Problem List
Blame
Brittany is dissatisfied with her parents’ moving to another place, and implicitly puts the blame for certain events on them. For instance, she blames her parents for making her attend classes where she feels isolated due to her beliefs and biracial background. She also puts the blame for her academic performance on her parents.
All-or-Nothing Thinking
Brittany still thinks that all her peers will not accept her due to her being different. In relation to her family matters, the adolescent sees the new environment as something totally negative and hostile. She believes that her parents “complicated her life” and did not understand her completely. This way of thinking makes her reluctant to hear her parents and see the situation in a more objective way.
Mental Filter
Brittany does not want to pay attention to the positive aspects of her new life. Her parents’ decision to move was due to certain reasons and the desire to improve the family’s life (in financial or other terms). The daughter disregards these aspects and seems to be unaware of the reasons for moving to another city.
Jumping to Conclusions
Jumping to conclusions prevents Brittany from making friends with her new classmates. She believes she is very different from her peers, which makes her feel isolated. However, it is not clear if her peers are hostile or unfriendly.
Problem Formulation
In order to develop an effective treatment, it is necessary to come up with a detailed problem formulation that should include such areas as environment, thoughts, emotions, behaviors, and physiology (Newman, 2013). As for the environmental element, Brittany feels uncomfortable when with her parents, and she is reluctant to speak with them. It is unclear whether she feels unconfident in class and the way she behaves with her peers. As far as the thoughts axis is concerned, it is critical to discuss Brittany’s thoughts and emotions in such situations. When it comes to her behavior, it is clear that she tends to avoid communication if it is out of her comfort zones, which makes her communication with new classmates and parent unlikely. It is necessary to discuss possible physiological manifestations for Brittany’s reluctance to communicate with peers and parents.
Interventions
It is noteworthy that Brittany’s parents should have a conversation with the specialist and discuss her old self and the prospects of this to happen. As far as the work with Brittany is concerned, the discussion of her old and new self should be a part of the sessions. It is critical to help the adolescent cope with certain developmental aspects that might cause discomfort due to some major changes in life. Several tools can be employed to help Brittany cope with her issues related to the relationships with her parents and peers.
At this point, it is necessary to state that the therapy will be based on the principles of REBT. One of the characteristic features of this framework is the active role of the client who is encouraged to self-reflect, analyze, develop new ideas, and, eventually, change (MacLaren & Freeman, 2017). REBT also presupposes the use of the ABCDE model that involves the identification of the activating event (A), the discussion of beliefs (B) and their consequences (C), disputing of these consequences and beliefs (D), and considering new rational beliefs (E). The patient is guided rather than instructed, which makes the therapy more effective since client are motivated to follow the path they developed.
One of the CBT techniques that can help Brittany is Thinking in shades of grey. The adolescent tends to see their new location as a complete disaster and the reason for her isolation. Thinking in the shades of grey can help the patients evaluate situations in a more rational way (DiGiuseppe & David, 2015). Brittany should consider the reasons behind her parents’ move as well as positive aspects of their new life. These aspects can include the environment (for example, better air or picturesque sites), the community, new house and room, more free time for the family. It is possible to arouse the teenager’s curiosity to explore the new place. Clearly, it is essential to base on Brittany’s preferences and interests.
Cost-benefit analysis is another effective instrument that can be helpful (Gilman & Chard, 2015). The adolescent should make a list of the advantages and disadvantages of her relationships with her parents. Brittany should evaluate her behavior and identify its consequences. Based on this assessment, the girl will see that the situation is not favorable for her so it should be changed. The same technique can be employed to help Brittany develop effective relationships with her peers and even make friends with some of them. Socratic questioning can facilitate the discussion of these issues. This method is appropriate as it helps develop rapport and make the client feel that she will be heard. Empathy and exploration are other features of this technique aimed at indicating distorted beliefs and inappropriate behaviors and coming up with rational approaches (Sommers-Flanagan & Sommers-Flanagan, 2015). Brittany can infer her weaknesses and inadequate behavioral patterns, and this information will be used to address the adverse effects of her behavior. The therapist can ask Brittany to share her memories related to the time spent with her parents as well as the emotions associated with those memories.
