Using the Case Study of Mr. X, Identify and Explain the Client’s Issues and Devise a Course of Treatment for Him, Taking Into Account Any Ethical Issues.

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In this essay I will explain the issues Mr X has expressed as I understand them. I will also explore the ethical considerations that should be considered before devising a relevant course of treatment.

Mr X stated that he has been employed as an estate agent in the same company for 18 years. During this time he has regularly demonstrated that he is capable of successfully executing the role of manager by “standing in” when the manager is absent. Despite this he is apprehensive to put himself forward as a candidate for the managerial position now that the role has been made available. The phrase, “he does not want to upset the apple cart if he is not successful.” immediately suggests that he has a fear of rejection because he will not put himself in a position where rejection is a possible outcome. Mr X also demonstrates hesitation to socialise with his colleagues because he believes they find him boring; but he is afraid to ask them to meet on another evening for fear of rejection. He is unable to socialise with them as they do so on Friday evenings which is when he visits his mother. He indicates that he does not feel comfortable suggesting any change to his mother because, “.... she would pick on him even more than usual.” This suggests that his mother is a controlling, critical parent and that Mr X will do anything to avoid displeasing her. Mr X wants his mother’s approval but fears her rejection if he fails. He indicates he is capable of emotional attachment however he cannot express them. This is shown in his description of his girlfriend as a “sort of” girlfriend but he say he would like to marry her. This suggests that he has not discussed his feelings nor has he established the nature of the relationship with his girlfriend because he is scared of her rejection.

In my evaluation Mr X is presenting with self-confidence and self-esteem issues in addition to having a great fear of rejection and failure. Before pursuing any potential course of treatment I must, as an ethical and responsible therapist, ensure that hypnotherapy is truly suitable for his issues. I would make certain at this stage that he is not suffering from depression, as it would be out of my remit to treat him were this the case, and I would also enquire from him about any medication he may be on that could cause changes in his mental state, thus interfering with the proposed therapy.

I would not agree to conduct any treatment until I had satisfied myself that he is not suffering from any psychosis, that he is not taking any psychotherapeutic medication or dependent on alcohol or drugs,

Mr X has demonstrated that he is very capable in his job and is valued by his manager; however Mr X does not recognise or value his own achievements. In addition his colleagues are also obviously eager to socialise with him but his lack of self esteem prevents him from seeing how his colleagues really perceive him. It is Mr X who has labelled himself as boring. Hadley and Staudacher state that, ‘The major cause of poor self-esteem is past negative programming that is the product of judgemental parents.’ This is most certainly going to be true in Mr X’s case, as he has spoken of his mother’s critical nature towards him, and even now feels unable to ask her to adjust the day for his visits to her in order that he could facilitate the social night with his colleagues. Self criticism manifests itself as a disabling critical voice in the mind that in time can become self-defeating and cause the person to formulate beliefs about themselves that are inaccurate and false. It is important that the therapist accepts the client’s belief about themselves in order for the treatment to be effective. ‘Self-esteem is one of the fundamental influences on nearly everything you do. When your self-esteem is low, almost all areas of your life – working, socializing and loving – are made more difficult.’ (Hadley and Staudacher) In this case it would be necessary to reframe the...
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