Case Study of Jose and Therapy Approaches

Case Study of Jose and Therapy Approaches

The case study reflects that Jose is suffering from various depressive disorders. Depressive disorders indicate an array of mood disorders, where a person is unable to enjoy his surroundings and exhibits various physical and psychological manifestations. These disorders are co-morbid and the presence of anyone such disorder makes an individual prone to other depressive disorder/s.

The situation of Jose has been aggravated by his family members. He is a truck driver and spends his weekend for a course in mechanical engineering. Jose had a breakup with a Caucasian lady on the issue of abortion. Presently Jose is not interested in settling down with a family. Jose is not at all independent, and every decision of Jose is under the rigid control of his family members. He does not have an independent room and stays with his parents in a common room.
It is evidenced that the privacy of Jose has been jeopardized in every occasion in his life. Apart from sharing a room with other members of his family, there are other personal issues that have been publicized by Jose’s family. It was revealed that Jose had a breakup with a Caucasian lady, on the issue of abortion. The issue was so sensitive and should have been kept within the family of Jose. However, the issue was publicized by their own family members. That is why Jose mentioned, that he feels out of the family. He loved his mother and shared everything with her, but such an act lead to the mental trauma in Jose.

He even mentions that the guilt of opting for an abortion haunts him. With Jose being so sensitive and repented of his act, it was the moral duty of his family members, to extend Jose with all the support. Instead, he was not extended any empathy by his family members. Jose belonged to a Mexican-American family, and rarely visited places of religious worship. However, Jose’s family members were Catholic, and their family was very conservative and outdated (Rusch, Angermeyer, & Matthias, 2012).
A loss of independence, decreased social interaction, self-declaration of “being out of the family” and “not getting joy”, were clear diagnostic features to suspect Jose, for depressive disorders. As a potential therapist, I need to manage Jose for his depressive conditions. Depending upon the situation and severity of depression, I would intervene with pharmacotherapy or psycho-counseling as desired for improved health outcomes in Jose. I should ensure that the privacy, dignity, and independence of Jose, must be maintained at all stages of therapeutic intervention.

To me, Jose seems to be like a work-horse for the family and is also a victim of family bullying. I feel that Jose may suffer from Post Traumatic Stress disorder also. As he actively recollects his breakup with the Caucasian lady, it seems that Jose was unable to forget her. However, the continuous family pressure of settling down with a spouse evoked his thoughts on the passing affair. He narrated that the only woman he loved was the Caucasian lady, and did not feel any interest in other women. He had no plans of settling down in life with another woman. However, his family continuously insisted on the issue with Jose. Jose expressed his wish for seeking therapy for his stress and depression.
I feel that Jose’s wish of actively seeking help for therapy is quite emotional and tragic too. I also felt, that appropriate therapy must be initiated in Jose, as because he is involved in a risky profession of truck driving. The momentary lapse of concentration, due to depression may lead him to road traffic accidents. Such incidences might have further negative consequences, on his physical, as well as psychological health. Moreover, the depression of Jose can also be due to the terminal illness of cancer in her mother, whom he loved very much and relied upon (Rusch, Angermeyer, & Matthias, 2012).

Jose has been affected by the background culture of his family. Being a Mexican American, Jose’s family were immigrants in the United States. They did not have many aspirations in their life, but to struggle for daily existence. They belonged to a typical Catholic conservative family. They believed in doing work to meet daily requirements and then settle down with spouse and children (Silverstein, 2002).

Jose’s father was a drunkard and had no commitments to his family. Jose was not all happy with the attitude of his family members. He did suffer from communication gap, in expressing his aspirations to his family. Jose is a compassionate fellow and is knowledgeable, with definite aspirations of gaining an education. He is studying mechanical engineering, in spite of his busy schedule of driving. Jose was broad minded and did not have emotional or religious compulsions. The case study reflected that the mindset of Jose was quite different from his family, and his family members failed to understand him.

With such background information in my mind, I would opt for providing an individual therapy as well as family therapy, for the alleviation of symptoms of depression in Jose. With regard to the family therapy, I would talk to his brother-in-law and mother and share them to provide a certain degree of privacy to Jose, in his day to day life. First of all, I should voice for a separate living room for Jose, to provide some space for Jose.

I would ask the family members of Jose to have compassionate feelings for him. They should not raise the incidence of the breakup issue of Jose with the Caucasian lady. Further, they should not pressurize him for settling down in life, against his will. I would also sensitize his family members, regarding Jose’s aspirations and ambitions. I will also try to evaluate, if any other family members of Jose suffer from psychological challenges. Under such situation, I should focus my individualized therapy, to such persons too.

In my therapeutic approach with Jose, my endeavour would be to counsel Jose. I should assess his severity and category of depression, based on DSM-IV guidelines (Rusch, Angermeyer, & Matthias, 2012). Upon assessment of Jose, I would take a decision whether to initiate pharmacological therapy or cognitive behavioural therapy, to alleviate the episodes of depression in Jose.

The end goals of treatment would be, to return the happiness and independence in Jose. I should also ensure that Jose gets his confidence and joyfulness at the end of therapy. He should also come out of the guilt of the incidence of abortion. This will help in reducing the anxiety and post-traumatic stress in Jose.

After analyzing the health care needs of Jose and his family members, there are certain legal and ethical considerations that I should bear in my mind. I should not under any circumstances make such comments or interventions that may erode the spiritual and cultural beliefs of the family. I must respect the individual decision of each family member and must not violate any form of human rights, which inflicts constraints in his family. Further, I should not impose any behavioural action on any family members of Jose, which can put them under stress.

While ensuring therapy or treatment approaches, I should be guided by medical ethics, both towards Jose and his family members. First of all, I should ensure that Jose is provided with enough autonomy for deciding his treatment and healthcare goals. Apart from his healthcare goals, Jose should be encouraged to voice his concern in accepting or rejecting a certain intervention planned. I would further ensure that Jose should be treated with Beneficence. This means the goals of any therapy implemented on Jose should pivot around the well-being of Jose. Lastly, the medical ethics that I should ensure is non-malificence.

Under any circumstances, the treatment should not cause more harm, than good. At each and every level of my proposed therapeutic interventions, I would ensure a strong risk-benefit ratio. If the therapeutic intervention for depression leads him to self- harm, then I should opt out from such interventions. I would be flexible enough to initiate an alternative treatment modality. Under any circumstances, my proposed therapy should not threaten and impose the risk on the health of Jose or his family members.
References
Rusch, Nicolas; Angermeyer, Matthias C.; & Corrigan, Patrick W. (2005).
“Mental Illness Stigma: Concepts, consequences, and initiative to reduce
stigma”. European Psychiatry, 529–539
Silverstein, Brett. (2002). “Gender Differences in the Prevalence of Somatic
Versus Pure Depression: A Replication”. American Journal of
Psychiatry, 159(6), 1051–2