Psychosocial Assessments Study
Study
Gender: Male
Age: 33
Marital Status: Single
Race/Ethnicity: Caucasian
Language Spoken: English
The purpose of the study is to display the effect that social trauma has upon the life of an individual. The subject is James Reke, a 33-year old Caucasian male who currently works as an accountant in Fayetteville, NC. James is an only child who was born and raised in North Carolina. His parents passed way when he was 18 years old. A year after their passing James lost his parents’ home due to not being able to make the necessary mortgage payments. Auctioneers threw him out of his family house. James was homeless and lived at the kindness of his maternal aunt and uncle. He dropped out of school after the death of his parents but later with the help of his aunt he worked part time jobs and completed his education. He is now an accountant working for the JJ Investment Company.
The problems surrounding James have been many especially those involving deaths. The effect that said problems have had on his social outlook begins with his involvement with a woman whom he dated for four years and planned to marry. Unfortunately during this time they were involved in an accident that left him with a vertebral fracture and spinal injury and with severe forms of headaches that are linked with migraines. Sadly his fiancé died at the scene of the accident. James was under medical observation for a year and eventually recovered from his vertebral fracture though he still suffers from chronic back pain. He has shown significant improvement and moved on with his life. He started dating another woman but before a year was over, the woman was involved in a fatal accident. James started keeping to himself and ceased all interaction with his friends. In response to the event James attempted suicide but was saved by his friends who referred him to Community Mental Health Center at Cape Fear Valley.
Community Mental Health Center is an organization that treats individuals with major psychological issues. On staff are neurosurgeons, counselors, and social workers who help in dealing with the individuals at a personal, one on one level. The goal is to understand the issues that may be leading to their volatile, potentially self-harming state of mind. The center serves a large population of such clients, which has been in existence for the last 20 years. It offers guidance and counseling to individuals with different issues in life. It also offers medical treatment for psychologically affected patients.
James’ case was thoroughly reviewed before he was admitted, as people are not generally admitted to the community center without good reason. Taking into consideration the challenges of losing his parents and then two women with whom he had an intimate relationship it was determined that he met the criteria and needed help. His habit of internalizing his pain and shutting everyone away is a common response to high levels of stress. This was evident from the manner in which he withdrew from his friends after the death of his second fiancé. While he might have had help in accepting the loss of his parents and first fiancé, the death of the second was not met with any closure or true emotional sense of loss. Instead James internalized his sorrow and withdrew from the world.
A week after the funeral of his second fiancé James was found trying to kill himself. He justified the act by stating that it was his destiny to not exist in this world. His friends felt that he needed help and referred him to the community mental health center for help. It is clear that James is depressed and requires psychological treatment. He is faced with great losses in his life, which must have led to his increased stress as he thought of the challenges he has encountered in life. According to James, everyone has abandoned him in his life and he feels that God wants him to join those who passed on before him. James is under the belief that he is not sick, but seeking to follow God’s will.
Judging simply by his mental state James believes that he is cursed. James stated that he believes that the death of the people around him is abnormal and he needs to be cleansed to be able to interact with other people. Because of this belief, he has grown to think that his death will remedy the situation he is currently in. What is clear is that James has gone through a great deal and has viewed only a few different possibilities concerning his ill luck. What he has been through in life may have led to the level of depression he is seen to exhibit. James has a history of stress related experiences that alludes to the belief of an individual being responsible for the accidental deaths by the simple fact that they exist.
When James lost his parents he was able to deal with the issue through counseling and acceptance of his situation at that time. When he lost the family property he was affected by the loss of a familiar home. After resuming his education the school he attended recognized his life challenges and referred him to a counselor as well. James has been referred to counseling a number of times, and it is clear at this point that it has not had much of an effect in regards to his future. James still believes that the only way to solve the problem is to simply not exist. Unfortunately he has not taken much thought as to who will miss him if he goes through with the act. At this time he does not believe the agency can provide a solution to his life challenges. Motivational interviewing is an empirically supported, client-centered, directive counseling approach designed to promote client motivation and reduce motivational conflicts and barriers to change (Wagner, Mcmahon, 2004).
