Posted: June 14th, 2023

COU 202 Assessment 1 2000 -2200 words

COU 202 Assessment 1
Individual Written Assessment (30%) Due Date: Week 7
Word Count: 2000 -2200 words
Students will research and write a report based on the following case study.
Your response requires you to provide at least 8 reference sources. These must be peer-reviewed academic articles, not websites.
PROVIDE NO MORE THAN 2 SENTENCES TO INTRODUCE THE CASE STUDY SCENARIO- IF YOU WRITE MORE YOU WILL LOSE MARKS
Answer the following questions, numbering your answers
1. Write a script of the exact words you would say to explain confidentiality to the client/s at the start of your first session
2. What principles will you use to develop the counselling relationship with the client?
3. Select TWO therapies, approaches, or perspectives from the following list
• Narrative therapy
• Cognitive Behavioural therapy
• Feminist perspective
• Anti-oppressive approach
4. Explain why you have chosen these two therapies, approaches &/or perspectives and why you think they would be helpful to use in your counselling work with the client.
5. For each of your selected therapies, approaches &/or perspectives, describe at least 2 interventions or techniques you would use in your counselling session with the client and explain why you think these would be helpful.
6. Identify your preferred therapy, approach &/or perspective from the 2 you have selected and give reasons for choosing this therapy, approach &/or perspective.
7. Name and explain the range of skills you have used to work with the client.
8. What ethical issues might be relevant for working with this client?
Use either the Psychotherapy and Counselling Federation of Australia (PACFA) or Australian Counselling Association (ACA) Code of Ethics and Practice to inform your answer. Provide a reference to the code you use in the reference list.
Use APA 7 referencing. Your essay should include at least 8 (scholarly) journal articles read and/or textbook references. The format of your essay will be discussed in greater detail during tutorials.Do NOT utilise sources such as www.tutor2u.com and other such web materials as these in no way constitute academic references for the purpose of your assignments. If you rely on such sources for theoretical support, you will be deemed NOT to have met the requirements of the assessment.
________________________________________
CASE STUDY.
Ann is a 68-year-old woman. She lives with her husband Andrew, age 79, in a
modest bungalow in a rural area about 10 minutes from town. Andrew was diagnosed
with lung cancer with metastases to liver and bone 10 months ago. Andrew had been
feeling unwell for several months before seeking medical attention. He now is very weak
and spends most of his time in bed. He has pain that is poorly controlled and eats very
little. At times, he is quite confused. There is a suspicion that he has brain metastases
but his wife and family feel there is no need for further investigations. His physicians
agree.
Ann was born in New Zealand, and she has several brothers and sisters still in Wellington.
Ann and Andrew have been married for 46 years. This is Ann’s second
marriage. She was married for 2 years to John, who was killed in a car accident
Ann was left with one child; a daughter Isabel now aged 50. Three years
after John’s death she met Andrew at work, and they married two years later. Ann
and Andrew had three children, a son Alistair now age 43, a son Jean aged 36 and a
daughter Michelle who died because of suicide 10 years ago at age 24. Isabel and Alistair both live in towns nearby but Jean lives interstate. Ann and Andrew have 8 grandchildren.
Andrew has been a heavy smoker for many years. He has had hypertension and
ischemic heart disease for about ten years. He was a heavy drinker for a number of
years but he stopped when Ann and he separated for a brief period. He
does not drink alcohol now. He worked as an accountant with his own small office
serving small businesses and doing income tax work. He is Scottish and has two
brothers in Scotland. He and Ann used to visit them frequently. He is worried about
how Ann will cope after he dies.
Ann has had rheumatoid arthritis for many years but was able to continue working
as retail clerk until about 10 years ago when she had a flare-up of her
disease. She is on multiple medications but has been able to do normal activities of
daily living reasonably well with Andrew’s help especially with household tasks. She is
concerned about how she will be able to cope without Andrew’s help. She does not
want to bother her children for help. She has had to cope with the death of her first
husband and her beloved daughter Michelle and feels that she cannot cope with another
death in the family.
Their marriage has been quite strong despite the one brief separation. For two years
after the death of their daughter Michelle, they grieved quite openly, and they recovered
slowly. Their children have been very close despite two of them living far away. They
are both Roman Catholic and have attending church regularly.
They live on their pensions now.
You are seeing Ann and Andrew for the first time.
!
Ann, a 68-year-old woman, is seeking counselling with her husband Andrew, age 79, who has been diagnosed with lung cancer with metastases to liver and bone. Andrew is currently weak and spends most of his time in bed, with poorly controlled pain and confusion. Ann is concerned about how she will cope without Andrew’s help, as she has had to cope with the death of her first husband and beloved daughter Michelle and feels that she cannot cope with another death in the family.

