Mara is divorcee of 36 suffering form quite depression has gone to a physiotherapist for consultation. She was migrated form Nigeria at her mid twenty and got marriage a Nigerian people in US. Due to physical and mental abuse by the husband she sees divorce.
She has two children belongs with her, lived in a small apartment. By profession she was a Medical Technician. By birth she was a Nigerian. But it is not clear in the given scenario what was her believe of faith. Religion Faith is also a vital factor for the supervision of a Mental Health Patient. But the description we cannot get any picture of his faith.
In this dilemma, it is mentioned that the husband physically and mentally abused. But they’re not an indication the nature of Mara’s abuse, which is required for providing therapy. It is a common scenario of every two American marriages now ends in divorce and one in every five people will be blindsided by depression at some point in their life. When we put these statistics side by side and take into consideration the negative thinking and behavior typical of depression, it’s no surprise that there’s a strong connection between the natures of torture and the gaining of the depression.
As Mara sought professional help, the divorce might well take a dive. But what makes her illness such a lethal weapon is its talent for camouflage. She slide into depression has no idea what’s the matter with her, so she assigns blame for the way she feels to the people closest to her. Her non-depressed partners, equally in the dark as to the real cause of what looks like a personality change for the worse, react to the barrage of criticism and resentment coming their way by responding in kind. The ultimate result is the unnecessary failure of a lot of otherwise good relationships.
After taking the Depression to Janet Thomas bone up on depression of Mara probably be surprised to learn that anger is more typical of depression than silent sadness, she need to overcome the incensed denial “What, she depressed? She must be crazy! Her partner is likely to proclaim. Janet work to encourage her to seek professional help. But we cannot stay clear of complaints about situation, criticism and selfishness and focus instead on depression’s physical symptoms, such as insomnia and loss of appetite and energy.
But it’s also very important to protect her from the heavy-duty emotional wear and tear that inevitably results from living with someone else’s depression. Trying to keep persuading her over months of misery that Janet can hang in there until treatment is accepted and works its magic can be discouraging and exhausting.
Analyzing the supervisory and Consultative Presented to the depression sufferers, surveying a familiar landscape and finding it lifeless and assume that their lack of pleasure is a sign of boredom and signals the need for change. Mara at the unwarranted and seemingly inexplicable treatment meted out to her by the supervisor and Consultant they love, respect, and thought they knew well.
Evaluation the Effectiveness:
John Gonsiorek is a of faculty member at Capella University with 25 years of practice he has vast experience in supervision and consultation activities. Janet Thomas is in Private Practice at Paul, Minnesota. He is providing supervision and consultation in the field of mental health. He is also efficient in Clinical supervision and consultation as well as ethics.
To comment on their effectiveness and therapy and professionalism, first let we indicates the standard Responsibility of the Consultant and Supervisor to the Client, simultaneously we point out, which of them are followed and which are not.
RESPONSIBILITY OF CONSULTANTS TOWARD CLIENTS:
This section refers to practices and measures of individual and/or group consulting relationships.
Herein “client” is defined as: the person(s) coming to a consultant for guidance or information in order to help an individual involved in a cultic relationship. When the client decides to pursue an intervention aimed at helping the concerned person revaluate his or her commitment to the group practicing thought reform, the involved person becomes the primary “client”.
A. General Standards for the Consulting Relationship
1) The Consultant’s primary commitment is to respect the integrity and promote the welfare of the client(s), whether the client(s) is (are) assisted individually or in a group relationship.
2) When working with clients, a subscribing consultant avoids prejudice due to race, religion, sex, political affiliation, social or economic status, or choice of lifestyle.
3) If a Consultant cannot put forward service for any reason, he or she will make appropriate to a referrals as soon as possible.
4) The consultant will not use his or her consulting relationship for personal needs or to further religious, political, or business interests.
5) The consultant will not employ methods or techniques such as neuron- linguistics programming, hypnosis or Ericksonian hypnosis or other techniques similar to those employed by cult groups without fully informed permission of the client.
6) Consultants recognize their boundaries of competence and provide only those services for which they are qualified by training or experience. Consultants should only accept those cases for which they are qualified.
7) The consulting relationship have to be one in which client self-direction is encouraged. The consultant must sustain this role constantly and not become a decision-maker for the client or create within the client a future dependency on the consultant.
8)The Human Services field is fitting increasingly complex and specialized. Some thought reform consultants are able to deal with every alternative problem, and many possible clients have difficulty determining the competence of thought reform consultants. Selecting one is difficult because of the lack of knowledge about pertinent qualifications. In some cases, stress itself may impair judgment.
9) The consultant must notify the client of the purposes, goals, a rule of procedure and limitations that may affect the relationship at or before the time the consulting relationship is begun.
10) Before an intervention can be initiated, subscribing consultants and client(s) must agree on the definition of the problem, the goals of the intervention, and the range of possible consequences.
11) The consultant must update the concerned party that should a client be prevented from leaving the site of the consultation or physically restrained in any manner.
12) Obtaining the client’s, a consultant may choose to consult with any other professionally competent person about a client or aspects of the situation. If the client refuses to allow consultant to seek outside consultation when the consultant deems such consultation necessary, the consultant should consider terminating with that client.
13) The consultant is engaged in individual or group consulting, he should be cognizant of mental health resources available.