James’ attitudes and beliefs both past and present are based largely on his life experiences. According to his friends James is usually a well-groomed man, but has as of late not taken any pride in his appearance. He is unkempt and responds to situations at work in a most illogical manner at times. James is tall man but after the accident and back injury, he walks with a notable slouch and has a very slow pace. James comes across as a very confident individual and believes in himself a great deal. James appears to be very bright; he stated that while attending college his teachers believed that he was a student with a high IQ despite having a high chance of experiencing mental issues. He communicates effectively and is very attentive to different happenings in his life. According to his teachers James was a very special student and carried great potential to do most anything.
James has had economic issues since the loss of his family property, which was inherited from his parents. However, after the completion of his education and securing a job he has a steady income and is able to support most of his life necessities. His main source of income is his job. His parents lived a very humble life. According to James, both of his parents worked many hours at the factory distributor in Fayetteville NC. He lived a simple life with not many luxuries. After the passing of his parents though his life changed and he became homeless until his aunt and uncle took him in. After graduating college he managed to secure a job and gradually worked his way into the middle class lifestyle. His daily activities involve going to work and attending church sessions twice a month. He has a small group of friends that are involved in different social activities. Currently he lives in a neighborhood that is less violent and considered safe. James’ own cultural believes contradict the principles of the treatment agency and they are likely to pose a challenge when helping him to overcome the challenges he faces.
As pertains to his current social functioning, James has lived a lonely life since the death of his parents and interacts sparingly with members of his society due to the life challenges he has encountered. He has a problem in socializing with others within society, though he has been able to establish healthy social connections that he is able to use when needed. He has no family to relate with since the death of the parents except for friends who have supported him like a family. The fact that he has grown without a stable family affects his social life and in most cases he has acted much like a classic recluse. Living with his aunt and uncle for a time introduced a new family dynamic to his life experience that, while positive, was not the norm he had grown with. While still living with his parents James grew used to the typical nuclear family dynamic in which he had a mother and father, who were hardworking and who had managed to keep their finances sound and secure. Moving into a home where the primary wage earners had constant financial issues was a greater challenge than he had been taught to handle. In this manner James had to learn how to fend for himself more often than ever, as along with financial issues came domestic violence issues as his uncle was very abusive towards his aunt both physically and mentally.
Unfortunately there were times that James was included in such abusive altercations, and was forced to deal with yet another facet of life that he had not been prepared to deal with. Life at that point became a series of challenges that he had to adjust to quickly in order to get along. Once he obtained a job he was on track to finding the happiness he’d been wanting in the form of a family of his own. Unfortunately this did not happen. James’ life challenges are easily traumatic enough that it is reasonable to assume that he requires a great deal of support. According to his known family history James had to deal first with the loss of his parents, which can be catastrophic to an only child. Add to that losing one’s home, the main source of comfort, and it is considered likely that James would begin to exhibit antisocial and even harmful behaviors as a result. It speaks to his mental discipline and moral fortitude that he has not made the decision to engage in violent or otherwise illegal behaviors, though his desire to commit suicide is still troubling.
James’ psychological functioning can be summarized as potentially self-destructive. The life experiences that James has encountered are challenging and they have had great impact in his life since his childhood. Mentally it can be reasoned that James may not be stable; a fact that can be attributed to the behavior he exhibits. He has lived a life full of challenges and has known little peace, a factor that has created great conflict and stress in his life. His intellectual functioning has been altered by the persistent challenges and he views life based on the experience he encounters (Sharan, 2012). From his behavior it is clear that he has given up in his life and is not interested in moving forward. To date the more he has tried the more challenges he has had, and thus more tragedies. To date his coping style has been to work towards a defined goal in order to better his current situation. Yet as of late his attempts at suicide have made it clear that he no longer wishes to better his life.
Psychologically it would be reasonable to state that while James possesses a strong personality the challenges he has faced are simply too much for his overloaded emotions to cope with. Despite the mental and emotional endurance he has shown to reach his current status as a middle class worker, the continual tragedies that have struck his personal life have proven too much, leading him to believe that suicide is the only way out. He has exhibited suicidal tendencies and has shown commitment to the act, leading those who have supported him, friends and counselors alike, to conclude that he is convinced that ending his life is the only viable option left.
