Reference no: EM133792025

Assignment: Health Care Policy & Leadership

Learning Outcome

1) Describe personal strengths that are important within the field of counseling.
2) Explain what personal opportunities exist for growth.

After reviewing What Is Nature Versus Nurture? and, use the case study at the end of Chapter 1, Case Illustration 1.2 Charlie, and answer the following question.

Part A

Photo 1.2 The journey of human development, from infancy to elderhood, continues to evolve during the lifespan. Source: Stockphoto.com/Tana26. Table 1.2 Periods of Human Development Period Estimated Age Range Description Conception/prenatal 0 Period involving rapid and extensive growth from a single cell to a human with neurological capabilities Infancy Birth to 24 months While highly dependent, the development of language, symbolic thought, social skills, and modeling takes place Toddler 1 to 3 years (overlap) Increasing mobility and independence; "the terrible twos" Early school age 4 to 6 years Increasing self-sufficiency, peer interest and interaction, and school-readiness skills Middle childhood 7 to 12 years Achievement drive becomes evident; the fundamental skills of reading, writing, and arithmetic are mastered Early adolescence 13 to 18 years Rapid physical changes and the development of sexual characteristics; increased peer interaction and influence; cognitively moving into formal, abstract reasoning Late adolescence 19 to 25 years The pursuit of independence (socially, psychology, and financially) and desire to identify vocational direction and personal identity Early adulthood 26 to 35 years Focus on establishing personal and economic independence, career development, and, for many, selecting a mate, possibly starting a family, and rearing children Middle adulthood 36 to 50 years While maintaining a satisfying career, interest turns toward social responsibility and in assisting the next generation Late adulthood 51 to 75 years Adjusting to post-work identity and retirement; adjusting to challenges of changing health Elderhood (oldest-old) ≥75 years Reflection and life review; preparing for the end of life As you scan these periods of development, begin to consider the challenges, those tasks encountered by an individual at each period, and the role that you, as counselor, could play in facilitating the individual's development through that period. Your thoughts on these issues will take greater form as you proceed in your reading. Development as Contextual While Table 1.2 points out some generalized tasks or challenges confronting individuals at each period of their development, the nature of the challenges as well as the quality of the responses can be influenced by the context in which the development is occurring. Simply consider the situation of two individuals entering a late adult period of their development. Imagine that one has a healthy retirement plan, wonderful physical health, the support of an intimate partner and extended family, and job-related health benefits. Addressing the tasks of this period will be different for that individual as opposed to one who is without family support, living on Social Security and food stamps, and has to employ emergency hospital services as his or her only form of health care. These are contextual variables, and they clearly impact the continuity of development. Whether it is our local neighborhood or global community, our development occurs and is influenced by the setting and conditions as context. Factors such as culture, ethnicity, social values, histories, and economics come into play in the unfolding of our personal stories. We are developing, but we as people of the 21st century are developing in a different context than that of our ancestors. As such, when viewing development, one must appreciate the influence that context contributes. According to Baltes and Smith (2003), context exerts three types of influences on human development: (a) normative age-graded influence that presents individuals as similar to those within their age group; (b) normative history-graded influences, such as the widespread impact of major sociopolitical events like world war, the civil rights movements, or even the terrorist attacks of September 11, 2001; and (c) nonnormative or highly individualized life events, such as the death of a loved one, the experience of being abandoned or abused, or even something like winning the lottery. LIFE DOMAINS OF HUMAN DEVELOPMENT As you proceed in your readings, you will see that the upcoming chapters discuss development by way of reviewing the theories and research targeting specific domains of development within the context of a particular developmental period. These domains refer to specific aspects of growth and change as noted in socioemotional, physical, linguistic, and cognitive development. There are times when it appears that growth in one domain is dominant, even to the point of overriding development in other domains. For example, consider the case of the crawler who almost magically transitioned to taking her first steps. While the physical expression of this child's development may gather attention, the truth is that other domains are changing, perhaps more gradually and less prominently but changing nonetheless. The child's new physical capabilities interact and benefit from improved sensory perception and stimulate increasing cognitive development by way of infusion of new experiences. Change across domains is occurring often but sometimes not in obvious ways. Photo 1.3 Healthy lifestyles, including good nutrition, contribute to a healthier longevity. Source: Digital Vision/Photodisk/Thinkstock. Consider the changes accompanying adolescence. While one can see and most certainly experience the physical changes (deepening of the voice, physical development, body hair growth, etc.) and emotional liability (adolescent moodiness) that accompany puberty, the cognitive changes that are occurring may be less apparent. Changes that are qualitative in nature provide the adolescent with an increasing ability to think about his or her own thinking and to operate in the world of the hypothetical. Development is a multifaceted process consisting of growth, regression, and change in many different domains. Understanding the uniqueness of these changes across domains, as they take form at different chronological periods of development, is essential if counselors are to know what is normative and what to do when help is needed. A BIOPSYCHOSOCIAL APPROACH For years, the question of the degree to which our development is the product of our biological inheritance or our lived experience has been debated. The question of nature (biological forces) versus nurture (environmental/experiential/learning forces) and the influence of each continues to rear its head, especially when addressing issues of intelligence and behavioral aberrations. Do we simply write off developmental variations and deviations as a function of the luck of genetics, positioning ourselves somewhat impotently on the sidelines and allowing nature to run its course? Or do we argue for sociopolitical and environmental changes that will ensure the proper nurturance for all in the human condition? Is it really that simple: either nature or nurture? Review of the literature and research outcomes tells us that it is not. As noted above, human development is complicated. Development is multifaceted, multidimensional, and contextual. Our development is, at any one point, the result or outcome of the interaction of biological, cultural, and uniquely personal factors (Baltes, Reuter-Lorenz, & Rösler, 2006). As such, development should be viewed and studied from an interactive perspective valuing the influence of biology, psychology, and social context in the same environment.