“Confidentiality means that whatever we talk about in this session will remain between us, and I won’t share it with anyone without your permission, except in certain situations where I may be required to disclose information to ensure your safety or the safety of others. These situations will be explained to you in more detail if they arise.”

The principles I would use to develop the counselling relationship with the client are empathy, warmth, genuineness, and respect. I would aim to create a safe and non-judgmental space where Ann and Andrew feel comfortable sharing their thoughts and feelings with me.

Narrative therapy and Cognitive Behavioural therapy.

I have chosen narrative therapy because it focuses on the stories that individuals tell about themselves and their experiences, and how these stories shape their perceptions and behaviours. This approach would be helpful in working with Ann, who has experienced multiple losses and may benefit from exploring and reframing her personal narratives. I have also chosen Cognitive Behavioural therapy because it is a goal-oriented, evidence-based therapy that focuses on the relationship between thoughts, feelings, and behaviours. This approach could be helpful in addressing any negative thought patterns or behaviours that may be contributing to Ann’s anxiety and stress.

For Narrative therapy, two interventions that could be used are externalizing the problem and
Confidentiality is a crucial aspect of counselling, and it is my responsibility to ensure that everything discussed during the session remains confidential unless there is an indication of harm to self or others. With your permission, I will keep records of our sessions, and you will have access to them upon request. However, in certain circumstances, I may need to disclose some information to other professionals, such as a doctor or a lawyer, but I will discuss this with you before doing so.

To develop a therapeutic relationship, I will use empathy, respect, genuineness, and active listening to create a non-judgmental and safe environment where you can freely express your thoughts and feelings without fear of criticism or rejection. I will also focus on building trust, understanding, and collaboration by acknowledging your concerns and beliefs, and ensuring that I am transparent about the counselling process and my expectations.

The two therapies I have chosen are Narrative Therapy and Cognitive Behavioural Therapy (CBT).

I chose Narrative Therapy because it is a strength-based, collaborative approach that focuses on exploring the client’s personal stories and experiences to help them re-author their lives in a more positive light. This approach is useful for clients who may feel powerless, stigmatized, or marginalized and can help them identify their strengths, values, and resources to overcome their challenges.

I chose CBT because it is a goal-oriented, evidence-based approach that focuses on identifying and changing negative patterns of thinking, emotions, and behaviours that may contribute to the client’s distress. CBT is particularly useful for clients experiencing anxiety and depression, as it helps them develop skills to manage their symptoms and improve their quality of life.

For Narrative Therapy, I would use the technique of externalization, where we separate the problem from the client’s identity to help them gain a new perspective on their situation. This technique can help clients view their problems as external entities that can be managed, rather than as an inherent part of themselves. Another intervention I would use is the re-authoring technique, where we encourage clients to explore alternative narratives of their lives that are more empowering and positive. This technique can help clients shift their focus from their problems to their strengths and resources, thereby increasing their self-esteem and resilience.

For CBT, I would use the technique of cognitive restructuring, where we challenge and replace negative thoughts with more balanced and positive ones. This technique can help clients reframe their beliefs and expectations, which in turn can reduce their anxiety and depression symptoms. Another intervention I would use is behavioural activation, where we encourage clients to engage in pleasurable and rewarding activities that they may have been avoiding due to their symptoms. This technique can help clients improve their mood and increase their motivation to pursue their goals.

My preferred therapy is Narrative Therapy because I believe it aligns with my values and philosophy of empowering clients to create positive change in their lives by focusing on their strengths and resources. I also appreciate the collaborative and non-pathologizing approach of Narrative Therapy, which can help clients feel more respected and understood.

To work with the client, I have used a range of skills, including active listening, empathy, reflection, open-ended questioning, summarization, normalization, and validation. These skills have helped me create a safe and supportive environment where the client can explore their thoughts and feelings without fear of judgment or criticism. I have also used my knowledge of various therapeutic approaches and interventions to tailor the counselling process to the client’s needs and goals.

Some ethical issues that may be relevant for working with this client include informed consent, confidentiality, and boundary management. As per the PACFA Code of Ethics and Practice (2021), I must obtain informed consent from the client before starting the counselling process, which includes explaining the nature, limits, and expectations of counselling, as well as the potential risks and benefits. I must also respect the client’s right to privacy and confidentiality, except in cases where there is a risk of harm to self or others or where disclosure is required by law. Additionally, I must maintain clear boundaries with the client to avoid any potential conflicts of interest or dual relationships.