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The Counselling Session

The counselling helps an individual to go through tough times. Around 3.8% of the total population suffers from some type of Mental Health Condition and needs counselling or therapy. The assignment critically analyses a counselling session with the help of the academic literature, case conceptualization, and counselling skills implied.

At the beginning of the video, it is seen that the individual is facing anxiety because of marrying a person from different religion and is highly distressed about the family differences. According to Crespin-Boucaud, (2020), marrying someone from a different religion may have significant barriers; however, as the nations diversify, interethnic marriages increase. She explained that she is getting married in June. She explained that her family is a Greek-Italian orthodox, and her other half is Muslim. She said that even though there are only a few differences in their family, such differences also cause huge issues. Before their marriage, they were having debates about their religion, and she had constantly defended her faith and value in front of her partner. She had come to an agreement with her partner to make her family know more about Islam so that her family does not get defended about sensitive terms or feel burdened about the language.

According to Rodríguez-García et al. (2018), the number of inter-religion marriages has increased, which has also increased the number of multilingual kids, creating a significant confusion among the kids leading to stigmatization, which is why kids are resistant to learn their mother tongue language. She explained that she is constantly defending her religion which is making her feel anxious and feel bothered. She explained her scenario with an example that her partner most times read Quran, which does not bother her but may bother her parents, which caused problems in her household. She explained another difference that her family drink most of the day; however, his family does not go to the restaurant to eat. All these are causing dilemmas in her life about the wedding. She has also pointed out the term compromise, which is a significant indicator that she is severely stressed and anxious about the wedding and her future life. The counsellor summarized the entire situation and explained that she is stressed because she is thinking about her future family and also her own family. The counsellor started asking basic questions to her clients, why are how long she and he were together? In response, she replied that she had been with her partner for more than two and half years and married in the Islamic religion for around 6-7 months. She explained how her dad came to an understanding and accepted the fact out of empathy that his daughter is getting married to a person of a different religion. She explained to the counsellor that she has compromised a lot in the past as a woman and has to compromise a lot because of her kids. The counsellor asked what is her partner’s take on the different religious marriage, whether he was anxious or not? In response, she replied that her partner is more go with a flow kind of a person and not much worried about this situation. She explained that her partner wants her to dress more modestly, and she is completely fine with such amendments as dressing more modestly shows respect for an elder person. She further explained that her partner did not care and also said she would love her mom. In light of this conversation, the counsellor had pointed out how much fun her partner’s mother is? In response to that, she explained that her partner’s mother could have thought that she would not have the same values and morals as their families, which is because her partner’s family is very constrained to their culture and values.

Case Conceptualization

According to Nasution (2019, August), religious values affect the decision-making of an individual. A marriage is fully completed if the religious values are respected. Hence, both the individuals associated with the marriage need to respect each other cultural differences. After listening to her client’s part, the counsellor jots down main points such as being stressed about marriage, having religious differences and being judged with her relationship. The counsellor again asks a question if her partner could talk to her parents about the religious differences. Then she explains how the reception is weighing down her as Muslim religion have specific rules, which are not being able to dance in front of other men and not consuming alcohol. She explained that she is transforming into a hypocrite defending her religion and as well as support the religion of her other half. The counsellor reassures her that she is there for her and his family. In the end, the counsellor recaps all the events she is stressed about, and the counsellor points out that her mother-in-law is very friendly, and in the future, she could get help from her mother-in-law.

A case conceptualization is a type of mental model which is mainly used to understand the problems the client is facing and provide a solution (Padesky, 2020). I think, counsellors imply the case conceptualizations in order to make a cohesive plan for the session and therapy for maximizing the possibility of meeting treatment goals, examples of such are making a therapeutic alliance. Case conceptualization is a technique and clinical strategy for gathering and arranging to understand the client, comprehending and attempting to explain the client's circumstance and counterproductive trends, helping guide and concentrate treatment, anxiously awaiting challenges and stumbling blocks, and planning for a successful conclusion (Easden & Kazantzis, 2018).

The evaluation of the case on the basis of the eight P’s, which are the presentation, predisposition, precipitants, pattern, perpetuation, plan, protective factors and strengths and prognosis (Hof et al., 2018). The presentation is defined as the nature of the clients, and at what severity level the client is affected. Here, I think the client seemed to be distressed about the situation and moderately affected as she was constantly questioning her marriage and reception. The predisposition is defined as all the factors the individual have a concern about. It can be biological, psychological, social or even cultural. I think here it seems that the individual is worried about the cultural issues which are severely affecting the individual. The precipitants are defined as the stressors which are causing significant issues in an individual (Ci et al., 2021). Here, I think the stressors seemed to the reception and cultural differences which she was causing stress. This is mainly caused due to disappointment and religious insecurity. The protective factors and strengths are factors that have the potential to develop a clinical condition.

