[SOLVED]: Jeff And Sandy Williams Present Themselves In Your Counseling Agency. Sandy Williams Has Called For An Appointment And Cited Family Issues Along With Couple Conflict Between Her And Her Husband.

Jeff And Sandy Williams Case Study


This case study represents some effort to plan for a treatment strategy for the Williams family. This paper will not contain a DSM axis diagnosis as well as outlook; for that reason, William’s family diagnostic actions as well will not be included in this case study. Nevertheless, it is an idea of intervention for William’s family. This write-up defines and discusses a cohesive management plan for the whole family based on the community counseling model. The community counseling model aids the counselor to help the family with the multiple concerns presented by the family. While preparing for this treatment strategy, the information collected and inferred from the family during the intake counseling sessions will dictate where the community mental health counselor will begin. The family will distinguish the different, visible, or hidden concerns the family is assumed to be undergoing. Based on those family presenting issues, the counselor will determine what services he may consider vital to offer the family and provide whatever assistance needed to the family locally.

People are convoluted creatures; nevertheless, God bestowed a Way long before the origin of man. God understood that forming a person with a free will would drive to a need for salvation for His children. According to Isaiah 55:1-12, 61:1-11, Christ, the Way, promised to clear the dues for humankind’s salvation, which involves healing as well as the liberation of man’s emotional distress, and mental and bodily ailments. The mental health community counselor is one instrument used by the Creator to lead humanity to the one real infinite source for all things. This Provider is the Triune Creator consisting of the Father, the Son, and the Holy Spirit. Thus, when developing a treatment plan or strategy, the mental health community counselor needs to consider a systems theory, “a generic term for imagining a group of interrelated components that combine as a whole entity,” when planning for a treatment strategy for this family and multitasking. William’s family is presenting concerns involving many connected elements and causes distressing the family as a whole.

William’s Family

William’s family entails of Jeff and Sandy, a middle-aged married couple for 21 years. Jeff and Sandy have two sons, Jacob, who is 18-years-old and Leo, who is 15-years-old. Jeff owns a used car showroom, and Sandy has been working as a teacher’s aide at a local elementary school for the past ten years. Nevertheless, as a result of slow business and a decline in the economy at the car ration, the financial burden has added to the family worries. The couple’s expenditure performances and lack of financial supervision measures are factors totaling to their stressful state. It is an area that needs skillful improvement.

Rather than talking about how William feels, he goes on to drink liquor all night. People use alcohol or drugs to feel better. This usually will make things worse, certainly in the long run. William’s work is going to suffer, and alcohol usually leads to irresponsible, offensive, or dangerous behavior. He will begin to focus more on production rather than on his wife and children or home life. This can cause conflicts with ones’ husband, wife, or partner. He gets no time for his children either. Therefore Jacob and Leo develop a distant relationship with their father such that they collide and misunderstand each other regularly.

Case Conceptualization Tactics

            Everyone responds to possibly stressful circumstances individually. Several characters cope with a crisis or different stressful circumstances by concentrating on the difficulty and setting everything else away. To most people, this exclusively works in the short term.

            Case conceptualization is among the central aspects of psychotherapy, as well as cognitive-behavioral therapy, where the definition is commonly known as the “soul of the evidence-based exercise.” Conceptualization is the heart that produces the concerns presented by the client and guides an intervention plan. Case conceptualization is a vessel in which numerous components are put together to comprehend a client’s presenting concern (Eells, 2010). Case conceptualization, in this case, transpires locally or instead within the community by the community models. Case conceptualization is designated as the description for a client’s presenting concern. Case formulation, on the other hand, will refer to the process by which a case conceptualization is advanced or designed. Besides, only cognitive-behavioral therapy (CBT) and case formulation techniques will be gone through in the existing document (Eells, 2010).

            Community counselling model is an agency of counsellors whereby they handle not just a single individual or family, but a number of clients unlike with the professional therapists who handle a specific case as the first and last through to the end.

