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Introduction To Counselling And Behavioral Changes

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1. Interpretation about two goals to assist Mei

Mei's present behaviour can be comprehended by employing diverse theories that explicate the mechanisms of behavioural transformation and the driving forces behind them.

The Transtheoretical Model (TTM)

Figure 1: The Transtheoretical Model (TTM)

(Source: Imeri et al. 2021)

The Transtheoretical Model (TTM) posits that individuals who modify their behaviour should progress through a sequence of stages (Hashemzadeh et al. 2019). The stages that constitute this particular stage are the pre-contemplation stage, the contemplation stage, the preparation stage, the action stage, and the maintenance stage. Mei appears to be in the contemplation stage, characterized by an acknowledgement of the need to modify her behaviour, yet without any active steps taken towards implementation. Mei is currently situated on the stage above.

Theory of Planner Behaviour

Figure 2: Theory of Planner Behaviour

(Source: Abbasi et al. 2021)

As per the Theory of Planned Behaviour (TPB) postulations, three constituents are accountable for influencing behaviour (Oteng-Peprah et al. 2020). Attitude, subjective standards, and perceived behavioural control are significant factors of this theory. Mei's outlook towards her science class seems pessimistic as she frequently expresses her dissatisfaction with the course material, citing it as uninteresting and causing her to feel isolated in the classroom. The lack of motivation displayed by the individual may be attributed to her perception of subjective norms, particularly in light of the inadequate support she received from her peers and teachers. It is possible that Mei may possess a lower level of self-perceived behavioural control. This could be a potential scenario as she seems to encounter difficulties in adapting her study habits.

Regarding Mei's level of motivation, it seems that her primary driving force is the aspiration to uphold her academic scholarship and maintain high grades. Conversely, the absence of any inclination or communication with the subject suggests that her motivation may not be intrinsically linked to the topic. There seems to be a lack of interest and engagement on her part towards the content.

Two distinct objectives could be pursued to assist Mei:

Mei's apparent lack of engagement with the subject matter suggests a potential absence of intrinsic motivation. As such, it is imperative to explore strategies to enhance her motivation towards the topic. One potential objective could be to facilitate the process of identifying a personal interest or passion that is linked to the subject matter under consideration (Russo and Russo, 2019). Mei should engage in introspection regarding her decision to pursue a science major, her areas of interest within the discipline, and the potential integration of her passions into her academic pursuits. This is a course of action that may be suggested by the counsellor. By enhancing her intrinsic motivation, Mei could potentially increase her likelihood of effectively engaging with the information, acquiring a more profound understanding, and cultivating a greater appreciation for it. These potential outcomes could arise if she is more likely to actively engage with the content.

Mei acknowledges that she is falling behind in her academic responsibilities and acknowledges that she is encountering difficulties in adjusting to the requisite modifications in her study habits. One of the objectives may involve facilitating the development of more efficacious study practices (Jiménez-Zazo et al. 2020). The counsellor may advise Mei to devise a study timetable, break down the tasks into smaller and more feasible segments, and employ active learning techniques such as condensing the topic, producing study resources, or instructing someone else on the subject matter. By enhancing her study habits, Mei could potentially experience increased autonomy in her learning and a heightened likelihood of staying on course.

In summary, a comprehensive comprehension of Mei's behaviour can be attained by employing various theories about behaviour modification and individual motivation. This approach may provide insights into the optimal strategies to assist her. By enhancing her study habits and augmenting her intrinsic motivation, Mei could potentially surmount the obstacles she encounters and attain triumph in her scholarly pursuits.

2. Smart Goals and Explanation

Specific:

To provide greater precision, I intend to maintain my weekly attendance at therapy sessions for the subsequent three-month period.

Measurable:

To ensure accountability, I intend to monitor my attendance by utilizing a calendar and prioritize the timely completion of all sessions.

Achievable:

The individual intends to engage in proactive planning by scheduling therapy sessions in advance, prioritizing their mental well-being, and communicating any scheduling conflicts with their therapist.

Relevant:

The utilization of therapy can aid in enhancing an individual's capacity to manage anxiety and depression, develop effective coping mechanisms for stressful circumstances, and promote overall wellness.