Strengths such as self-control, resilience, mindfulness and self-confidence face challenges due to the stressors (Bédard Thom et al., 2021). The pattern is defined as the consistent style or manner in which an individual thinks or acts. Here, I think the patterns are cultural problems before marriage. The perpetuates are defined as the process in which the individual’s thinking pattern is reinforced by the setting the individual stays. The plan refers to the treatment implied after fully accessing the client’s mental status (Chorpita & Daleiden, 2018). Here, I think the counsellor had asked the clients to book further sessions, which would help the counsellor to understand the client’s condition thoroughly. The last is the prognosis which is the response received from the clients after the plan is established; here in the video, no prognosis is done as the plan is not established.

Evaluation Based on the Eight P’s

According to the American Counseling Association External link (ACA), professional counselling is the act of forming friendships with people to help them achieve their psychological health, academic, and career prospects (Erickson et al., 2019). The counsellor and their client work together in this connection. Counselling entails honing and honing the counselling skills that will best serve the clients. These are among the most crucial counselling approaches that individuals will most likely employ during consultations. Listening/Observing: I think this is the most crucial element in therapeutic counselling is listening. It has three applications. Observing: The capacity to be genuinely there for the patient is referred to as having to attend (Kaihlanen et al., 2019). Offering them the whole concentration, creating acceptable eye contact, mimicking language and actions, and acknowledging are all part of it. These able to attend actions demonstrate that individuals care about the customer. Listening using all of the emotions is known as active listening. According to the Perinatal Mental Health Project External link, active listening means responding with your body, heart, ears, eyes, and lips. Verbal listening: This demonstrates that the individual is paying attention by using words (Morrison, 2020). These verbal cues are used to convey that the individual is paying attention and to urge the client to do further exploring. This might be as simple as saying 'yes' or 'continue'. It can also take the shape of summarizing or reiterating an emotional term expressed by the client. Questioning: In a therapeutic setting, asking the question is beneficial since it allows people to discover something about the client (Mellor et al., 2019). The rapport between the counsellor and the clients depends on the questions asked by the counsellor during the counselling time. Two kinds of questions are asked during the time of counselling open-ended and close-ended. The questions which can be answered with a 'yes' or a 'no' is known as closed question. This type of question needs to be avoided while counselling because they do not help the counsellor in a detailed understanding of the situation or the mental state of the individual. An open inquiry is required to collect information. The session where the clients have to think and answer is called the open-ended questions. This type of questionnaire cannot be answered with a  "yes" or "no". Reflection: In the counselling process, reflections are utilized to appropriately describe the client's state based on their verbal or nonverbal indications. Feeling’s reflections: Clients can hear their feelings after speaking to them. It is not always easy to find the descriptive feeling in a client's remark. Examining a client's nonverbal feeling clues can also be beneficial. Restating/Rephrasing: Restating and rephrasing can help to strengthen the interaction between the client and the therapist. Affirmation is a type of encouragement used to validate certain behaviors or life choices. Two examples of popular affirmations are professing progress towards a goal or supporting a client to achieve what they want to achieve in life. Empathy is defined as the ability to put oneself in another's shoes. Every therapist is unique and offers a unique therapeutic approach (Price & Hooven, 2018).

From the analysis of the video, there are a few points that are very clear and transparent. One such factor is cultural differences. Kalmijn & Kraaykamp, (2018), in their study, analyzed the values and beliefs about marriage among the Moroccan and Turkish migrants. In the study, the authors have highlighted that Muslim countries have very conservative thought processes, which the client also mentioned to the counsellor during the session. Overcoming this cultural boundary can be challenging as sometimes an individual from outside has a more open thought process. However, the author also highlighted that the second-third generation Muslim individual has a more diverse thoughts process. Another issue from the session is the acceptance of cultural differences. Sassler & Lichter,(2020), in their study, have explained about the cohabitation and marriage complexity and diversity in the union-formation patterns. The authors have highlighted that marriage is facing a complication in terms of historical influence. Nowadays, people marry individuals from different religious and ethnic backgrounds. However, because the nations around the world are diversifying, the acceptance of cultural differences has become a common factor.

In the counselling video, I observed that there was an interruption from time to time between the clients and the counsellor. Such circumstances need to be avoided. I think interruption in between the conversation can make the client’s voice suppressed. It can be recommended to respond to the clients with a yes or ok to keep the conversation going and reassure the clients that the counsellor is paying attention. But if the counsellor continues to interrupt the clients the clients may feel more distress. Another area I observed which could be improved is that the session was only for 20.14 minutes which is considered quite less for building up a conversation. I felt that the client had something more to say about her distress but could not due to the constrain of time. This type of situation needs to be avoided and a timeframe of at least 50-60 minute need to be considered. I further observed that there were not many intimate questions from the counsellor. The session was filled with more generalized questions which highlight that the client is distressed about the wedding. The counsellor needs to ask questions about the client’s overall health and if such is taking a toll on her mental and what she thinks she will be doing in the future if marital problems arise due to religious conflicts. Instead, the counsellor asked the client to book another session this needed to be completely avoided. I think the counsellor needs to end a counselling session for understanding and evaluate the client’s overall mental state.