            CBT case conceptualizations majors on four corporate components: concern presented, triggering factors, upkeep factors, as well as etiological factors. Concern presented refers to the first complaints that a client carries forward to the counselor. Triggering factors refer to the latest stressors that happened in the client’s life that may cause augmented symptoms. Upkeep factors refer to the mental idea, usually centered on research, which describes why a client is undergoing the presenting concern (Dudley et al., 2015). Etiological factors try to clarify why the hypothesized mechanism developed. These four elements of CBT case conceptualization are present in every type of CBT case formulation method. However, the various methods tend to emphasize certain elements more than others, and some methods add additional elements for psychologists to consider in case formulation. Our methods are of CBT case formulation. One method, developed by Blevins et al. (2010) and recently updated, comprises four key elements of case conceptualization. A conceptualization should: 

1) Discuss all of a patient’s symptoms and concerns; 

2) hypothesize a mechanism that leads to and retains the concern; 

3) Describe the latest precipitant events of the current problems, and 

4) Hypothesize the source of the mechanism. 

            To hypothesize the maintaining mechanism, Blevins et al. (2010) suggested to first rely on nomothetic mechanisms and theories for specific disorders, and, second, rely on general psychological principles. These mechanisms should be based on empirical research. For example, when treating an individual with depression, in this case, Jacob, the counselor ought to hypothesize a lack of positive reinforcement to supply a necessary explanation for a major depressive episode. The counselor as well may also rely on general psychological concepts such as negative automatic thoughts or core beliefs as causal mechanisms for functional impairment.

A final point to the Padesky tactic is to conceptualize at three different levels: symptom, concerns and case. Symptom-level conceptualizations majors on the individual’s symptoms within concerns or illnesses, and the reasons as to why the individual experiences the concerns. Concern-level conceptualizations majors on the reasons a specific illness or functional damage has come up. Case-level conceptualizations aim to describe all of the clients’ issues with one clear clarification. For example, a symptom-level conceptualization may perhaps explain how symptoms of depression are connected. A concern-level conceptualization explains the maintenance of an apprehension disorder, and its symptoms are linked to negative corroboration of avoidant performances. Case-level conceptualizations appear to be more difficult, and it explains how a nervousness disorder, depressive disorder, as well as hospitalization are all connected (Blevins et al., 2010). The lack of positive support may have led to thoughts of hopelessness and increased suicide ideation that led to hospitalization. Excellent conceptualizations should be able to illustrate behavior at all three levels, and these conceptualizations should be internally dependable. 

            Another CBT preparation technique was established. In their archetypal, an incident conceptualization ought to illuminate consumer presentations in terms of the mental notion that notifies remedy. Situation conceptualization as a receptacle which signifies the concept and study of cognitive-behavioral treatment and the buyer’s skill. In the receptacle, analysts syndicate the user is giving difficulties, triggering aspects, preserving devices, weakness features, and defensive causes enlarge on the cauldron classical with three philosophies of situation conceptualization: collective pragmatism, level of conceptualization, and consumer fortes (Blevins et al., 2010). That is, conceptualizations ought to be advanced with the user, should create vivid data with the mental concept, and ought to integrate opinion from users about its legitimacy.

The second opinion is the close of conceptualization: disorder-specific and generic. Disorder specific conceptualizations are useful when a client suffers from a single disorder, and generic conceptualizations are more suitable for comorbid or complex disorders. A disorder-specific conceptualization for posttraumatic stress disorder strength hypothesizes cognitive stuck-points from cognitive-processing treatment. A standard conceptualization of posttraumatic stress disorder may ascertain a schematic that societies cannot be confidential to define collective dodging, connection problems, and posttraumatic signs.

The third opinion is to comprise user power and elasticity aspects. According to Andersen (2012), investigative client powers may boost customer inspiration, disorder the maintaining factors of a client’s hands out problems, and progress behavior product. Strength and resiliency causes may also divulge why the unruly is existing in some backgrounds but not others, and also defined situation conceptualization and if an explanation is consistent with the authors above. Eells (2015) described conceptualization as a hypothesis that identifies the causal factors, precipitating events and stressors, and maintaining mechanisms for a client’s presenting problems. Case conceptualization should organize information and act as a blueprint for treatment. Eells described a three-step process to conceptualization.

