ILLNESS CASE OF BRIAN
Illness case shows Brian is a young adult because he is not at the age of 18 and is a first-year student in the university. He is also the firstborn diagnosed with cancer through the medical test and supports to go through chemotherapy and radiotherapy as the only chance of healing. However, Brian refuses the medication because of the side effect, e.g., nausea and hair loss. Brian seems to be going through anger and isolation since he has stopped going to school, talking to his friend, and is hostile to his siblings.
Brian has withdrawn from his parents because he is not sharing with them while his parents are going through a crisis of blaming each other for his sickness, which is not adding up to the causes of cancer. He is also not taking care of himself in terms of eating and bathing; he has to be reminded.
Explain the goals of Therapy
There is a big difference between counseling and therapy because therapy is aimed at the “personality change. It is an in-depth process requiring specific and extensive education and expertise. These can take considerable time since it is utilized with problems that are quite severe” (Wicks, 61). The therapy, therefore, deals with a person to change while counseling is “a helping process the aim of which is not to change the person but to enable him to utilize the resources he now has for coping with life.”.
Brian’s Therapy Treatment
In our case of Brian is important to set therapeutic goals because the problem has been presented. The goals are for helping Brian and his family become open to appointing they come up with their own problem – solving with the available resources. One of the greatest goals of a counselor, in this case, is to help solve problematic behavior that might cost Brian not to heal and continue getting sick because he has refused to go for chemotherapy, and it’s the only option for him to become better. In the fact that Brian has really special needs as a counselor, it’s important to explore his feeling about everything that is revolving around him.
Many questions might be going on around his mind after he has been diagnosed with cancer like, why me? Why now? Knowing that he had a bright future and all over sudden, he has to refocus on treatment. Brian hates going for chemo as a young person the side effect of the chemotherapy effects his look with the hair loss and nausea, therefore, the counselor should help Brian to reflect and explore emotions because of its an “important goal in counseling. It permits the person to open up, to identify and evaluate the feelings he has”.
To establish goals for therapy and working on steps to get, there is very important for Brian as an individual, and his family, as well as family therapy, is important. Another important goal for therapy is to “elucidate the inappropriate or fruitless pattern of dealing with a situation”. Brian, not talking to the friends and is hostile to his siblings, is out of the interpretation of how he thinks people are viewing him. Therefore, he may be having a negative personal opinion of what he is going through.
The therapy should help Brian build up a social relationship by being positive and also make an effort together with the counselor to look at the situation together. Looking at the situation together helps look at how he is feeling and how the feeling has resulted in him isolating and avoiding others to appoint of stopping schooling. This act will help Brian know he is in charge of his life and accept the situation and know that even when it seems very difficult, it’s not time to give up but face the situation.
Another goal of therapy is to psycho-educate the family, Brian’s parents are blaming each other for his sickness, therefore the need to know they are not the cause, and it’s not like God is punishing them and it’s not their fault. Psycho-education will help the parents to come into agreement with the situation and also to help each other instead of fighting the will help their son too.
The goal of enhancing coping skills is very important since it’s impossible to run away from the difficult, and for Brian, he cannot run away from the fact that he has cancer. It’s important for him to learn behavior patterns that will help in coping with the effect of chemotherapy and accept himself through its very hard, but it’s possible.
Improving relationships is a great goal of therapy because people with terminal illnesses develop major problems like Brian’s change in the view of their self-image. These cause the inadequate social skill that has brought about Brian not talking to his friends, and social difficulties are also observed in family, marital problems, and siblings interaction. It’s the responsibility of a counselor to strive to help Brian improve the quality of life by helping in developing an effective interpersonal relationship with family and friends.
Brian is struggling with making up his mind; therefore, another goal is helping in decision making. In his condition, he has to make critical decisions regarding his health. Therapy helps in getting information about the advantage of chemotherapy and clarifies emotions cancers like the loss of hair; it will affect his self-esteem and body change that are not positive. Identifying attitudes and emotions helps influence the decisions and choices, and Brian and the parents should evaluate, accept, and work on the choice, therefore, loaming the decision making process.
Facilitating behavior change is a good of great importance, in this case, to help Brian and his parents to have a change in their behavior of blaming each other. Brian also needs to change his behavior of isolating himself from the world and look at life in a positive way because he might be in denial about cancer he is having, therefore not wanting any medical help. It should be emphasized that he change his behavior and be positive about the medication being offered to receive treatment and healing before it’s too late.
The goal that is applicable in this case is many having in mind that the whole family is in a mess due to the news of the illness of their son and brother. The other goal would be facilitating Brian and family potential. These are by giving them the freedom to control their environment while analyzing their response and pressure of the disease; help him in taking care of himself.