Are Charlie's symptoms of depression and anxiety due to biological or environmental factors?

Charlie is a 28-year-old Caucasian female presenting with symptoms of possible depression and anxiety. Charlie reports that her boyfriend, Jack, asked her to marry him 2 months ago, but she has not yet accepted the proposal. Ever since, she has been feeling anxious, overeating, and sleeping 10 to 12 hours at a time. Charlie has been withdrawn from her friends because she knows that they do not support her relationship with Jack, as they believe that he is an alcoholic and has abused her. She also lacks interest in her work, has been taking numerous days off, and has demonstrated very low performance on her job duties. Charlie grew up in a very rigid and religious family. She states that her parents are very supportive of her, but they were always very critical toward her while she was growing up. Her father is very authoritative, and he is also a heavy drinker. While drunk, he often exhibits extremely violent and abusive behavior toward his wife and Charlie. Charlie's relationship with her mother is strained because she is critical of her father's behavior and often voices her disapproval of her father's actions toward her mother. Charlie reports that her relationship with Jack has been rocky, with multiple breakups and a history of heated augments. Jack becomes extremely violent when intoxicated, and it reminds her of her father's behavior and how that affected her family. Charlie's religious beliefs cause her to feel guilt over her father and Jack's drinking problems. She reports having a few good friends whom she sees "from time to time." She expresses that she can "rely on them to vent her frustrations" but has recently "pulled back from them" because they do not approve of her relationship with Jack. Charlie and Jack have a history of domestic violence. She reported one incident of domestic violence to the police, in which Jack was arrested and referred to participate in anger management counseling. Although there has not been an incident since then, Charlie is worried that he might do it again when he drinks. Charlie reports no homicidal ideation, plan, or intent to do so. She also denies any personal alcohol or substance abuse. In summary, Charlie is presenting symptoms of depression and anxiety. The symptoms and findings are prominent and clinically significant: oversleeping, overeating, isolative behavior, and feelings of anxiety. The symptoms are relatively acute. Protective factors include a supportive mother and friends, as well as Charlie's insight and motivation for treatment. Significant biopsychosocial stressors include absences from work and her relationship with her supervisor and coworkers. Other stressors include her relationship with her boyfriend, Jack, and her traumatic experience while growing up with an abusive alcoholic father, a demanding mother, and also a history of domestic violence with her father and her boyfriend. You may want to use this case for role-playing activities in class and for discussion purposes.

Part B

Sal grew up in a close-knit family with the males being patriarchs and expressing little emotion. Alcohol was normally consumed with all meals, and Sal started drinking at the age of 10. Sal indicates that he was a "hard drinker" during his 20s and 30s, when he developed stomach problems and high blood pressure. At that point, he limited his use of alcohol to his Friday night poker club and to Sunday dinner with the family. Since Maria's death, Sal has regularly consumed 3 to 4 drinks a day but lately has been drinking more than usual. He says it alleviates some of the pain, stress, and loneliness. It also helps him sleep, along with the over-the-counter medications that he takes for arthritis pain and as sleep aids. He came to the clinic because his hypertension and gastritis have become extremely labile and intractable. When you ask Mr. Franco how he is doing, he says, "Oh, I guess I'm okay for an old widower. I don't think it really matters how I feel or what I do anymore at my age."

I.

A. Establish context for your case note by briefly describing the client based on the information that you are presented within his or her case scenario.

B. Describe the basic elements of the theory that you are applying to the client's case. Does the theory include developmental stages or other unique characteristics?

C. Explain foundational information about the theory, including information about its founder.

D. Explain why this is an appropriate theory to apply to the client. Include supporting evidence from across the client's lifespan.

II. Assessment

A. Through the lens of the developmental theory, explain the physical and cognitive components of the client's case across the lifespan.

B. Through the lens of the developmental theory, explain the systemic and environmental components of the client's case across the lifespan.

C. Using the developmental theory as a guide, explain the client's career development across the lifespan.

D. Using the developmental theory as a guide, explain the client's work environment across the lifespan.

E. Describe how the client's career and work history across his or her lifespan relates to his or her current state.

F. Explain, through the lens of the developmental theory, any cultural components of the case that play a role in the development of the client.

G. Explain, through the lens of the developmental theory, any ethical components of the case that play a role in the development of the client.

III. Plan

A. To create context for your Plan section, summarize your assessment of your client's case by describing the outcome of the application of the developmental theory.

B. Describe any specific ethical and cultural considerations you will make when working with this client, based on your assessment of his or her case.

C. Based on your description of the client's current state, in regard to his or her career and work history, describe any specific considerations you will make when working with the client.

D. Explain the client in terms of his or her overall wellness and mental health status. Use your assessment to inform your explanation.

E. Based on the client's overall wellness and mental health status, describe what needs to be addressed to get the person to a state of mental wellness.