The assessor should obtain descriptive information, infer and interpret descriptive information, and then create a treatment strategy that aims the hypothesized mechanisms. For instance, a counselor may collect information concerning an academic issue for a student who self-reported that he cannot concentrate during class (Eells, 2015). During a clinical interview, the student may explain feeling restless, failure to concentrate on schoolwork as well as related complications. The student may as well describe undergoing disturbing thoughts concerning his recent ex-partner. To understand the information, the counselor requires to gather proof to reinforce or refute, unlike hypotheses, such as depressive cogitation, lack of attention disorder, or usual coping response. Once the counselor decides on the hypothesized mechanism, the treatment strategy should aim at this mechanism, for instance, increasing social reinforcement and activities to enable healthy coping reactions.

Eells (2015) as well concisely described a socially well-versed case conceptualization. First, Eells proposed that the therapist should be familiar with how the client categorizes culturally and the strength of this distinctiveness. Second, Eells (2015) proposed, the therapist ought to consider how culture may affect the presenting problems. Thirdly, Eells advocated incorporating culture into non-pathological considerations of the client, for instance, language choice and social interaction. Fourthly, Eells proposed that therapists ought to study how culture touches the therapeutic association.

Bucci, French & Berry (2016) went through the purposes and subjects of case conceptualizations. From a cognitive-behavioral perspective, Bucci, French & Berry (2016) offered three additional considerations for standard CBT case formulation approaches, which typically included identifying presenting problems and examining antecedents and consequences of behavior. They suggested clinicians should: hypothesize mechanisms as dysfunctional systems, recognize vulnerability and epidemiological factors, and examine the client’s problems in a social context.

According to Andersen et al. (2010), the first consideration-referred to as broad mechanisms maintain dysfunctional patterns of behavior. For example, an individual with depression may have a social skills deficit that causes difficulties at work, an incapability to form inmate relationships, and anxiety in social situations, in Jacob’s and Leo’s case. The second principle, vulnerability, and epidemiological factors referred to early client experiences and characteristics that make problems more likely to occur. Maybe the individual suffering from depression disorder was abandoned as a little boy or had less opportunity to grow close relationships with his parents. The third principle is referred to social relationships and functional patterns of behavior in social contexts. For both clients, the lack of social reinforcement may stand for a real problem in which people may have banished them in social circumstances because of their poor social skills (Eells, 2013).

            Fascinatingly, only one method Eells (2015) described above openly recommended counselors to scrutinize culture in case formulation. There is little research that discusses multicultural case formulation. Some data suggest that including culture into conceptualizations is a different skill set compared to typical case conceptualization (Flinn, Braham & Das Nair, 2015). Graduate student counsellors who write skilful multicultural conceptualizations tend to have been uncovered to cultural variety (Eells, 2013). According to Bucci, French & Berry (2016), they tend to be open to new experiences and have taken numerous multicultural courses.

Additionally, graduate student therapists tend to incorporate cultural issues into conceptualizations when explicitly mentioned by the client, but may omit culture if not mentioned by the client (Flinn, Braham & Das Nair, 2015). For some psychological mechanisms, for example, minor stress; Ellis, Hutman & Deihl, (2013) highlight how ultimately incorporating culture into case conceptualization is consistent with the models of CBT case formulation, given the CBT emphasis on environment and context.        

            In this short review of cognitive-behavioral conceptualizations, there seem to be common elements.

