Aurora University Mood Disorder Essay

I’m working on a social work discussion question and need an explanation and answer to help me learn.

discuss how you would explain a mood disorder as well as treatment for this to a newly diagnosed client who is reluctant to start therapy. Explain your approach. Depending on what theories make the most sense to you, and the style of work you find most interesting, your approach will vary from your peers. You are encouraged to show your authentic style as a social worker as you explain your approach.

A mood disorder is complex because of the very fact that one’s mood plays a role in the journey of self reflection and social awareness.  These are fundamental aspects of the journey with regards to therapy.  When a client is treatment resistant they are often in a state of essentially euphoric beliefs ad therefore struggle with the realizations of how their moods impact both themselves and others. Some ways to help guide a client in this journey might include the foundation of building a relationships and rapport.  As a therapist of over 2 decades I have found this to be the foundation of the clients journey.  In addition, to the therapist having the skills and intuition that helps us to signal a shift in their moods. 

Building rapport requires:

• Managing eye contact appropriately. Constantly observing your client and knowing their facial expressions and the shifts in their eyes.
• Helping clients feel a sense of relatedness to you. You can do this by trying to match the client’s initial demeanor, disposition, and rhythm. Even some story telling and a safe amount of self disclosure.
• Keeping negative topics neutral—avoid framing statements using negative connotations. Being careful with our tone of voice. 
• Using the client’s name.
• Setting the tone.
• Letting clients get to know you—that is, being a real person. This is so important.
• Being approachable and engaged.
• Acting interested. Even if you feel bored, step in toward the client and help them feel seen, heard, and important.
• Being authentic, honest and having boundaries that are supportive but clear.
• Gaining their trust with your ability to reframe and create a safe non-judgemental place.

2) Therapist imposing their agenda onto client.

Therapy needs to be conducted by developing client goals based on collaboration between the client and the therapist. If a client is being resistant or otherwise “noncompliant,” then the issue should be directly and honestly discussed.  If a client is not accomplishing certain tasks in therapy, then perhaps these aren’t important to the client and the therapist is simply imposing their own agenda on the client. Be careful about not pushing the agenda we might have on the client. 

3) Therapist inflexibility.

Clients are very aware of us and the way we respond to them. They know if we are not being honest and will then not be honest with us.  If a therapist lacks a client-centered approach, then the client will notice (if not consciously, then unconsciously) that their therapist is inflexible or rigid. If a client has issues from childhood resulting from a controlling parent or has problems with authority figures, then they may unconsciously resist what is being perceived as external control from the therapist. 

4) Failing to realize that noncompliance is part of the “pathology” that needs to be treated.

If goals for therapy have been arrived at collaboratively between therapist and client and there is still noncompliance, then resistance can be addressed as part of what needs to be focused on in treatment. The resistance should be actively discussed with the client, without judgment or surprise. Issues contributing to client resistance may include fears of failure or the fear of terminating therapy. One question a therapist can use to address these types of fears is, “What would happen if you were successful?” or something else along those lines. Always explore topics of resistance with curiosity and encouragement.

5) Need to process fears and early life “schemas” or experiences.

A therapist can explore a client’s fears and early life experiences by using the Socratic questioning method. Determine what the client’s underlying beliefs about life are. For example, does the client have a strong need to manipulate others or have power over them? Unmasking and revealing underlying maladaptive schemas, along with addressing their protective factors, should be addressed in the treatment plan.

6) Therapist fears of engagement.

A therapist needs to be willing to fully engage with their clients, even if it puts them out of their comfort zone. When a therapist tries to keep the relationship with their clients at a distance because of fears, such as fear of countertransference issues, the clients may sense this distancing. The effectiveness of therapy might then be diminished. A therapist can benefit from taking emotional risks with their clients. Client relationships aren’t so fragile that mistakes can’t be dealt with and overcome.

To address therapist anxieties, a therapist needs a good support system, including people with whom they can discuss their fears. It is also good for a therapist to reframe their fears with anxiety-reducing strategies, such as:

• Challenging unrealistic performance expectations placed on the self
• Reminding oneself that it’s okay to make mistakes
• Focusing on the client rather than on the self
• Realizing that no mistake is fatal and that part of good therapy involves the concept of “rupture and repair.” When ruptures in the therapeutic relationship occur, repairing of the relationship can be healing in and of itself.

It is always helpful for therapists to realize that everyone has limitations – including therapists and clients. It is important for therapists to understand when they are placing unrealistic expectations on clients based on the therapist’s own experiences. Remember, clients have their own personal experiences that may or may not be conducive to certain treatment outcomes.

TREATMENT PLAN

The best way to ensure effective therapy is for clinicians to formulate a well-thought-out case formulation and treatment plan, including the following:

• Determine client’s core problem(s).
• Examine client’s developmental contributing factor(s) to core problem(s).
• Evaluate client’s relationship wants/needs in the therapeutic relationship:
  • What does the client want from me or others?
  • What does the client expect from me or others?
  • What is the client’s experience of self in relationship with others?
  • What are the client’s core beliefs?
  • What are recurring themes in the client’s relationships?
• Establish best therapy interventions to incorporate into treatment.
• Address client self-sabotage.
• Assess and evaluate effectiveness of current strategies, and make adjustments as necessary. Remind yourself that therapy is supposed to be a fluid enterprise rather than a stagnant one.