Multicultural and Contextual Considerations Case Study
Order ID | 53563633773 |
Type | Essay |
Writer Level | Masters |
Style | APA |
Sources/References | 4 |
Perfect Number of Pages to Order | 5-10 Pages |
Contextual and Multicultural Considerations Marisol Program Transcript (Case Study) [SOUND] [MUSIC] [SOUND] [SOUND] [SOUND] [ NARRATOR: To provide informed ethical care, professional counselors consider all aspects of a client’s personal background and history. As a result, individuals who belong to special or minority populations require special consideration from the counselor in order for appropriate care to be provided. Marisol, the client in the case you’re about to see, has unique ethnographic requirements. Consider possible areas where the client requires a treatment approach that incorporates culturally sensitive considerations as the client is introduced. Consider how specific addiction and mental health issues can be linked to cultural considerations. What criteria should be used to evaluate this client? What other strategies should the counselor use to overcome cultural barriers? Marisol is a 25-year-old Latina who lives in a traditional home on San Antonio’s south side. Marisol has spent the majority of her life in the United States, with extended family in Mexico and San Antonio. She is the sixth child in a family of six. Her family and friends are putting pressure on her to marry. Her grandmother, mother, and married friends all bring up the topic of marriage on a regular basis. Marisol is concerned about her ability to be a good wife and mother, and she sees her siblings struggle just as much as she does to live a good life. Marisol is a native Spanish speaker. Marisol, on the other hand, speaks English as a second language. Marisol struggled as a student and did not complete high school, despite her desire to succeed. In school, she was always jittery. She started working to help support the family and could never find the time to finish her GED. She is concerned that her lack of education will prevent her from obtaining a good job. Marisol is being treated for comorbid cocaine and benzodiazepine addiction, and she is having trouble talking to her Caucasian male psychiatrist about her mental health issues. Marisol has been seeing Dr. Dan, her psychiatrist, for addiction treatment. Dr. Dan is a Caucasian master’s level counselor with specialized addictions counseling training. Marisol appeared hesitant to communicate with her psychiatrist during the previous two counseling sessions, as evidenced by her limited verbalizations. She only answered the questions that were asked, and she didn’t say much else.
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Contextual and Multicultural Considerations Marisol’s information goes beyond yes/no responses in this case study. Her responses have occasionally come across as evasive or insincere. MARISOL: I had two appointments with my doctor. Dr. Dan has requested that I inform him of my current situation. However, when I began to tell him a little more, he became impatient. These are the topics I prefer to avoid discussing with anyone who isn’t a member of my family. He might think I’m a bad woman if I share too much. He’s a doctor, so whatever he says is true. He already knows everything he needs to know about me, and I don’t want to bother him. Dr. Dan is one of my favorites. He appears to be nice and all, but I don’t believe he understands my problems. To begin with, I don’t believe he has ever struggled with addiction. How can he possibly understand what I’m going through if he’s never had an addiction? He’s a white man, too. As a Latina woman, the issues I face are vastly different from those he faces. I’m just not sure how he’ll be able to assist me. Let me begin by telling you a little about myself. I’m 25 years old and have been abusing drugs for over a decade. I only began taking drugs to alleviate my anxiety. [SPANISH SPEAKING] When I’m nervous, I tend to forget to speak in English. Whatever the case may be, I’ve been nervous for as long as I can remember. I’ve just—something bad happened to me that I don’t want to discuss right now. How am I supposed to explain these things to a man? I understand that in order to improve, I must talk about my problems. But I can’t bring myself to discuss them with such an educated man. I tried to tell him something, but he seemed to be in a hurry or something. He began writing me a prescription. You must understand what I’m talking about. And—you know, I don’t know, maybe I shouldn’t talk so much. What was I doing? Oh, yes, I’m talking about my anxiety. I suppose I can tell you something about it. Please keep my mother in the dark. Something bad happened to me. But even before that, we were just barely scraping by. Una santa, my single mother, raised me. She’s a saint, in my opinion. She worked 14-hour days to ensure that [INAUDIBLE] and the rest of us had enough to eat. We also relocated frequently. And there were times when I wasn’t sure if I should even unpack or if we’d just up and leave. My mother worked 14 hours a day, as I previously stated. She worked two jobs at the same time. Laureate Education, Inc., Laureate Education, Inc., Laureate Education, Inc., Laureate Education,
