problem based scenario

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COUNSELLING

PROBLEM BASED SCENARIO

HUMANISTIC OR EXISTENTIAL THERAPY

ALICIA JAMES

REBEKAH ROBERTS

YOLANDA RODNEY

6/30/2011

"Birds sing after a storm. Why shouldn't people feel as free to delight in

whatever sunlight remains to them?"

Rose Kennedy


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UNFAMILIAR TERMS

Abuse: to hurt or injure by maltreatment, or to misuse the power accompanying an

office or position. Abuse does not necessarily involve mistreatment of others. Drug

dependence, alcoholism, and misuse of anabolic steroids are examples of self-abuse.

Prostitute: Prostitution, the performance of sexual acts solely for the purpose of

material gain. Persons prostitute themselves when they grant sexual favors to others in

exchange for money, gifts, or other payment and in so doing use their bodies as

commodities. An individual paid to provide sexual acts/sexual intercourse

Relapse: to fall back into a former mood, state, or way of life, especially a bad or

undesirable one, after coming out of it for a while.

Symptomatic: indicating or typical of a particular illness. Relating to, affecting or based

on a symptom or symptoms of bodily disorder.

Shoot up: inject drug, to inject an illegal drug. Slang

Devastated: to become extremely shocked or upset

Alcoholism: or Alcohol Dependence, chronic disease marked by a craving for alcohol.

People who suffer from this are called alcoholics.


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THE PROBLEM ANALYSIS: ALL THE MAIN ISSUES

y her past substance abuse

y prostitution history

y HIV status updated to AIDS

y Estrangement from her children

y Fear of death

y Inadequate Coping mechanisms

y Concern about support systems

y Job insecurity

y Relapsing into drug abuse

y Fear of rejection by children and husband

PROBLEM SUMMARIZATION

Her prostitution, though at an early age was not the cause of her HIV status due

to the time line. Her history of prostitution exposed her to a variety of diseases of the

reproductive system including cervical, pelvic and ovarian cancer, pelvic inflammatory

disease as well as STIs. She also predisposed her children to congenital defects such

as fetal alcohol syndrome and decreased bone density. However her substance abuse

contributed to her estrangement from her children, and is a more probable cause for her

contracting the HIV virus. At the same time due to her prolonged abuse of cocaine,

heroin*, alcohol and marijuana, she was predisposed to a variety of systemic

dysfunctions, which further compromised her immune system making her more

susceptible to the virus, influencing its rapid progression and proliferation. The


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respiratory system was affected by the use of marijuana and cocaine, as they destroyed

the mucosal lining of the respiratory tract and the alveoli of the bronchi which plays a

vital function in gaseous exchange. Since the structures were compromised, gaseous

exchange will not be as effective, this in turn affects the cardiovascular system, as it is

forced, by the greater demand on it to compensate for the oxygen deficiency. This over

exertion of the heart will further predispose her to cardiovascular disorders such as

stroke, myocardial infarction and hypertension. Her smoking also predisposed her to

diabetes mellitus, chronic asthma, emphysema and COPD and bone brittleness. She

was also exposed to liver cirrhosis by her consumption of alcohol and intake of heroin.

Neurological system is affected by her heroin and alcohol use and is evidenced by alter

gait and consciousness, impaired judgment and reflexes, slowed reaction and speech

and convolutions (uncontrollable movement of limbs). The integument system is

affected causing diminished turgor and moisture. Her depression from her AIDS

diagnosis caused her to relapse into drug use. Because of coping problems she turned

to drugs to mask emotions.

HYPOTHESES

y If HIV can be contracted from needles by heroin addicts then it is most

probable that Sandra contracted the disease from this method.

Due to the time line of the scenario it is not possible that she contracted the

disease neither from her prostitution nor from the father of her children. It is most

probable that it was contracted from a sexual partner before her husband but that


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was not stated. Drug abusers usually share needles as they are more concerned

about the high and are least concerned about transmission of pathogens and

viruses.

y Sandra is fearful of rejection from her husband and children because of her

condition. If devastating news affects cognitive abilities then Sandras fear

of rejection by her family is irrational.