            Case culture may indirectly contribute to mental illness and inform case-level conceptualizations. Conceptualizations tend to describe the client’s presenting problems, identify precipitating factors that elicited distress, hypothesize a mechanism maintaining the problems, and describe the origin of this mechanism. Although similar in content, each approach emphasized certain factors more than others. For example, Dudley et al. (2011) differentiated between disorder-specific and generic conceptualizations matches, and Eells, (2013) detailed the three-levels of case conceptualization. That is, disorder-specific is the same in both the Padesky and Kuyken models, and the general level is similar to the case level described by Padesky. Although Padesky adds a level of individual symptoms, the Kuyken et al. model might subsume individual symptoms within the disorder-specific level. Barlow et al. (2012) would describe general levels of conceptualization as hypothesized mechanisms of dysfunctional systems to conceptualize how multiple concerns interrelate within the individual.

Dudley et al. (2011) stress collaborative experimentation, which is a fundamental constituent of cognitive-behavioral therapy that all of the conceptualization tactics can combine. Barlow et al. (2012) referred to client strengths as significant to reflect when applying the treatment, but not as profoundly stressed like in the Dudley model. The constant account of case conceptualization across scholars and counselors shows that presented concerns, triggering stressors, mechanisms maintaining issues, and etiological factors are essential for excellent case conceptualizations.

            It is important to note that relying on standardized assessments and progress monitoring may be the best way to reduce errors in clinical judgment (Flinn, Braham& Das Nair, 2015).

Better provided services by other agencies or organizations

            Aside from case conceptualization management by the community models, various counseling agencies offer services professionally, and after that a follow-up. In this case, they will walk with William’s family all through to recovery. Among the best is Open Path Psychotherapy Collective. It is an organization that is just at the doorstep. It is presented in all countries of origin. It is a non-governmental agency that provides adequate mental well-being benefits. Their goal is to offer a pleasant experience that will enrich one’s life, minimize stress, and aid in goal achievements, for instance, in the case of Jeff and Sandy’s children (Jacob and Leo), who still need much guidance throughout their school life till completion. It offers both online and face-to-face counseling sessions. It has among the best psychotherapists in the entire universe. Their pricing is pocket-friendly between $30- $200 per session — they offer professional guidance to clients with various mental disorders. In this pattern, Open Path Psychotherapy therapists give family members guarantee that they will discuss only the concerns the family needs, in order to put to rest their worries about being “uncovered” by the psychotherapist.

            Unlike with the community models, the psychotherapist is more into details, and this therapy is long-term. In community models, counseling majors on particular concerns and is intended to assist a person in disclosing a specific matter, such as addiction, otherwise stress management. The emphasis might be on problem-solving or else on learning particular tactics for coping with or evading problem situations. Community counseling, too, is typically more short-term compared to therapy. In this case, William’s require more advanced sessions that will offer a total follow-up to the entire family until recovery. More specifically, psychotherapy will create awareness within Jacob and Leo. Psychotherapy discusses ways in which stress disturbs their day-to-day life, emphases on how to best comprehend about anxiety and depression as well as control symptoms and keep an eye on medical recommendations where need be.


            In conclusion, case conceptualizations are at risk of error when formed by counselors. According to Dudley et al. (2015), counselors are subject to cognitive biases, such as the convenient experiential, which may affect how a counselor identifies their client and how to assimilate an overwhelming amount of information. It is difficult for clinicians to evaluate the validity of their conceptualizations, mainly when there is little to no feedback. Despite these difficulties, it appears there are means to minimize the error in case conceptualization. Firstly, combining assessment data through advancement monitoring throughout psychotherapy could notify counselors whether or not their conceptualizations are legal, and aid the counselor alter the management plan. Secondly, make use of the present research to comprehend general codes of behavior may stop the counselor from using irrelevant information when treating clients (Bucci, French & Berry, 2016).

            Aside from the psychotherapy sessions, Jeff and Sandy must get involved with their children in activities such as playing together, read, or laugh together. It is quite essential even though it is just a few minutes every day.

            Jeff and Sandy should learn to be patient and warm, especially while handling their children. They should learn to use kind words even while rectifying either of their children. Congratulate when they do well either in house chores or school-work. They are entitled to show them love always. Getting involved in Jacob’s and Leo’s life actively brings the children close and boosts their confidence in their parents.


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