Contextual and Multicultural Considerations Marisol is a case study. And she left the six of us kids with whoever was willing to keep an eye on us. Alejandra, you remind me of my tia. Please accept my apologies, my aunt. It was difficult for all of us. We had a lot of fights. My mother is upset because all of my siblings have issues. Juan, my oldest brother, has spent the majority of his life in and out of jail. He teamed up with MA, and now he’s all tough and gangster. My sisters have been in abusive relationships for a long time. They don’t seem to know how to keep their men happy, in my opinion. My youngest brother, my youngest brother, has had the most difficult time because he was exposed to too much too soon. We used to get together and party every now and then, you know? But he’s put in a lot of time. He parties as hard as he works these days. He’s probably stuck on [INAUDIBLE]. For all of us, things have been difficult. My poor mother—I try to maintain composure because I know she deserves at least one daughter to be proud of. It’s excessive. That’s probably why I started drinking. I started with alcohol. It served as a way for me to unwind and forget about my problems. Plus, Tia Alejandra claimed to have started drinking at the age of 12 in Chiapas. It’s not a big deal. I’ve never been a fan of being hungover. Then I began to take Xanax. I was very pleased with how I felt as a result of that. I didn’t have as much anxiety as before. I could leave the house, make new friends, and do everything. But then I began to crave more and more, which terrified me. Friends of mine have overdosed, and others have become ill as a result of it. I reasoned, “I’ll just cut back.” Even the day I tried to avoid taking it, I had a panic attack. My heart felt like it was about to explode. So I called the counseling center, and they had me see Dr. Dan. They told me to come see you too. I sometimes use cocaine. I don’t really like the way it makes me feel, though. It usually just makes me feel more anxious. I know it sounds stupid, but sometimes I feel like if the cocaine gets me too up, I’ll be too up to even care about being anxious. Yeah, you know, it’s like I can take it. Anyway, I can talk to people and not feel so stupid all the time, you know? I just want to feel better. I want a normal life. I want my mother to be proud of me. I know that using cocaine and Xanax are very wrong for me. But I just don’t want to feel anxious every day. I don’t want to feel anxious every day. I—I haven’t been in a relationship in over three years. And I’m afraid that I can’t trust anyone. What kind of woman am I if I can’t keep a husband and have a house and have my husband happy with the way I make things work? © 2014 Laureate Education, Inc. 3
Contextual and Multicultural Considerations Marisol is a case study. It’s all too much. So like, I can’t tell Dr. Dan any of this stuff. I’ll be so ashamed. I mean, he is the doctor, right? He’ll want to lock me up or tell me that it’s my mother’s fault. She’s a good woman. She’s worked so much. I wish I could be like that, you know? What if she found out? It would kill her. I don’t—I just think I won’t go back. I can’t stand the judgment. Dr. Dan. He can’t even pronounce my name right. “Mare-ah-saul”. It’s “Mar-ie-sole.” I just might not come back. I can’t stand the judgment. Maybe my anxiety isn’t so bad. Maybe I could just cut back on the Xanax and maybe only do coke like in the weekends or something. I think I’m wasting his time
Mental health professional’s appreciation for culture and context extend beyond general understandings of people grouped by factors like ethnicity and sexual orientation. Mental health professionals invest in understanding the deep, underlying components of all the things that come together to make our clients who they are.
When culture and context are at odds with societal norms and hegemonic expectations, mental health professionals may need to work with clients to help instill and utilize resources to cope with the possibility of negative messages from society. In addition, mental health professionals work together with clients, for clients, and with other professionals to make changes. Consider how collaborating with others promotes positive changes in client well-being. How might collaboration through advocacy result in alternative approaches for addressing cultural or contextual considerations in treatment recommendations?
For this Discussion, view the media “Multicultural and Contextual Considerations Case Study: Marisol”in the Learning Resources. Consider new and alternative methods that mental health professionals could use to advocate for Marisol.
By Day 4
Post an explanation of how you would advocate for clients like Marisol. Explain at least one strategy as a mental health professional you could facilitate culturally and contextually ethical treatment of clients. Support your strategy with evidence from the Walden Library.