The aim of counseling goals are applicable to clients depending on the case and should focus on the value of the client’s need of the moment. The goal of the therapy should also be applicable and observed; goals for therapy, in this case, are that some are ultimate, some intermediate, and others immediate to help deal with the problems being witnessed.
Explain the approaches and techniques and why they use them. An approach is therapy about language learning and cares psychologically focused, e.g., behaviorism or cognitivist, while a technique is a single activity that comes from a procedure of approach. One of the approach to use in Brian’s illness case is the
- Psychodynamics approach, which, according to class notes (2019), has to do with emotional conflicts and defense mechanisms of the individual. This approach will help understand Brains’ emotional reaction and the stressors accompanied by the diagnoses, and Brian has mixed feelings about chemotherapy and its side effects. He also has to look at the future as a young person with no good health, and it seems overwhelming and has chosen withdrawal and isolation and hostility as his defense that is continuing to affect him emotionally and have a healthy attitude toward chemotherapy.
- Behavioral approach and technique are important in Brian’s case to help him have adequate coping skills to help deal better with cancer. As a young person, a cancer diagnosis can be so stressful and has resulted in an emotional reaction, which has led to hostility and withdrawal from social life. The behavioral approach will also help Brian to gain control of his life and know there is no other option toward him becoming better except for the unwanted chemotherapy.
- The cognitive theory approach and technique focuses on the client’s present situation is Brian’s diagnosis of cancer, and it’s on how he is thinking about cancer, and therefore this approach is to help him change his feeling about chemotherapy and his behavior toward his family friends, school and parents. This approach is also helpful to the parents because it can help them change the behavior of pointing to each other or blaming each other for Brian’s sickness and instead come together and help him. Brian’s siblings might be in a shock about their brother’s new development of being hostile, and therefore, this cognitive approach will help them change their view and feeling on him and understand him much better.
- Family approach and technique these approach sees the symptoms of one affected family member as pointing to the large family unit, therefore, affecting the whole family in different ways. This approach, therefore, focuses on the treatment of the whole family to help in solving the social problem in interaction in that Brian is hostile to his siblings and friends. The parents are also busy fighting and blaming each other for his sickness. One goal of this approach is to improve communication patterns in this family because the family “plays a significant role during the time of illness and their reactions will contribute a lot to the patients’ response to his illness” (Parkes, 2005). When communication is poor, it affects his progress to go and make a decision about chemotherapy.
The family approach also helps in solving some family problems. As we have been, Brian is hostile to his sibling and likely as the firstborn it could affect their relationship much by feeling threatened and lack of security, meaning they are also affected. Brian being sick, might have affected the change in household affecting the younger siblings who used to look on him. These family problems can be solved through talk therapy to address the problems and work on them.
Family members go through different stages, trying to come to terms with either death, terminal illness, or mental illness. In Brian’s family, the rents are angry with each other, and they are blaming each other, and “just as the patients go through a stage of anger, the immediate family will experience the same emotional reaction”. Brian’s parents feel guilt because of trying to come in terms with the sickness; if they are nit not psycho-educated, their disagreement could grow into a major family misunderstanding.
The approach is also so helpful to boost family functioning misunderstand improve the relationship in a family whereby Brian can fully share his feelings and return get encouragement from the family to make a decision because the immediate family influences the decision in a huge way.
Aspects of Counselling
The developmental stage of Brian as the case states Brian is 18 years old, and according to Erickson’s Theory, he is young adulthood (18-24). The stage is referred to as intimacy versus isolation; the aspect to consider is what happens around this stage where young people are developing close and meaningful relationships. The condition that Brian is a terminal illness and where he has not started chemotherapy. At this developmental stage, its time that Brian is focusing on a school, which he was doing so well and start on a career, and cancer diagnosis is interfering with a very important part of his life.
The other aspect of Brian worries about what will happen after chemotherapy, like losing his hair and change his body image about dating and intimacy and cause anxiety. Therefore it’s important to consider his thoughts and feelings as a young adult dealing with cancer. It’s important, therefore, to deal with the denial of refusing to believe a reality about cancer as a terminal illness. Therefore, it’s good to consider a support group where he can get people of his age fighting cancer and can be encouraged.
Discussing a treatment plan for him is a very great aspect to discuss with Brian, and when the treatment is starting, also him talking about it and sharing is part of the healing process. Although no much is written about young adults and cancer, it’s a very important aspect to help the families know the crisis that is Brian is going through as a young person with cancer. He might be using a projection mechanism toward his siblings, and therefore, family therapy is important even to the siblings to build relationships.
Cancer as a terminal illness causes a great impact on a person from the time it’s diagnosed, and something to consider is monitoring the response of the illness because so much has been interrupted with.