptation difficulties and the inter-generation aspects is necessary to provide a wholesome resolution to the challenges at hand. This paper presents a discussion on the ideal approach in social work for the case of Lisa, who had suffered abuse in her childhood and left with the traumatic experiences.

Social Work Practice

To be in a position to come up with a comprehensive assessment of Lisa's case it is important to look deeply at the social-political, social-cultural and socio-economic factors relating to her. This will help to determine the preexisting situations that facilitate the continued existence of the problem (Greer, 2004). This assessment facilitates an understanding of the occurrence of the initial problem while trying to draw links to its continued existence. The Bird's Eye view concept commonly referred to as expanding a bird's Eye-View takes into account the client's social-political, social cultural and socio-economic factors. This concept emphasizes the differences that exists between working with the aboriginal persons and non-aboriginal persons. With this knowledge at hand, a social worker will be able to relate to Lisa's challenges and put it to perspective the ideal measure to resolve the situation. Subsequent interpretations can be drawn highlighting the past experiences and current difficulties in overcoming them.

Posttraumatic stress disorders similar to the ones evidenced in Lisa's case are attributed to memory, cognitive and self-related difficulties. Abuse related posttraumatic stress include: intrusive reliving experiences, intrusive thoughts, heightened emotional reactions to events reminiscent of maltreatment stimuli, nightmares, avoidance (efforts to prevent people situations and places associated with the abuse), (autobiographical) memories of the abuse, numbing, for example, reduced or constricted emotionality and autonomic hyper arousal, involving chronic activation of the sympathetic nervous system (Briere, 2002). It is not the case for all persons who have suffered abuse to display PSTD. In the case of Lisa, the preexisting conditions of her alcoholic mother played a key role in reducing her tolerance to stress exposures.

Research shows that an individual's capacity to handle stress is overwhelmed by the existing condition making one incapacitated to sufficiently embrace the challenges (Brave Heart, 2004). Lisa's developments while in her mother's womb were incapacitated by the alcohol thereby compromising the normal capabilities to deal with trauma. These incapacities trigger narrative or sensory memories that in turn activate negative response emotions. The negative emotions occur with the memory being a primary sensory. Articulations of the individual's past abuse in the brain by primary sensory sets in an ordeal that simulates similar actions as going through the abuse. The imaginative part of the brain triggers fear to the individual forcing one to relive past experiences (Brave Heart, 2004).

In the case for Lisa the aftershave worn by the neighboring patron simultaneously activated her memories on previous abuse and was unable to clear her thoughts. To be able to overcome her thoughts Lisa sought to use drugs that were unavailable. Her in capacities of booking out the traumatic memories pushed her result in inflicting physical her to herself. This actively suppressed her emotional and mental awareness of the previous abuse by shifting her concerns to the injury. The injury forcefully suppressed her awareness of the past experiences and cleared her awareness of the primary thoughts that relate to the abuse (Connolly & Harms, 2009).

The avoidance in the case of Lisa is said to occur out of disrupted normal mental, psychological reasoning (Burton, Westen, & Kowalski, 2012). In many cases, where a person surfers PSTD, bodily harm is presents. For the case where an individual is struggling to relate to new environment more and server cases of bodily harm or drug abuse are likely to prevail. Lisa was struggling to relate to the new environment and has a biological deficiency following from her mother's alcoholism. This made it difficult for Lisa to share with others as well as take charge over the memories of her abuse.

A Bird's Eye view will facilitate a comprehensive introspect on the current and previous aspects likely to be connected to Lisa's situations. This will allows a thorough assessment of measures to attend to the Lisa's condition and incorporate those aspects that are specific to her case. Further understanding of the external factors that relate to her situation will also present an opportunity to consider different social and environmental conscience measures.

To obtain complete background information, a narration from Lisa on their previous experiences should be encouraged. This narration coupled with follow-up questions should target to obtain deeper understanding of the past abuses and also help the client embrace these experiences. From the narrations and follow-up questions, it will be possible for a social worker to draw possible links and evaluates deeper challenge the client faced and faces connected to the problem. As the client narrates the problems they face or faced, their inner conscience will work to embrace the challenges and remain open to allay their fears.

The avoidant and intrusive measures related to PSTD oftenly act with one another. In the case of Lisa for example, traumatized or otherwise abused person will have intrusive cognitions or flashbacks sparked off by a resonant event. They will then make efforts to inhibit these memories and thoughts so that to quash the connected conditioned reactions. Such shunning may require distraction or other measures to avoid feeling anything or thinking about affiliate traumatic experiences. As noted by (Haskell & Randall, 2009) however, suppression of feelings or thoughts is difficult especially so for persons with other social and biological challenges. Research shows that trying to switch ones thought to something else subsequently results deeper and more intrusive thoughts (Haskell & Randall, 2009). In most cases intrusive trauma related though result from the very first act of suppression on initiator primary thoughts (Haskell & Randall, 2009). Consequently, although the primary though might have been triggered by an environmental stimuli then suppressed, the re-intrusions that follow is attributed unsuccessful avoidance of suppressions.