Time-bound:

The commencement of the project is imminent as it is scheduled to begin next week. The intended objective is to complete all sessions within a period of three months.

Table 1: SMART Goal 1

Specific:

I shall allocate half an hour of my daily routine to participating in endeavours that foster my state of wellness.

Measurable:

I intend to maintain a record of their self-care activities through the use of a journal, with the goal of incorporating a novel activity on a weekly basis.

Achievable:

The individual intends to allocate a specific duration of time daily for personal self-care, premeditate their undertakings beforehand, and modify them as per the current demands.

Relevant:

Engaging in self-care activities has been found to positively impact an individual's well-being by reducing stress and anxiety levels, and enhancing mood and sleep quality.

Time-bound:

My objective is to participate in a self-care activity for a period of thirty minutes daily for the subsequent two weeks.

Table 2: SMART goal 2

In order to improve my psychological state, I have formulated a SMART goal to participate in therapy sessions on a weekly basis for the next three months. As a result of my proclivity towards making modifications, I have been encountering symptoms of anxiety and depression that have been impacting my daily routine. The author recognizes that therapy has the potential to equip them with techniques to manage their symptoms, enhance their general well-being, and assist them in attaining their individual and professional goals.

My objective, in accordance with the theory of planned behaviour, is to modify my conduct by regularly attending treatment sessions. In order to attain this objective, I intend to take a proactive approach by scheduling appointments in advance, prioritizing my mental health, and effectively communicating any scheduling conflicts to my therapist. The prevailing belief is that engaging in therapy can bring about a positive transformation in behaviour, which can yield numerous benefits for an individual's holistic well-being.

Transtheoretical model of behaviour modification

Figure 3: Transtheoretical model of behaviour modification

(Source: Tsampoula et al. 2023)

According to the Transtheoretical model of behaviour modification, my current position in the developmental process is the action stage. The writer has demonstrated a commitment to upholding their promise to attend therapy sessions and has proactively arranged their first session. To enhance the probability of attaining my objective, I can make alterations to my environment, including creating a serene ambience for my therapeutic sessions, reducing interruptions during these sessions, and recognizing any potential obstacles to attending the sessions, in order to devise a strategy to overcome them.

Additionally, I can solicit aid from my acquaintances and relatives by articulating my objective to them and appealing for their backing while also ensuring that they hold me accountable for my progress. A viable strategy for tracking personal development involves maintaining a log of therapy sessions using a journal or calendar (O'Grady et al. 2020). This can enable a reflective process in which the individual can assess the degree to which these sessions are contributing to the intended results. Ultimately, the individual has achieved a sense of contentment through their accomplishments and maintains their motivation by regularly reflecting on the advantages of continuing with therapy and the advancements they have made in their life.

3. Two relevant ethical issues

The observance of ethical standards is a pivotal facet of counselling practice, as it protects clients' welfare and advances their general welfare. The case of Peter, a former member of the armed forces who are presently struggling with distressing memories from his military service, raises two relevant ethical inquiries.

The breach of confidentiality is the foremost ethical issue. The Australian Psychological Society (APS) mandates that psychologists are bound to maintain the confidentiality of their patients and clients in accordance with the Code of Ethics (Allan, 2021). However, it should be noted that this obligation is not universally applicable, and there may be instances where it is not valid. An exemption may occur when there is a significant probability of causing harm to the client or other parties. Currently, Peter's spouse has conveyed concerns regarding his health status, indicating the possibility of him posing a risk to either himself or others. As a result, it may be necessary to compromise the confidentiality of the data and reveal it to the relevant authorities in order to guarantee his safety.

The second ethical concern relates to the matter of competence. It is crucial to determine the appropriateness and effectiveness of the interventions utilized for Peter. It is possible that counsellors may not have undergone specialized training or supervision in therapeutic approaches that focus on trauma (Essex, 2019). Therefore, it is crucial to ensure the acquisition of such training. In accordance with the Code of Ethics established by the American Psychological Society, psychologists are required to fulfil their duty of improving their professional competence and knowledge (Allen et al. 2022). Given the circumstances, it may be necessary to advise Peter to seek the assistance of a mental health professional who specializes in a range of trauma-focused therapeutic approaches.

