Psychoanalysis Tools and Techniques

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. Rebecca’s 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 client’s 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 client’s 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 teenagers. It would be unfair to bundle the youth together with adults.

The agency identifies policies that have the good will but lack when it comes to implementation. Working directly with clients, we can uncover areas where changes are needed and go about recommending changes. The agency pushes for an analysis of social welfare and services policies to ensure they meet their objectives. When a challenge is identified, policy modification can be initiated. Also, there might be areas not covered by any policy, and policy formulation is necessary. The goal is to develop practical solutions that meet the community’s needs. Social welfare and services are mediated by policy by ensuring they meet the community’s needs. Policies ensure people receive proper services and support when they need them. However, when a policy overlooks the needs of the community, then the social service will not attain its objective because few people will be using the service.

2. How have you identified ways in which policy impacts human rights and social justice and therefore impacts the well-being of clients?

Social justice focuses on the distribution of wealth, opportunities, and privileges in a society. Human rights focus on moral principles for specific standards of human behavior. Policies offer guidelines for achieving rational outcomes, and there are guidelines on human rights and social justice. The guidelines affect how people are treated, and their fundamental rights ensuring their human rights are not denied. The policy on discrimination against people is one good example where people used to receive varying services due to their race, color, or gender. Changes only started when there was a deliberate push for service improvements through policy modifications. Human rights policies ensure fair treatment of all individuals, and there is no discrimination based on race, color, sexual orientation, or gender. The result is a positive effect on the well-being of the clients. Without the policy on human rights, discrimination would be rampant, and clients would find it hard to seek services due to their differences. However, with the same treatment of people due to policies on human rights, there is the freedom to interact with others and receive necessary services without fear of discrimination.

Social justice policies push for the equitable distribution of wealth, privileges, and opportunities. In the past, some communities had been left out and never received any federal government support. The result was a depreciation of services to the extent of desperation. However, with social justice policies, there is a deliberate push for improvements to ensure all citizens have equal access to opportunities to better their lives. Social justice policies have had a positive effect on the well-being of clients. The policies identified areas needing improvements and developed solutions targeting those areas. There has been an increase in offered services in previously neglected areas and opportunities to improve the welfare of people. Clients no longer have an excuse for neglect since they have equal opportunities for work and education.

3. How have you collaborated with clients to advocate for and with them and to incorporate client voices into advocacy at the organizational, local, state, and federal levels?

Collaboration with clients took place through education and knowledge building. Clients need to know their rights for them to demand services. Education was used to impart knowledge on expected services, areas of improvement, and policies that need change. Working with the clients, we offered them information on areas we have identified as lacking and should be covered by a particular policy. The clients would then follow through with their local and state authorities to demand improvements. The information we offered the client was used when they met with the leaders, and the push for improvements constantly ensured changes occurred. When clients know they are not alone and someone is advocating for them, they have the motivation to push through with their demands. Another collaboration that took place was in terms of service demands and delivery. Most clients are not aware of what they are entitled to receive when it comes to service delivery. Through advocacy, we educated them on what services they should expect and where they could receive them. Armed with the information, the clients would demand these services when needed.

Knowledge was disseminated through policy briefs informing the public and lawmakers to generate support for funding and service improvements. Policy briefs were shared with the key stakeholders and used as educational materials informing the public where changes are needed for service improvements. The collaboration was vital to assisting clients navigating the social services, legal, and healthcare systems. With the assistance received, clients were empowered to advocate for themselves. Policy reform was only possible through interaction with the clients. Listening to their needs and learning about their challenges offered insights into areas that need changes. Educating those involved and empowering community members to push for policy reforms raised awareness.

Part 3

Outline of Integrated Clinical Paper

Compare and Contrast Dialectical Behavior Therapy (DBT) with Acceptance and Commitment Therapy (ACT) in the Treatment of Addiction

Abstract

DBT and ACT are theories associated with mindfulness and acceptance. These are theories that emphasize understanding behaviors as acts in context. DBT and ACT are effective in treating addiction though they do so differently. Addiction is a problem faced by numerous individuals across the United States. Therefore, we should uncover the best strategies for treating addiction if we are to assist those impacted by it. DBT and ACT are types of cognitive-behavioral therapy used to treat addiction. The focus is on adults aged between 22 and 50 years. This paper will compare and contrast DBT with ACT to determine their effectiveness in treating addiction. The suitability of each theory for a particular population will be uncovered. Can the use of one prove to be more effective than the other?

Thesis Statement

This paper determines the best treatment strategy for assisting addiction clients by comparing and contrasting DBT and ACT to establish the strength of each and determine its effectiveness.

Introduction

Addiction is a complex disease that needs extensive treatment. Without correctly understanding the impact of addiction on the individual and society, we cannot grasp the importance of treating addiction. Social workers play a critical role in assisting those battling addiction. Therefore, having a good understanding of the available treatment options will help the social workers to have a tried and tested method for assisting their clients. DBT and ACT are theories associated with mindfulness and acceptance. These are theories that emphasize understanding behaviors as acts in context. DBT and ACT are effective in treating addiction though they do so differently (Amirian et al., 2018). Addiction is a problem faced by numerous individuals across the United States. Therefore, we should uncover the best strategies for treating addiction if we are to assist those impacted by it. DBT is a type of cognitive-behavioral therapy focusing on the psychosocial aspects of treatment (Cavicchioli et al., 2020). DBT emphasizes the importance of collaborative relationships, skills development, and client support. ACT aims to assist clients in accepting what they cannot control (De Alarcón et al., 2019).

When looking at how to help clients overcome their addiction, we should consider strategies we are 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.

Items to Include in Paper

Dialectical Behavior Therapy (DBT)

· DBT is a type of cognitive-behavioral therapy focusing on the psychosocial aspects of treatment (Cavicchioli et al., 2020)

· DBT emphasizes the importance of collaborative relationships, skills development, and client support

Acceptance and Commitment Therapy (ACT)

· ACT aims to assist clients in accepting what they cannot control (De Alarcón et al., 2019)

· ACT is an action-oriented approach that stems from CBT and traditional behavior therapy

· It uses acceptance and mindfulness strategies to increase psychological flexibility

Considerations For Micro, Mezzo, and Macro Systems

· They all have similar missions in they seek to uncover and address emotional, mental, familial, social, and financial challenges people face

· The difference lies in the techniques used to address the challenges, the impact of their work, and how close social workers interact with clients

· Description of Micro systems

· Description of Mezzo systems

· Description of Macro systems

Implications for the Field of Social Work

Addiction is a complex disease that needs extensive treatment. Without correctly understanding the impact of addiction on the individual and society, we cannot grasp the importance of treating addiction. Social workers play a critical role in assisting those battling addiction. Therefore, having a good understanding of the available treatment options will help the social workers to have a tried and tested method for assisting their clients. Addiction negatively affects society and families, and it is the role of social workers to keep families together. When looking at how to help clients overcome their addiction, we should consider strategies we are 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.