A comprehensive understanding of the thoughts and their intrusive nature is only possible through expanding the bird's eye view. The investigations will allow attention be given to the thought stimuli and to measures of dealing with the thought stimuli. The dysfunctional nature of man Kind to suppress thoughts may be given sufficient attentions by inquiring from the clients the trigger to the thoughts and allowing the client to come with far much effective measures to deal with the intrusive thoughts. The possibly ideal means reducing the effect of intrusive thought is complete processing of the trauma related intrusive thought and allowing them to clear on their own. The client ought to be given countermeasures to facilitate them embrace the pain and agony of reliving their previous ordeals to the point they can accommodate the thoughts and inhibit distressing situations from the thoughts (Hays, 2008).

Additional to "Expanding the bird's Eye-View" it is important to incorporate the Triadic approach that incorporates three important steps. The steps in the Triadic model include "STOP," "LOOK" and "DETERMINE." This approach allows for further developments on the surrounding issues and instigates logical synthesis of the matters. The first step is "STOP" that cautions one from continuing before they consider the matters they ought to be aware of. This goes hand in hand with the Bird's Eye View where factors relating to the clients and the surrounding environment and put into perspective.

To facilitate an all-inclusive measure as a solution to the client, a social worker needs to evaluate their relevance to the client and assess the ideal ways to bring out their purpose (Hays, 2008). Since Lisa is not so much willing to attend the prescribed psychiatric treatment prescribed, caution is needed not to overstep boundaries. There is a need to assess right approaches to Lisa's condition and target potential positive outcome through ideal interactive, positive relations. For this case, the Second step is "LOOK" where the social worker needs to assess the ideal operating point is relevant (Hays, 2008)

In this step the social workers assess the part they need to play for the client's situation. Additionally, they need to make possible linkages of the client's situation to the pre-existing and current situations. To understand the depressing state of the client's situation and the possible harm it poses to the client is not enough for the social worker. There is need for self-assessment on the part of the social worker to determine the role that will ideally result to positive outcome. Some situations call for the social worker to play a listener and only direct the patient towards logical self-evaluation while some call for them to take up an empathetic situation and discuss with the clients the logics of the situation. This part is critical especially so where the cultures of the two individuals are different as in the case for Lisa. Further to this the assessment of the role the social worker plays server to eliminate possible conflict with the client that may derail potential positive outcome. As a result, the social worker will look at the clients situations establish possible linkages and map out strategies that will attend to the cases.

Lisa's case portrays at least four possible linkages that include her neglected maternal upbringing, childhood abuses, delineation and drug abuse. It is important to fully comprehend how these aspects interact to bring to live traumatic experience and determine measures to deal with them both individually and as a group. To bring Lisa to terms with her childhood abuses, thorough discussions will be ideal but there is a need to determine what part the social worker is best suited for. This will allow for Lisa's complete appreciation of past ordeal as the past and encourage her close that chapter. Drug abuse according (Sue & Sue, 2008) are temporal measures for putting aside once trouble, and this is the reason Lisa resulted to using them. From this perspective, it is ideal to determine how best to engage Lisa and clarify how much the drugs serve as a temporary solution as opposed to being a solution in any way. To attend to drug abuse problem, attendance to discussion group groups can be encouraged where persons with similar experiences share. This will serve open Lisa to a new world where she would realize he is not the only one suffering and seeking closure. Additional to the group therapy, counseling on drugs and body health can be extended to add to the groups knowledge.

Lisa faces a challenge in trying to embrace a new way of life, socialize, economically sustain her livelihood and attend to her educational needs. Being an immigrant with low levels of education, there are limited avenues for good employment. This aspect asides of being challenging presents Lisa with a conflict of choice. One choice is to stay and leave her past in her country of origin or go back home and experience her childhood fears. Additional to option of going back home, Lisa will have to face her mother who neglected her while she was young and cannot be of meaningful help currently. The option to go back home is already dreadful, and the current social and economic status is not bidding for her stay. A combination of these fears presents Lisa with only one option of fighting her conscience through drug abuse.

The above situational analysis presents grounds for the social worker to assess and ideal position to play and calls for articulated measures. This takes us to the third step of the Triadic model - "DETERMINE." Determine is where the social worker is called upon to assess measures to circumnavigate the issue (Hays, 2008). This steps call for further consultations with the persons the client considers being part of their problem or else the one facilitating persistence of their trauma. In the case of Lisa it may not be possible to consult with the perpetrator of the abuse but consultations with the mother is possible. For Lisa's case, it is ideal to try and allow her to talk more through discussions on the person who abused her. This will give a deeper insight on the personality of the abuser and give a chance to Lisa to understand the person as an isolated individual case. These will also afford an opportunity to dissolve to the client's mentality that another individual is capable of the heinous acts.