It is essential to engage in an open and honest discussion with Peter and his partner regarding the ethical concerns that have been raised in order to reach a satisfactory outcome. The first step involves initiating a dialogue with Peter concerning the constraints of confidentiality and the utmost importance of safeguarding his well-being. During the present session, it would be advantageous to examine the potential avenues for directing individuals to a mental health practitioner who has the requisite proficiency to provide specialized trauma-focused therapeutic interventions.

4. Safety plan and assessment for Maya

Maya's presentation during the initial interview elicits concerns pertaining to her mental health and the potential risks that she may face. As an individual in the field of psychology who holds a provisional status, it is of utmost importance to carry out an evaluation of potential risks and establish a protective strategy for Maya in order to promote her overall welfare and satisfaction. Obtaining additional information is essential to improve the understanding of potential hazards' scope before performing a risk assessment (Naslund et al. 2020). It is advisable to conduct additional investigation to determine if Maya is presently manifesting suicidal or self-injurious thoughts, has a record of hospitalizations, substance dependency, and availability of firearms or other hazardous methods. It is crucial to perform an evaluation of Maya's availability to mental health interventions and the scope of her social support.

Maya's prior history of depression and self-harm may heighten her vulnerability to suicidal ideation and subsequent self-injurious behaviour. The aforementioned discord with the individual's significant other and the waning of pleasure in formerly gratifying pursuits could potentially indicate an escalated encounter with stress and anxiety (Nesi, 2020). The lack of a strong social support system and the existence of strained interpersonal relationships with her partner may heighten the likelihood of her experiencing depression and entertaining thoughts of suicide.

The incorporation of Maya's perspectives and requirements is imperative in the formulation of a safety strategy, underscoring its significance. When Maya encounters circumstances that induce a feeling of being overwhelmed or threatened, it is recommended to establish a safety strategy that encompasses practical measures. The aforementioned measures may entail contacting the individual's primary healthcare provider or a crisis hotline, seeking assistance from a reliable confidant or family member, or participating in self-care routines (Martiniuk et al. 2023). Engaging in a dialogue with Maya concerning the implementation of strategies aimed at restricting access to potentially dangerous instruments, such as firearms and pharmaceuticals, is of utmost importance.

It is recommended that the safety plan include a list of emergency contacts, which should encompass crisis helplines, mental health agencies, and emergency services. Moreover, the proposed strategy should specify the actions that Maya can implement in case she identifies a hazard to her well-being, such as arranging a meeting with her principal healthcare provider, participating in a counselling session, or, if required, hospitalizing her. It is advisable to subject the plan to periodic examination and make necessary modifications, while considering the prevailing circumstances and requirements of Maya.

5. Steps to terminate therapy

Determining the optimal moment for a client to conclude therapy and shift towards alternative forms of care can present difficulties for both the therapist and the client. In the process of deciding whether to discontinue therapy, it is essential to take into account the client's overall psychological welfare, as well as their progress and goals during the therapeutic process (Sanford et al. 2020). Jay has demonstrated notable progress in effectively managing their social anxiety, enhancing their self-esteem, and actively seeking new employment prospects. On the other hand, it can be inferred that Jay is encountering difficulties in recognizing the concerns that necessitate intervention throughout their therapeutic progression. This implies that they may have reached a stage where the benefits of attending therapy sessions are no longer advantageous.

The person displayed feelings of unease and distress about the possibility of being left alone after I informed Jay that they had reached a point in their therapy where it was possible to stop. The aforementioned assertion does not inherently imply the requirement for continuous therapeutic sessions. Instead, it underscores the significance of additional communication to acquire comprehension regarding the person's concerns and evaluate their preparedness for terminating the therapeutic intervention (Pépin et al. 2021).

In the capacity of a therapist, I would engage in a collaborative effort with Jay to delve into the fundamental motives behind their decision to pursue continuous therapy. Additionally, I would initiate a discourse with Jay to gain insight into their future aspirations. Engaging in a discourse concerning the progress achieved during therapy and emphasizing that the termination of therapy does not imply abandonment or absence of aftercare may yield benefits (Lawson et al. 2021). Possible areas of exploration involve formulating strategies to maintain the advancements achieved during clinical treatment, as well as identifying any remaining challenges or barriers that may require additional support. This action would be performed concurrently with the previous statement.

