Social Work Clinical

In detail, describe two behavioral techniques. Offer examples of the techniques by applying the techniques to a fictional client has a bipolar disorder.

Part 1

Activity scheduling (AS) is an effective behavioral treatment that actively involves clients by increasing their daily activities. The goal of AS is to increase client contact with the environment in a positively reinforcing way. Previously, AS involved scheduling only those activities that the client believed gave them pleasure and elevated their mood. However, any activity should be scheduled provided it offers the intention to socialize. Having a schedule is vital for clients with bipolar disorder since they prefer routines, and clients tend to avoid disruptions. Therefore, these clients should have a daily routine that involves work and rewards. With a set schedule, the client will rise and shine at the same time every day, assisting them to avoid disrupting the brains regulating system for waking and sleeping. Bipolar clients have mood shifts that can leave them feeling helpless as their mood moves from one extreme to another. Having a routine will assist in countering these helplessness feelings. The goal of AS in bipolar disorder is to reduce some of the uncertainty that could cause the client to have mood shifts. With time, the client learns to perform certain activities at certain times each day, and they look forward to doing those activities.

Malik was diagnosed with bipolar disorder type I last year, and he had been struggling with his daily activities where he does not have a schedule, and he operated based on what he feels like doing. He had constant mood swings and could not focus for long periods. However, after starting on AS, he has seen tremendous improvement in his daily mood, and he feels much better and happy most of the time. Malik was given a daily weekly schedule and weekend schedule that involved waking and sleeping times, activities planned for each hour of the day when he is awake, and time for meals. With the schedule, Malik can now focus better on his work. People who are unaware of his disorder do not believe him when he tells them he has bipolar because it does not interfere with his work or personal life. Malik has something to focus on with a schedule instead of a negative thought.

Relaxation training is used in behavioral therapy to reduce tension, anxiety, and stress. Relaxation training teaches clients to become aware of tension in their minds and bodies. The client can then incorporate systematic relaxation methods like progressive muscle relaxation, diaphragmatic breathing, or guided imagery. These techniques will assist in reducing the tension experienced by the client and allow them to change their thoughts. Malik can be trained to be mindful of these thoughts and become aware of what they are thinking and feeling. The purpose is to encourage him to stop being judgmental about his thoughts and feelings. Bipolar patients tend to focus on one thought and overly think about it negatively, forcing them to start believing and judging themselves. However, with relaxation training, Malik can learn how to embrace his thoughts and feelings, be aware of them, and remain nonjudgmental.

When one is aware of their thoughts, they can then modify their actions because they can pre-empt when they become depressed. Deep-breathing exercises can be taught to Malik to encourage him to perform deep-breathing at certain times of the day. With a routine, he manages to stay calm most of the time, and he can perform the deep-breathing exercises when he feels his mood is changing. In the daily schedule offered to Malik, there should be relaxation practices incorporated throughout the day. The goal is to reduce his stress and keep his mood even. Malik can be encouraged to take up yoga classes where he gets to practice yoga in a group setting. Yoga enables him to get in touch with his inner self and learn how to calm himself.

Part 2

Social Anxiety Disorder in Adolescence

To ensure the decisions made are not reliant on anecdotes, personal experience, and received wisdom, we must adopt an approach based on critical thinking and the best available evidence. Using such an approach, we can be certain the decisions we make are supported and referenced to ensure their trustworthiness (Gifford et al., 2018). In clinical practice, we have to make critical decisions all the time, and in some instances, the decisions can be questioned, especially those assumed to be based on intuition. For this reason, we have to ensure we can support the decisions we make with references from current literature on the topic. Also, with increased research on the topic, we get to learn more and increase our knowledge. Social workers should rely on decisions that will have the desired effect on the client. Its unfair to take a client through therapy using strategies that have no evidence they will work for this client. There are different strategies to use to locate the best evidence, but the best would be to use Google Scholar for starters. Here one will receive a listing of all articles relating to the research being done, and they can filter the articles based on year. We rely on research done within the last five years for our case. The links offered have brief information on the article, allowing one to filter out the ones they would like to read more about and those...…well that the client couldnt notice it. The question asked was similar to what a friend would ask, and the client approached it like they were talking to a friend.

Cognitive restructuring looks at the clients negative thought patterns and tries to get the client to reframe their thoughts. The therapist tried to get the client to see how their thoughts affected his mood and feelings at work. The client was asked how they could approach the issue, and they gave a detailed explanation of how they could do it. Using this strategy, the client noticed how he could approach the issue instead of approaching it with anger. Identifying the negative patterns allowed the client to reframe how they could approach the issue, and they were given a timeframe of one week for them to role play in their next therapy session.

2. What weaknesses did you notice? What might you have done differently?

The therapist failed to ask the client about his thoughts on why the coworkers do not do their part in projects. For example, when the coworker failed to complete their part of the recent project, and the client had to attend to it, it would have been vital to understanding what the client thinks the reason could be. The clients automatic thoughts are not properly expressed, and they tend to take the slack or assume it is their responsibility to do everything. The client could have viewed the situation at work as black and white, and it is more complicated. A question like Do you think your coworker would just fail to perform their part of the project? could explore what was happening and reveal more regarding the situation. The client could have read the sitution wrongly, and they assumed that the coworker did not want to pull their weight. It seems the client already has automatic thoughts regarding the coworkers and before even being asked, he starts doing the coworkers part of the project. Such a situation could also impact the coworkers since they do not understand why he keeps doing their work and they might be frustrated with him.

Encouraging him to talk about it with the coworkers is vital, and he should approach the matter as proposed by the therapist. However, before he does that, he should first express his thoughts about why he believes they are letting him do all the work. The client should be asked about his automatic thoughts regarding his coworkers and if these thoughts are based on relevant evidence or merely evidence that supports his belief. Looking at the bigger picture can assist the client in stopping seeing things from his perspective but the perspective of the coworkers or supervisor. With a different perspective, he…