Defining terms can also be instrumental in developing proper relationships with peers as well as parents. When using this tool, it is necessary to pay specific attention to cultural aspects. When labeling oneself and others, Brittany should not feel that she is judged or treated differently for her beliefs. It is important to make the girl feel that her race-related concerns are understood. The definitions to the provided labels should be clear and detailed, which can equip the therapist with the ideas concerning the things that “others” and Brittany share in common. For instance, her biracial origin can be referred to as one of her advantages as she can fit into both groups.
When working on the girl’s relationships with her parents, it is necessary to pay close attention to her self-identification. It is obvious that the girl is exploring her new self, but this process is affected by distorted beliefs. Moreover, Brittany stresses that she will never be her old self, which is a form of punishment for her parents’ actions. Therefore, the methods mentioned above can be instrumental in identifying the client’s real self (Sommers-Flanagan & Sommers-Flanagan, 2015). Brittany should be aware of the traits she actually has and the ones she exhibits to make her parents feel bad. She should be able to distinguish between these two identities. The therapist should also help the adolescent evaluate the advantages and disadvantages of her behavior related to her self-identification. The girl should accept the fact that she is changing, but this process cannot be distorted by such external factors as her desire to punish somebody.
Generating alternative thoughts is another technique that can be used in Brittany’s case. This instrument consists in assisting the patient to replace some negative or undesirable thoughts with alternative ideas that are more positive and rational (Sommers-Flanagan & Sommers-Flanagan, 2015). This approach will help Brittany in developing friendly relationships with her peers. The girl often jumps to conclusions thinking that she cannot be accepted as she is very different. It is possible to encourage the teenager to try to find alternative explanations for other people’s behaviors. For example, if a classmate shares some opinions concerning races and cultures during the class, Brittany’s first thoughts can be associated with this person’s being racist or hostile to her. It is necessary to make the client analyze the situation as the classmate can be interpreted in different ways. Another possible example can be the situation when a classmate Brittany likes did not smile and was absent-minded during their conversation. The patient’s first thought would be this classmate’s unwillingness to communicate. However, the person can have family issues or health problems.
Outcomes Measurement
The set of instruments discussed above should be employed to help Brittany develop healthier relationships with her parents and peers. The fact that she attends the sessions and is working on her behavior at school is a good sign meaning her willingness to fit in. The primary measurement outcomes will be her attitude towards her parents and adequate (or inappropriate) communication patterns. New friends will also be regarded as an outcome measurement as this will mean that Brittany is capable of developing friendly relationships with her peers. Clearly, her overall thoughts concerning her life will be seen as an outcome measurement.
References
DiGiuseppe, R., & David, O. A. (2015). Rational emotive behavior therapy. In H. T. Prout & A. L. Fedewa (Eds.), Counseling and psychotherapy with children and adolescents: Theory and practice for school and clinical settings (pp. 155-216). Hoboken, NJ: John Wiley & Sons.
Gilman, R., & Chard, K. (2015). Cognitive-behavioral and behavioral approaches. In H. T. Prout & A. L. Fedewa (Eds.), Counseling and psychotherapy with children and adolescents: Theory and practice for school and clinical settings (pp. 115-154). Hoboken, NJ: John Wiley & Sons.
MacLaren, C., & Freeman, A. (2017). Cognitive behavior therapy model and techniques. In A. Freeman (Ed.), Cognitive behavior therapy in clinical social work practice (2nd ed.) (pp. 25-44). New York, NY: Springer Publishing Company.
Newman, C. F. (2013). Core competencies in cognitive-behavioral therapy: Becoming a highly effective and competent cognitive-behavioral therapist. New York, NY: Routledge.
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2015). Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques (2nd ed.). Hoboken, NJ: John Wiley & Sons.