Sandra fear is irrational as her husband has stood by her side and has been her

support for the years that she has had HIV. It is highly probable that now that she

has AIDS he will stick with her and be even more sympathetic and supportive.

The fact that he married her and accepted her HIV status is testament to his love

for her which has brought them thus far, it is highly unlikely that he would leave

or stop loving her now. Her children may harbor negative or cold feelings toward

her because they may feel that she was not the mother that she should have

been. Their knowledge of her condition may trigger their base and innate desire

to have a connection with their mother. They will therefore strive to have a

relationship with her, or at least communicate with her.

y Her drug use may have been a direct result of her prostitution lifestyle.

Because of her inability to cope with her lifestyle she may have turned to drugs

as a way of temporarily forgetting her problems and became addicted. Drug use

and prostitution usually go hand in hand as they form part of the illicit, immoral

and taboo lifestyle.


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y If Sandra was a prostitute then it is most probable that her first child was

conceived with one of her clients.

Based on the time frame of her years doing prostitution it coincides with the year

that she had her first child, noting that there was no predominant man in her life,

and the variety and number of sexual partners and encounters, the probability of

one her clients fathering her first child was increased.

OBJECTIVES

y Define the stated drugs and discuss the effects of drug use on the body and the

correlation between these systems

y State the main concepts of existential and humanistic theory

y Identify symptoms of HIV

y Identify the stages of dying

DEFINE THE STATEDDRUGS AND THEIR EFFECTS ON THE BODY

Cocaine: a white, crystalline powder with a bitter taste is extracted from the leaves of

the South American coca bush. It is used medically to produce anesthesia for surgery of

the nose and throat and to constrict blood vessels and reduce bleeding during surgery.


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theory suggests one major theme: the stress on concrete individual existence and,

consequently, on subjectivity, individual freedom, and choice, also consciousness,

freewill, nature of reality and individual ethical choice.

HUMANISTIC

Humanistic psychologywas born out of a desire to understand the conscious mind, free

will, human dignity, and the capacity for self-reflection and growth. An alternative to

psychoanalysis and behaviorism, humanistic psychology became known as the third

force. Humanistic theory states that all humans are born with a drive to achieve their

full capacity and to behave in ways that are consistent with their true selves.

IDENTIFY SYMPTOMS OF HIV

Over a period that may last from a few months to up to 15 years, HIV may destroy

enough lymphocytes that the immune system becomes unable to function properly. An

infected person develops multiple life-threatening illnesses from infections that normally

do not cause illnesses in people with a healthy immune system. Some people who have

HIV infection may not develop any of the clinical illnesses that define the full-blown

disease of AIDS for ten years or more. Doctors prefer to use the term AIDS for cases

where a person has reached the final, life-threatening stage of HIV infection.


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IDENTIFY THE STAGES OF DYING

These are the several stages through which dying persons go: denial and isolation (No,

not me!); anger, rage, envy, and resentment (Why me?); bargaining (If I am good, then

can I live?); depression (What's the use?); and acceptance. Most authorities believe that

these stages do not occur in any predictable order and may be intermingled with

feelings of hope, anguish, and terror.

PROBLEM RESOLUTION

y The counselor should help Sandra to explore other job opportunities that are less

stressful and hectic such as craft work, sewing and teaching family life education

at a rehab centre. She can also explore her interests; engage in things that would

give her joy and also a means of bringing in a pay check.

y Sandra should be educated on her condition, medication use, proper nutrition

and what she should expect now that the disease has progressed.

y Assist her in developing effective coping mechanisms

y Group therapy with her family to build relationship with her children, and iron out

insecurities, communication


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y Focus on the positive aspects of her life help her to accept her condition and

death help her to find meaning in her life. "The most authentic thing about us is

our capacity to create, to overcome, to endure, to transform, to love and to be

greater than our suffering."(Ben Okri).

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