The current emotional functions that James exhibits reflect his instability. Throughout the man challenges in his life James has been expected to show emotional responses that adequately convey his feelings. Regardless of this expectation however James has only shown sorrow following the deaths of his parents. Following the deaths of his first and second fiancé he exhibited only silence and a reluctance to communicate with others. Quiet at most times, James is normally seen to not react to social impasses that might otherwise evoke emotion. He has learned how to block out his emotions and to temper his responses to different situations he faces on a daily basis, thereby creating automatic and trained responses that are expected during expected interactions (Yamashita, 2012). Near the end, before he attempted suicide, James displayed a heightened level of anxiety that made it clear that things were not okay.
Currently James has become withdrawn, which leads to the reasoning that his social and behavioral functions are less than satisfactory. He displays a lack of ability to interact with others within societal norms. Within most of his personal relationships he is decidedly passive. While he takes part in social activities he is not always able to become fully involved in any one activity, which indicates that his mind is continually preoccupied with matters that are not related to those at hand. He is seen to be socially inept, as he cannot seem to create any new relationships either personal or romantic. The psychological implications of his life experiences have had a very negative impact on his ability to interact with others, and thus as a result he withdraws from society instead of becoming an integral part of it.
Looking at the different environments that James has experienced in his life it is no wonder that James feels some anxiety. The vast difference between being raised in a stable, caring home as opposed to being homeless and then living in an abusive home can easily cause both mental and emotional trauma. Because of this James has had to adapt to very different situations that in turn have fostered the need to bury his emotions. This in turn has made him blind to societal norms in which emotion is not only warranted, but expected. This makes James a hard person to read and therefore seemingly awkward in most social settings. In order to open him up a little more James requires counseling that will attempt to talk about his life experiences and how they have come to shape the life he currently lives.
James has given up in life and has lost the necessary motivation to keep going. The main duty of any counselor that James meets with is to make certain that James understands that life is all about challenge, no matter the severity. The client needs to be at ease and be able to open up and react normally (Ro, Clarke, 2004). With the change of the perspective of the client then there may be a chance that the client will be assisted.
The intervention that is necessary to fully illuminate and thereby bring to light James’ issues requires the help of a specialist who is qualified to help James gain acceptance of his own life. James currently lives in denial, which is why he opts to close out the harmful experiences of his past. Unfortunately this fosters depression that must be treated from a medical and psychological standpoint. The counseling sessions are important to help the client internalize the different life experiences and view them as a positive aspect in their life. All situations have a positive and negative side and it is important to focus on positivity (Bogart and Delahanty, 2004). It will be easy to help the client if he is ready to be helped. However, in the case where the client believes they are okay it may be difficult to help them. For the intervention program to be successful it is important for the client to accept that the situation they are in is abnormal and there is need for change (Steptoe, Deaton, Stone, 2015). Based on this perspective, the treatment may be challenging. However, with the right treatment, and by combining the right theories into practices James can overcome this challenging chapter in his life.
Works Cited
Bogart, Laura; Delahanty, Douglas. Psychosocial Models. Handbook of Clinical Psychology 3 (2004): 201-248. Print.
Ro, Eunyoe; Clark, Lee Anna. Psychological Functioning in the Context of Diagnosis: Assessment and Theoretical Issues. Psychological Assessment 21. 3 (2009): 313-324. Print.
Sharan, Deepak. Assessment of Psychological Risk Factors. Work 41(2012): 5361-5362. Print.
Steptoe, Andrew; Deaton, Angua; Stone, Arthur. Subjective Wellbeing, Health, and Ageing. Lancet 385 (2015): 640-648. Print.
Wagner, C. C.; McMahon, B. T. (2004). Motivational interviewing and rehabilitation counseling practice. Rehabilitation Counseling Bulletin [H.W.Wilson - EDUC], 47(3), 152.
Yamashita, Jun. A Review of Psychosocial Assessments for Disaster Mental Health Studies. Psychological Trauma: Theory, Research, Practice, and Policy 4.6 (2012): 560-567. Print.
