I also declare, if this is a practical skills assessment, that a Client/Interviewee Consent Form has been read and signed by both parties, and where applicable parental consent has been obtained.
1. List three influences of the dysfunctional environment Lucy grew up in. How might these have affected Lucy as an adult?
In the first example, the influence of Lucys father can be seen in the type of partners Lucy has chosen for her boyfriends. Lucy grew up with a father who had the disciplinary role in the family. Many of Lucys boyfriends have been violent towards her, she may be attracted to a partner who likes to be in control. This may be because, to her a mans role is to dole out discipline. Lucy may be unconsciously choosing partners that model the same type of behaviour as her fathers. It would be interesting to know if many of them were also cold and distant towards her.
In the second example, the influence of Lucys mother can be seen in how Lucy has also turned to alcohol to cope with her own depression. Lucys mother often found it hard to cope with life, especially when the children were younger. She allowed the eldest child Ted, to take on the responsibility of looking after the children when she felt too depressed or affected by alcohol to care. Lucys behaviour shows that she is finding it hard to manage her life, much like her mother did. She may be unconsciously modelling herself after her mother, in regards to how she copes with life and the issues that arise. Lucy may think of alcohol as a medication for her depression and anxiety, as she saw her mother use alcohol as a coping mechanism growing up. Lucys behaviour most strongly resembles her mothers, and I believe her mother has had the greatest influence and effect on Lucy as an adult.
In the third example, the disruptive household Lucy grew up in has impacted on Lucys adult life. Firstly, in the first ten years of Lucys life, she was regularly exposed to her parents arguments and fighting. Lucy must have grown up feeling very uncertain and anxious about her life, without the nurturing support of her parents. Secondly, she must have grown up resenting her older brother for acting as a substitute parent towards her.
2. How might the sibling birth order have affected the eldest and the youngest children and how they respond to Lucy, even though they had similar modelling and reinforcement from their parents as children?
Lucys eldest brother was the first born and often the first born child takes on the role of caretaker in a dysfunctional family unit. Ted has developed the typical characteristics of the first child in that he has taken on a leadership role within the family. Ted may feel more like Lucys father than her brother and this explains why he feels it is ok to voice his opinions about Lucys life. His role in the family has been to problem solve, so that the family functions as well as it can.
Ted wants to help and care for Lucy, by offering his advice on how to solve her problems, but Lucy resents this as she sees Ted as her brother not a parental figure. Amys position in the birth order is the last child and so she has been sheltered from the early turmoil of the family. The last child is often protected from the reality of the dysfunctional state of the family. Amy has not had to deal with the type of problems the older two have, and does not have the same pressure that the other two have. Lucy feels that Amy does not try to control her, and so she relates better to her.
3. Suppose that Lucys broad goals for counselling are to stop abusing alcohol and stop repeating the pattern of abusive relationships. Outline a program of change for Lucy, including: a) Identifying the specific goals she might work towards.
b) How you might apply and record reinforcement to help Lucy reach her goals?
c) How you might help Lucy monitor any changes made?
The specific goals that Lucy can work towards in counselling would be to manage my alcohol consumption in a responsible way and to choose a more suitable partner for a relationship. In helping Lucy reach her goals I would encourage her to keep a diary of her behaviours and the feelings associated with these behaviours. For example Lucy could record how she is feeling the next day after drinking too much alcohol, and she could also record how she felt the next day after making the choice to abstain from drinking. She could then compare her feelings and hopefully she can find positive reinforcements to encourage her non drinking behaviour.
Through keeping a diary it serves two purposes, firstly it helps Lucy identify her own successes and disappointments, and it will help clarify her own feelings toward her drinking behaviour. Secondly it is a record that Lucy and I, as Lucys counsellor, can use as a reference to check on her progress in achieving the goals she has set for herself. The more the successes outweigh the disappointments the more likely Lucy will continue to modify her behaviour and improve her feelings towards herself.
4. Explain the concept of stimulus and response in counselling and describe how it might be useful in helping Lucy reach her goals.
The concept of stimulus and response in counselling refers to the theory that a certain stimulus triggers a certain response in how we behave. The experiences we have (the stimulus) influences our behaviour (response). In Lucys case she has developed a dependence on alcohol as a response to her anxiety and depression. During our counselling I would help Lucy to recognise that she may be able to find other ways of responding to her anxiety and depression. Lucy has a learned response in regards to her feelings of anxiety and depression, which she learned from her mother. It would be beneficial for her to recognise that she can learn a new response to these issues. I would ask Lucy to think of other instances, where she has had success in overcoming an obstacle, has she tried other responses to her triggers. What has not worked in the past would also be helpful to know.
5. Explain the principles of negative and positive reinforcement and describe how they might be useful in helping Lucy reach her goals.
The principles of negative and positive reinforcement are that the consequences of our behaviour is strengthened due to the type of reinforcer being used. Positive reinforcers are when we receive a pleasant consequence to a type of behaviour that encourages us to continue with that type of behaviour. Negative reinforcers are the same as positive reinforcers in the sense that we still receive the encouragement to continue with a type of behaviour but this time it is because we are avoiding an unpleasant outcome to the type of behaviour. An example for Lucy is her use of alcohol, negative reinforcement could be used to help her change her behaviour.
In order for Lucy to stop abusing alcohol she needs to associate her drinking with the unpleasant outcomes of her behaviour. The use of alcohol is putting her at risk of losing her job, home and friendship. Negative reinforcement could help Lucy recognise that by choosing to stay sober she will avoid the unpleasant consequences of putting her job, home and friendship at risk. Positive reinforcement could be used to help Lucy recognise that by choosing to stay sober, her work life will be more pleasant if her bosses notice she is showing up on time. Her home life will be more secure if she pays her rent. Her friendship will become stronger if she is seen to be working towards change.
6. Explain what is meant by negative punishment and negative reinforcement and suggest how these principles might have impacted on Lucy in the past.
Negative punishment is when a particular pleasantry has been taken away as punishment for the type of behaviour being displayed. Negative reinforcement is when we stop or avoid a particular behaviour due to receiving a negative outcome to our behaviour. In Lucys case she has received a formal warning at her workplace, this means that she could be in danger of losing her job if she continues with this type of behaviour. She is also in danger of losing her home due to being behind in her rent, and losing her friendship with Jacquie who is her only real friend.
These are all examples of the negative punishments Lucy has incurred due to her behaviour. During counselling it may be beneficial for Lucy to make the connection between her behaviour and the negative punishment she will receive as a result. Using negative reinforcements would help Lucy to avoid the behaviour, she can choose to avoid using alcohol as a way of avoiding the unpleasant outcomes this choice brings with it.
7. Explain how influences from environmental modelling in Lucys life as an adult could help or hinder her in reaching her goals.
Helping Lucy to identify who her role models have been, and who they are now, will help Lucy have a better understanding of why she responds to certain situations in the way that she does. In the past I believe Lucys mother has been the most influential person in Lucys life. Lucy has grown up observing her mothers behaviour, this type of modelling has taught Lucy how to respond to stressful situations. Identifying with new role models in her adult life, can help Lucy find other ways of responding to these same situations. I would encourage Lucy to think about the people in her life now. Who does she admire, who stands out as someone she would like to be like? What type of person are they and how do they cope with life in stressful situations? By observing a different model and learning new responses to old stresses, Lucy can begin to see that there are many other ways that people respond to the stimulus in their lives.