If Jay communicates an unwillingness to discontinue therapy, a possible approach to ensure a smooth transition could entail reducing the frequency of weekly sessions and focusing on particular issues or anxieties that may be present. In addition, it is recommended to establish a collaborative approach to develop a comprehensive strategy for Jay to apply outside of the therapeutic context, with the aim of preserving their mental health and general well-being. The aforementioned may pertain to techniques for safeguarding oneself, receiving aid from the community, and identifying additional resources or support networks that may be utilized in times of need.

Therefore, it can be concluded that as a therapist for Jay, my role would involve working collaboratively with him to identify and clarify his concerns, examine his goals, and develop a strategy for maintaining his mental health and overall well-being beyond our shared sessions.

References

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  • Allan, A., 2021. The Australian code of ethics. In Handbook of International Psychology Ethics (pp. 77-93). Routledge.
  • Allen, K.A., McInerney-Leo, A.M., Gamble, N., Wurf, G. and Boyle, C., 2022. The ethical protection of genetic information: procedure analysis for psychologists. Clinical Psychologist26(1), pp.1-10.
  • Essex, R., 2019. Do codes of ethics and position statements help guide ethical decision making in Australian immigration detention centres?. BMC medical ethics20(1), pp.1-9.
  • Hashemzadeh, M., Rahimi, A., Zare-Farashbandi, F., Alavi-Naeini, A.M. and Daei, A., 2019. Transtheoretical model of health behavioral change: A systematic review. Iranian journal of nursing and midwifery research24(2), p.83.
  • Imeri, H., Toth, J., Arnold, A. and Barnard, M., 2022. Use of the transtheoretical model in medication adherence: A systematic review. Research in Social and Administrative Pharmacy18(5), pp.2778-2785.
  • Jiménez-Zazo, F., Romero-Blanco, C., Castro-Lemus, N., Dorado-Suárez, A. and Aznar, S., 2020. Transtheoretical model for physical activity in older adults: Systematic review. International journal of environmental research and public health17(24), p.9262.
  • Lawson, M.R., Lessen, L.N., Wang, J., Prabhakar, A., Corsepius, N.C., Green, R. and Puglisi, J.D., 2021. Mechanisms that ensure speed and fidelity in eukaryotic translation termination. Science373(6557), pp.876-882.
  • Martiniuk, A., Toepfer, A. and Lane-Brown, A., 2023. A review of risks, adverse effects and mitigation strategies when delivering mental health services using telehealth. Journal of Mental Health, pp.1-24.
  • Naslund, J.A., Bondre, A., Torous, J. and Aschbrenner, K.A., 2020. Social media and mental health: benefits, risks, and opportunities for research and practice. Journal of technology in behavioral science5, pp.245-257.
  • Nesi, J., 2020. The impact of social media on youth mental health: challenges and opportunities. North Carolina medical journal81(2), pp.116-121.
  • O'Grady, C., Melia, R., Bogue, J., O'Sullivan, M., Young, K. and Duggan, J., 2020. A mobile health approach for improving outcomes in suicide prevention (SafePlan). Journal of medical internet research22(7), p.e17481.
  • Oteng-Peprah, M., De Vries, N. and Acheampong, M.A., 2020. Households’ willingness to adopt greywater treatment technologies in a developing country–Exploring a modified theory of planned behaviour (TPB) model including personal norm. Journal of environmental management254, p.109807.
  • Pépin, J.L., Bailly, S., Rinder, P., Adler, D., Szeftel, D., Malhotra, A., Cistulli, P.A., Benjafield, A., Lavergne, F., Josseran, A. and Tamisier, R., 2021. CPAP therapy termination rates by OSA phenotype: a French nationwide database analysis. Journal of clinical medicine10(5), p.936.
  • Russo, J.A. and Russo, T., 2019. Teacher Interest-Led Inquiry: Unlocking Teacher Passion to Enhance Student Learning Experiences in Primary Mathematics. International Electronic Journal of Mathematics Education14(3), pp.701-717.
  • Sanford, S.L., Welfer, G.A., Freudenthal, B.D. and Opresko, P.L., 2020. Mechanisms of telomerase inhibition by oxidized and therapeutic dNTPs. Nature Communications11(1), p.5288.
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