14) Ethical behavior along with professional associates, including consultants subscribing to these ethical standards and those not subscribing, must be expected at all times. When information is possessed that raises doubt as to the ethical behavior of professional colleagues, whether the consultants or peer consultants, the member should take action to attempt to rectify such a condition. Such action shall use the procedures established by these ethical standards.
15) The consultant must have a high degree of self-awareness of his or her own values, knowledge, skills, limitations, and needs in towards the inside a helping relationship that involves decision-making capacity and critical thinking skills, and that the centre of attention of the relationship should be on the issues to be resolved and not on the person(s) presenting the problem.
16) A dual relationships with clients that might make worse the consultant’s objectivity and professional judgment must be avoided and/or the consulting relationship terminated through referral to another competent professional.
17) The consultants do not condone or connect in sexual harassment, which is defined as deliberate comments, or physical contacts of a sexual nature.
18) The consultant will avoid any type of sexual contact with clients. Sexual relationships with clients are unethical and are forbidden.
19) When the consultant concludes that he or she cannot be of professional assistance to the client, the consultant must terminate the relationship.
20) A consultant has an obligation to withdraw from a consulting relationship if it is supposed that employment will result in violation of the Ethical Standards.
21) The consultants come across a situation in that is appropriate ethical behavior is not clear, they should seek the advice from knowledgeable persons.
B. Confidentiality and Records:
1) The Records of the consulting relationship including interview notes, family internal information, correspondence, tape recordings, electronic data storage, and other documents are to be considered confidential information. Disclosure to others of such material must happen only upon the expressed written consent of the client.
2) The data derived from a consulting relationship for purposes of consultant training or research shall be confined to content that can be disguised to protect the identity of the subject client without written permission of the client is obtained.
C. Financial Matters
1) The consultant recognizes the significance of clear understandings on financial matters with clients. Arrangements for payments are settled at the beginning of the consultation relationship. The consultant should provide a written and dated schedule of fees to potential clients.
2) For establishing fees for professional services, the consultants must consider the financial standing of clients and her family. Established fee structure is inappropriate for a client, consultants are encouraged to support families in finding appropriate and available services at satisfactory cost.
3) The consultant should neither offer nor accept payment for referrals, and will vigorously seek all significant information from the source of referral.
In the given scenario, as a Consultant ; Supervisor Janet Thomas and Consultant’s consultant John Gonsiorek have successfully followed General Standards for the Consulting Relationship but they are failed to keep their evidence of effectiveness and professionalism in Confidentiality ; Records and financial maters.
Better Approach That Work with More Effectiveness
In the Case of Mara, as Nigerian migrant, her family member was not in US. There were no adiqute friends and relation for her mental support. Financial scarcity, losing insurance support and lacking of knowledge about state provided services, job uncertainty, physical and emotional abused by the husband and finally the divorce caused her depression. In my consideration for Mara the Evidence-Based Practices should bring better outcomes. Evidence-Based Practices has been reached through the methodical review of thousands of studies with combination of new statistical techniques and the judgment of expert reviewers. Agencies for Healthcare Research and Quality in the United States and the Cochrane Collaboration have recognized principles for determining the effectiveness of treatments. These include:
· Randomized clinical trials improve the validity of underlying conclusions,
· Replication of results in multiple settings improves the validity of results for actual practice,
· Constancy of findings builds confidence Evidence can be ranked in terms of validity, clinical confidence, and expert judgments.
Examples of evidence-based mental health practices are available in the Cochrane Library, in reviews commissioned by AHRQ from the Evidence-Based Practice Centers, and in professional associations’ clinical practice guidelines One of the most recent reference documents is Mental Health: A Report of the Surgeon General
The way of conducting systematic Evidence-Based Practice includes:
· Statement of objectives and eligibility criteria,
· Identification of (all) potentially eligible studies,
· Application of eligibility criteria,
· Use of unbiased procedures for extracting data,
· Critical appraisal,
· Assembly of the most complete data set feasible,
· Analysis of the data set, using statistical sensitivity analyses,
· Preparation of a structured report.
The statistical set of methods used in the process of systematic review. This called meta-analysis and it has become a science in the last decade. The new statistical techniques allow for combining data in ways, which allow assessment of effect sizes and of the level of confidence in the reliability of the conclusions. The researchers conducting these systematic reviews in most structured form as follows:
· Design and pilot testing of data extraction forms so as to ensure the standardization of the data extracted from each study,
· Selection of studies for review based upon explicit eligibility criteria and agreed upon by more than one reviewer,
· Assessment of inter-ratter reliability in extracting the data from studies,
· When possible, blinding of observers to authors, institutions, and journals,
· Data extraction and quality assessment by more than one observer,
· Careful assessment of biases in studies, including treatment allocation biases, blinding, and handling of patient attrition,
· Listing excluded studies, along with reasons for the exclusions,
· This methodology, as in other scientific endeavours, is designed to allow readers to evaluate the methods, and to allow others to try to replicate the findings, of the review.
There are two groups of mental health patients of particular concern as regards public-sector policy in the United States. Patterns of accountability, governance, financing and responsibility for mental health services have been changing the public mental health system and public mental health authorities now serve most population groups. No one agency is accountable for all services and resources.