References

Bédard Thom, C., Guay, F., & Trottier, C. (2021). Mental toughness in sport: The goal-expectancy-self-control (Ges) Model. Journal of Applied Sport Psychology, 33(6), 627-643. https://doi.org/10.1080/10413200.2020.1808736

Chorpita, B. F., & Daleiden, E. L. (2018). Coordinated strategic action: Aspiring to wisdom in mental health service systems. Clinical Psychology: Science and Practice, 25(4), e12264. https://doi.org/10.1111/cpsp.12264

Ci, S., Liang, J., Li, J., Wang, H., Zhou, Y., Sun, X., & Ding, Y. (2021). Microstructure and stress-rupture property of DD32 nickel-based single crystal superalloy fabricated by additive manufacturing. Journal of Alloys and Compounds, 854, 157180. https://doi.org/10.1016/j.jallcom.2020.157180

Crespin-Boucaud, J. (2020). Interethnic and interfaith marriages in sub-Saharan Africa. World Development, 125, 104668. https://doi.org/10.1016/j.worlddev.2019.104668

Easden, M. H., & Kazantzis, N. (2018). Case conceptualization research in cognitive behavior therapy: A state of the science review. Journal of Clinical Psychology, 74(3), 356-384. https://doi.org/10.1002/jclp.22516

Erickson, M., Lawrence, M., Jansen, C. W. S., Coker, D., Amadio, P., Cleary, C., ... & Yung, E. (2019). Hand pain and sensory deficits: Carpal tunnel syndrome: Clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of hand and upper extremity physical therapy and the academy of orthopaedic physical therapy of the American physical therapy association. Journal of Orthopaedic & Sports Physical Therapy, 49(5), CPG1-CPG85. https://www.jospt.org/doi/10.2519/jospt.2019.0301

Hof, M., Umar, N., Budas, N., Seemann, R., Pommer, B., & Zechner, W. (2018). Evaluation of implant esthetics using eight objective indices—Comparative analysis of reliability and validity. Clinical Oral Implants Research, 29(7), 697-706. https://doi.org/10.1111/clr.13261

Kaihlanen, A. M., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: qualitative study of nurses’ perceptions about cultural competence training. BMC nursing, 18(1), 1-9. https://doi.org/10.1186/s12913-020-06001-y

Kalmijn, M., & Kraaykamp, G. (2018). Determinants of cultural assimilation in the second generation. A longitudinal analysis of values about marriage and sexuality among Moroccan and Turkish migrants. Journal of Ethnic and Migration Studies, 44(5), 697-717. https://doi.org/10.1080/1369183X.2017.1363644

Mellor, A., Hamill, K., Jenkins, M. M., Baucom, D. H., Norton, P. J., & Drummond, S. (2019). Partner-assisted cognitive behavioural therapy for insomnia versus cognitive behavioural therapy for insomnia: a randomised controlled trial. Trials, 20(1), 1-12. https://doi.org/10.1186/s13063-019-3334-3

Morrison, H. M. (2020). Development of listening in auditory-verbal therapy. Auditory-verbal therapy: Science, research, and practice, 303-338.

Nasution, D. A. D. (2019, August). The Effect of Implementation Islamic Values and Employee Work Discipline on The Performance of Moslem Religious Employees at Regional Financial Management in the North Sumatera Provincial Government. In International Halal Conference & Exhibition 2019 (IHCE) (Vol. 1, No. 1, pp. 1-7). https://journal.pancabudi.ac.id/index.php/ihce/article/download/552/522

Padesky, C. A. (2020). Collaborative case conceptualization: Client knows best. Cognitive and Behavioral Practice, 27(4), 392-404. https://doi.org/10.1016/j.cbpra.2020.06.003

Price, C. J., & Hooven, C. (2018). Interoceptive awareness skills for emotion regulation: Theory and approach of mindful awareness in body-oriented therapy (MABT). Frontiers in psychology, 9, 798. https://doi.org/10.3389/fpsyg.2018.00798

Rodríguez-García, D., Solana-Solana, M., Ortiz-Guitart, A., & Freedman, J. L. (2018). Linguistic cultural capital among descendants of mixed couples in Catalonia, Spain: Realities and inequalities. Journal of Intercultural Studies, 39(4), 429-450. https://doi.org/10.1080/07256868.2018.1487388

Sassler, S., & Lichter, D. T. (2020). Cohabitation and marriage: Complexity and diversity in union?formation patterns. Journal of Marriage and Family, 82(1), 35-61. https://doi.org/10.1111/jomf.12617 

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