Critical Assessment of Clinical Practice (Essay Sample)

Critical assessment of clinical practice
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Introduction
Social workers especially clinical practitioners regularly encounter individuals, communities and families affected by different disorders. They are always the first to treat and diagnose individuals with mental, emotional and even behavioral disturbances. They play vital clinical role in many settings including hospitals, substance use treatment, recovery programs, community health centers, aging services, private practice and agency welfare. Social work entails addressing problems facing families, individuals, groups and couples and, therefore, it is vital for any practitioner to recognize the role played by the client in the treatment plan. Safdar (2003) defines clinical social work as the application of clinical methods and theories to treat, prevent, and diagnose psychosocial dysfunction, impairment, disability and mental disorders. This paper bravely and deeply presents a critical assessment of clinical practice with the client. It tackles the mission, goals and functions of the agency. As a guide to the practice, Cognitive Behavioral Therapy has been used. Towards its end, it gauges whether it is important to adapt the model in attempt to meet cultural needs, necessary changes, informal and formal training of the practice, varied clinical practice supervision and which model is suitable for that particular practice.
The functions, goals and the mission of the agency
In general, the agency’s mission is to facilitate positive patient outcomes via a well planned health care by nurses. This in turn achieves the well-being, economic and social justice for individuals. The general goals and objectives of the organization aim at highlighting the necessity of professional identity, critical thinking, understanding diversity, hold professional values, adapt changing context (environmental) and evaluation of the practice (Josephson, 2004). Specifically, these are agency’s goals and functions:
Creating environment that supports quality patient care.
Provide adequate resources for research based practice, clinical practitioners, peer review and clinical team consultation.
Improve clinical performance and professional clinical practical through promotion, encouragement and support.
Recognize and reward individual nurses as per their performances.
Organization’s theoretical frameworks
Since the usage of combined approaches can better benefit the client, the agency utilizes various methods based on the current situation. The agency uses various approaches for maximum benefit of patients. Selection of approaches solely depends on targeted goals, clients, and the situation. The common approaches used here are person-centered approach, motivational interviewing, task-centered approach, solution-focused approach and cognitive behavioral theory (Francis, 2011). In addition, the agency values the role played by psychosocial theory where the expert assesses the nature of the relationship, psychological processes and the environment of the client. At initial stages, the agency recommends the use of the psychodynamic approach where internal processes like emotions, needs, drives motivate individual behaviors (Josephson, 2004). The most recognized criteria for selection of approaches depends on clients, his/her environment, and the situation. In this paper, Cognitive Behavioral Therapy (CBT) is used to guide the entire clinical practice. This approach guides the clinical practice between the practitioner and an individual. CBT mainly focuses on psychosocial intervention. As per past researches, CBT is suitable and effective for panic disorder, depression, compulsive disorder and generalized anxiety.
Criteria for Cognitive Behavioral Therapy (CBT) and FIT characteristics of the model and client system
Since CBT majorly focuses on effective relationship (client and practitioner), current problems facing client, treatment plan, and services; it proved to be an effective model. In addition, these are the circumstances that lead to the selection of CBT; the patient preferred to use it or medication directed him to do so, problems like unhelpful and avoidant behaviors, unworthy and extreme thinking were found to be present, past medication did not or partially enhanced improvements, psychological problems like difficulties at work, and relationship problems and alcohol misuse were felt. It is noted that, it is due to these FIT characteristics between the client, and the model made CBT be selected here (Francis, 2011). For instance, there are similar characteristics that exist between the two; client preferred it, CBT emphasizes on emotions and thinking problems and these are the main problems of the client, it was witnessed that medication didn’t bring any significant change, and therefore it calls for CBT.
In addition, CBT is a psycho educational section of psychotherapy. The patient needs advice, adequate information and skills that help them in practice daily. After educating individuals, CBT encourages individuals to change the way they think and feel when putting into practice what they have learned (Josephson, 2004). These solid principles contributed a lot to the selection of this model. Contributions emerged from both the clients and the situation. As assessed by a qualified practitioner, it is evident that CBT is suitable for this particular practice. Nevertheless, some minor FIT characteristics contributed to its selection. For example, CBT is found to be briefer and time-limited and in most cases, clients need to experience positive changes quickly. What qualifies CBT to be briefer is due to its instructional nature? Studies proudly agree that CBT creates effective therapeutic relationship and therefore easily adapted. It does not only stand up educational model but also on a structured and directive nature. Research found that many clients prefer this characteristic.
For CBT to work effectively, the therapist should inform the client in advance on which approach he is going to utilize. This will allow both of them to structure sessions with distinct activities effectively such that the client becomes active and willing to participate fully. This remains the major objective of CBT.
CBT prevents suicide and reoccurrence of such behavior
Using relapse prevention approach, theoretical principles, and dialectical behavioral therapies, CBT has been found to prevent suicidal behaviors among youths. CBT involves both continuation and acute phases. For each phrase lasts for about 12 sessions whereby a series of analysis on suicidal event, skill building, and safety plan development and family intervention is done. Participants are youths (14-19yrs) who have attempted suicide. The 110 adolescents were randomly selected from 7 educational centers. After 12 sessions, they were interviewed in an attempt to analyze their thinking and emotions. It was clear that the likelihood of the group to again repeat suicidal behavior was almost zero. This implies that individuals who undergo all sessions are more likely to experience positive results within a short time. However, individuals’ suicidal reasons such as torture at home, breakups and extreme financial problems relationships and might contribute to the reoccurrence of suicidal behavior.
Stage of clinical work with the client
The client has undergone two initial sessions and now he is on his third session. Since earlier stages such as readiness, pre and post contemplation, in the third session is majorly concerned with ‘action’. This stage is sometimes called the maintenance stage and its prime role is not only facilitating behavior change but also allow individuals to cope up with these new changes. Based on previous stages, the client is dedicated towards change. The aims in this session include; to identify triggers, risky situation and coping strategies for this client, Seek dedication towards distinct behavioral change, acknowledge and support progress, support perseverance, reinforce the clients such that he sticks to the set plan and identify any progress, as a result, previous stages. These activities and aims are in line with cognitive Behavioral Therapy since they strategize and give a road map towards a permanent behavioral change.
In this stage, cognitive techniques like guided discovery are incorporated. Here, the client gets support as he tries to identify automatic thoughts, relevant cognitions, beliefs and assumptions (Josephson, 2004). The techniques are applied together with behavioral experiment when having discussions with the client.
In this stage, the following conversion took place between the social worker and the client.
W: Welcome back and feel free to discuss any issue with me so far. Remember the conversation remains between you and I. Therefore, no information will be leaked out.
C: Thank you for the assurance. I promise to be free and open to any question asked.
W: So you said you attempted to committee suicide, what lead you to this decision? After undergoing the last two sessions, have you felt any positive change?
C: I have had a series of problems in my relationship. As I told you earlier, my girlfriend threatened to leave me after spending 1000M dollars with her. The activities we did the other day helped me a lot.
W: I understand the situation you were in. Superficially, can you point out some areas that you feel there is a change after the two sessions?
C: To be specific, my parents and relatives have started accepting me back; they share with me unlike the past. Again, I feel the stress is leaving me slowly.
W: Happy to hear that. If you remember on our last session, we discussed the activities which you need to engage in most of your time. Did you find any problem regarding this?
C: Yeah. It isn&rs...