Saturday, January 18, 2014

Jane is a 69-year-old black, married, retired female who lives with her husband. She was referred to you for individual counseling to work on severe anxiety and moderate depression. Jane's physical health has been declining after injuring her knee a year ago. Jane has been doing water aerobics weekly and was working a part-time job and active in her prior to the onset of the medical problem. Jane underwent surgery to repair the injury, however, she still reports weakness and some numbness which impacts most daily activities. When Jane comes to meet with you, she is tearful and reluctantly using a walker. She tells you that she had delayed coming to therapy for a week in hopes of feeling better but finally came at the urging of her husband and using the walker for the first time that day to steady herself. Jane's doctor informed her that there is nothing more he can do to help her and suggested pain medication which Jane does not want to take because it makes her feel sick. Since receiving this news, Jane has been feeling more down and has been isolating herself and has refused to seek a second opinion despite her husband's urging because she does not feel any doctors will listen to her or understand. Using Multicultural Feminist Theory, how do you help to empower Jane and encourage her to explore other medical options? What strategies do you incorporate to address Jane's depression and anxiety?

Personally, I wouldn't use Multicultural Feminist Theory to help Jane overcome her fear and anxiety or to motivate her to change her mind about getting a second opinion from a doctor or a physician; in fact, I wouldn't use any psychological theory at all. I think that the best way to help Jane would be to directly address her fear and anxiety.
Fear and anxiety can last for a short amount of time, but they can also last longer and affect our ability to eat, to sleep, and to do basic daily tasks; essentially, they can greatly impact our lives. I would explain to Jane that every healing process, be it physical or psychological, takes time; not even the common cold can be treated overnight. I would try to make her understand that she must stay strong and patient and tell her not to give up on herself. I would also encourage her not to lose hope in her doctors, as they're trying to do the best they can to help her situation. As far as her choice to avoid medicines is considered, I would advise her to keep a healthy diet and practice different relaxation techniques, but if the pain is too much, then I'll try to explain to her that the doctor might prescribe her some alternative medicine that she might be able to tolerate. For her to understand her condition, she must first accept that the injury happened and that there's nothing she can do to turn back time. This is why Jane must always voice her problems and inner troubles, as communication is key when it comes to her therapy sessions. Likewise, her therapist must always be honest, rational, supportive, and compassionate, and they should show her that she is not alone and that everyone has her best interests at heart.
I would also like to mention that cognitive behavioral therapy has proven to be successful in the treatment of many patients who suffer from fear and anxiety. Thus, I might recommend CBT as a way to treat Jane's problem. CBT works because it helps the patient to identify the problem, challenge and face it, and then try to overcome it by replacing all negative thoughts and emotions with positive ones. I believe that this might be very helpful in Jane's case, as her inability to accept and face her problem and her medical condition seem to be the main reasons why she cannot motivate herself to initiate and speed up her recovery.

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