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Practical No. 5
Case Summary:
Tanveer is a 17-year old boy who completed his Class XII with average marks. He is an intelligent and hard-working student, however, for the last two years he has become disinterested in his studies. He is thoroughly dependent upon luck and fortune. Presently, he has been following someone on social media and started to meditate for long hours each day. The duration of meditation is somewhere between five-six hours every day. Though, completely disinterested in studies, he has applied in various colleges and University of his city for an undergraduate programme. He wants to pursue Journalism, but his father wants him to pursue Law (father is a Lawyer).
Introduction:
The pressure on teenagers to achieve high levels of academic excellence and fit into the goals of their peers sometimes kills the joy out of the education. It not only makes them anxious and stressed but also highly affects their performance as it can adversely affect their ability to learn, memorize, and earn good grades. So, students as well as their parents should be aware of the triggers that can cause stress among teenagers. Not always the symptoms of stress and anxiety are obvious. Some stress warning signs among the high school students are change in appetite, change in sleeping patterns, social isolation, disinterest in games and outings, drop in performance, inability to concentrate or complete the task, etcetera. Stress can be recognized by detecting a nu7mber of alterations occurring in a student’s routine activities. Parental, societal and peer pressure are some of the major factors in triggering stress among teenagers. Parents indulge their children into high expectations and continuous comparisons with their friends and classmates, which may lead to disastrous consequences regarding the overall health and growth of the child. Similarly, societal and peer pressure may lead to immense stress to the students, disturbing their academics and personal life. It’s important to understand that every child is unique in some way or the other and it is about identifying the traits and developing them with full support. Time when students have to start thinking about what kind of career they want to pursue, they also have to plan a career path to lead to that career which require stream choice, choosing the right college, vocational training etcetera. It’s normal for students to feel confused
and unsure about their decisions in such times. To tackle all the challenges, students have to make right plan and strategy which may include guidance of parents, teachers, or an academic counselor.
Case Context and Method:
The current case is referred for treatment in a clinical setting. The client was brought to the counselor by his mother regarding the current dilemmas faced by the client and worries about his future plans. The client was formally asked for written consent to make the case report for publication, to which he agreed with enthusiasm. The case history and data collection was done in form of written notes as well as diary report given by client in later sessions. The client was informed about the therapy sessions, their duration, and homework by the client, family involvement and basic explanation of how the sessions will proceed. There were no previous significant clinical records of the client, of any therapy.
Case Description:
Name of the Client: Tanveer Age: 17 years Sex: Male Education: Twelfth Standard Family Type: Nuclear Family Residence: Urban Socioeconomic Status: Average Middle Class Chief Complaints: The client Tanveer was referred for counseling and guidance regarding his future plans and career prospects on advice of his mother. The client had felt a lack of interest in studies since last two years after completing his Tenth standard, as he was interested in taking the Arts stream but had to take Commerce stream on insistence of his father. All his friends, with whom he always
as well and increased the duration of his meditation hours. When his mother asked him the reason for it he told her that he is not able to concentrate well in studies and that is why trying to improve his attention-concentration skills by meditation. Client’s father have always been a little firm with their son about his studies and always expressed his wish for Tanveer to go in the field of Law as he believe that he could help him at every stage in a field that he’d already done a good job in and his son wouldn’t have to deal with the obstacles that life throws in everyone’s path. Client’s mother feels that the father-son relation have been a little strained due to the little arguments they have about his career now and then, which bothers the client as he was closest to his father since childhood. Client’s mother reported that Tanveer’s interest in Journalism is news to them as he never mentioned it earlier, though she was always aware of his interest in literature and social sciences. She wants her son to choose a path of his choice but after working out all his options and their future prospects. Tanveer have always been friendly and cordial with all family members and relatives, and significant psychological issue or any other medical issue was there. This is the first time that she noticed that her son seemed slightly stressed out about something that started to affect his appetite and interaction with his peers around.
Case Formulation and Treatment Plan:
The current case is a two-fold problem; one being the career choice confusion in the mind of a teenager who needs to make one of the biggest decisions of his life till now and second being the distance client feels has come between him and his family due to this choice. In the treatment plan first and foremost target is to explore as much of the client’s life choices and decisions as much possible, his relation with his immediate family, his relatives, his friends etcetera. It’s important to understand what influences client’s decisions in his personal life and his academic choices; is it just the direction to which his friends go makes his decisions final or the teachers; if he is adequately aware of the different fields and career paths one can take; if his exposure to different areas and fields is adequate enough; is the social media influencer he follows helping him out and if yes, then in what ways. Answer to all these questions will be useful in not only formulating the treatment plan for the current issue of the client but also may bring out any hidden or ignored conflicts that client might have with himself. For all this information gathering it is crucial for the counselor to build a healthy and comfortable rapport with the client and make him understand about the role of counselor in his current situation which his mother believes is
vital to help out the client. Along with the rapport building, both counselor and the client should get an idea of the treatment plan and goals of the therapy. Client should be asked about their expectations from the therapy process and counselor is to define how these goals are to be achieved. Treatment goals are the most important factor of the counselling process and there should be no misunderstanding or discrepancy at any point about how the counseling process is going to achieve those goals. Second step in the process of counseling would be to apply adequate necessary tools for the assessment of all the factors for which treatment is deemed essential. In the current case, second and third session be used for assessment and any psychological test if necessary. The assessment is to be done with proper formal procedure and taking all necessary precautions in order to get the accuracy rate high. The client’s consent for all the assessment tools used should be taken prior and proper instructions to be given at the time of taking the tests. Assessment Tools used:
- For Personality Assessment: According to Cattell, there is a common structure based on which people differ from each other and it is empirically determined by the test structured by Raymond Cattell as Sixteen Personality Factor. It will help to assess the basic traits of Tanveer’s personality, as certain physical and emotional characteristics are beneficial for certain job types and gives an idea of the social traits, motives, personal conceptions and adjustments of the client.
- For Interest Assessment: Interest Inventory and Career Preference Record to be used for the vivid picture about how the client sees his future direction, and how sure client is about his likings and preferences. Here the role of the counselor is not only to take client’s response into consideration for his expressed interests but also to explore about the observed interests of the client which are inferred by the information gathered from interviewing his family and the client himself. Vocational Interest Record used to ascertain social- psychological factors of personality that identify his interests and match them to a number of fields that will most likely suit him.
- For Aptitude Assessment: Along with the interest in afield it is of utmost importance that an individual need to have aptitude for a career path they want to choose. Aptitudes are
To counsel and guide Tanveer, duty of the counselor is to consider all aspects and classify them broadly and with proper subsets. First issue to tackle is of the career choice for which the assessment previously done should prove extremely successful. Consider the assessment results and give exposure of various career options that may suit the client’s preferences. An overview of various fields such as Journalism, Law, Literature, Mass Media, Advertising, and related fields to client’s choices, plus the mechanism of how a job profile in these fields might look like. Being a field journalist is job of mind and physical strength as well, being a reporter requires not only excellence in speech but a vast knowledge of all fields, history, politics, entertainment etcetera. The client’s preference here is Journalism, it is important to understand the scope and growth of the field and if the client is choosing it for right reasons and not just to follow in steps of his friends. The parents wish here for the client to be lawyer, if it is justified and why client does not feel it is an appropriate choice for him. Also if the assessment results show that the client has better skills in some other field say literature or social studies then it is the duty of the counselor to make them aware of their impeccable grasp in that area and what kind of career opportunities are present to make use of their such skills. As a counselor it is also essential to take observable mannerisms and behavior of the client into consideration to know about skills of the client that he himself might not be aware of or may not see them as useful for his lack of awareness about all the career fields. Another session is to be completely dedicated to what personal issues client is going through with the family and friends? Why the client feels the need to meditate for long hours and how influenced he is by the social media? How much h relies on luck and fortune for his success and how much he believes in himself to make his own life better? Does it help him to do better when he keeps his faith in luck? These are a few important questions that should be reasoned to challenge client’s logic as it helps them get a clear picture of whys and whats of their reasoning. Another important issue is that of the family equation, how comfortable is client being open to discussing matters openly with family and putting forth his choices? Is the client ready to listen to his parents about their perspective to why they wish for him to do Law, how they can help him and want to support him with his career. How he can better his relationship with his parents and not let little disagreements to strain the family ties.
Course of Treatment and Monitoring of Treatment Progress:
The current case of Tanveer require a short term therapy of 4-6 sessions each of which is 45 minutes over the duration of two months.The first session to be dedicated to rapport building and exploration of issues in detail and note down anything of importance as informed by the client and his parents. This can done in form structured or unstructured interview and case history taking. Along with case history a formal Mental Status Examination also conducted. The next session should be for all the psychological tests and assessment tools along with furthering the therapeutic alliance between client and counselor.Third session is for explanation of results and outcome of the assessment and goals are presented and fixed by the mutual consent of the client and counselor.The most amount of the sessions are then assigned for the family therapy and discussion and exploration of prospects for the future plans of the client. During these sessions client is to move from the bundle of issues towards finding solution and answers to his questions. If necessary, required by counselor or the client, more of assessment tools can be used for further clarifications. The client should at all times be informed of the number of sessions and counselor to take care of the termination and follow up process. Only when the client is satisfied with the therapy outcome, last session is for termination and discussion of how the client feels that the sessions helped him to achieve his goals. Questions as follows should be answerable for the client: Was the therapy helpful? Does the client feel self sufficient to take a decision about the college and course he wish to pursue? Is the client self-decisive? Does the client feel that his parents are facilitator of his career choices?
Discussion and Limitations:
The goal of therapy is to make the client self sufficient for taking his own decisions with appropriate amount of influence from his surroundings. Hence it is important to not only address the academic part of client’s life but also his personality and personal choices. Here the social media influence was not a bigger problem but the “why” of client’s inclination toward an external source of avail is a concern that needed to be addressed. Intrapersonal relations of the client were cordial as well interpersonal relations among the family, but often teenagers feel isolated when dealing with internal issues and dodge discussions that might put them on spot. A
