Presenting Problem
April, a 23-year-old client featured in Season 2, Episodes 2, 7, and 12 of “In Treatment,” undergoes therapy for lymphoma while carrying a burden of secrecy. She grapples with the dread of disclosing her ailment to her family and peers, exacerbating her psychological distress. Her relationships and decision-making processes are affected by this fear, as seen in her discussions with Dr. Weston. Her reluctance to reveal her ailment hinders her from receiving emotional support and appropriate care. Her concealment isolates her and hampers her treatment plan because her loved ones are ignorant of her psychological and physical requirements.
Assessment of Functioning
April’s physical health is now impacted by her recent lymphoma diagnosis, leading to symptoms and stress that might damage her immune system and overall physical strength. April exhibits signs of anxiety and refusal to accept her condition. Her initial refusal to acknowledge the gravity of her position suggests a defensive tactic to deal with profound fear and unpredictability. April appears socially isolated because she is reluctant to reveal her illness, which indicates her internalized desire to appear strong and self-reliant. The way she interacts suggests strained family relationships, which adds complexity to her support network. Isolation has a vital influence on her mental health and coping abilities.
Theoretical Application and Problem Formulation
Analyzing April’s condition via a cognitive-behavioral framework helps to understand her problematic thought patterns and actions associated with her sickness. Her denial and terror are considered psychological defenses against the existential danger of cancer, as suggested by the concept. These practices impact her social relationships and her capacity to seek and receive assistance. This approach allows for targeted interventions to modify these cognitive tendencies and promote adaptive behavioral responses to her illness.
Intervention Plan
Strategies
- Communication Enhancement: Encourage April to disclose her condition to her family gradually, strengthening her support network.
- Cognitive Behavioral Therapy (CBT): Address negative thought patterns regarding her illness and foster more adaptive coping mechanisms (Orzechowska et al., 2021).
- Interprofessional Collaboration: Coordinate with oncologists and support groups to provide a holistic care approach, integrating medical treatment with psychological support (Mao et al., 2021).
Goals
- April will inform at least one family member about her diagnosis within the next month to reduce her emotional burden and isolation.
- Participate in bi-weekly CBT sessions to develop healthier coping strategies over the next three months.
Evaluation Plan
The intervention’s effectiveness will be measured using SMART goals:
- Specificity: Clear identification of behavioral targets in therapy sessions.
- Measurability: Regular assessments through self-reported measures of anxiety and depression.
- Achievability: Goals are set in collaboration with April to ensure they are attainable.
- Relevance: Directly addressing her immediate needs for emotional support and psychological coping.
- Timeliness: Setting timelines for each goal to ensure progress is trackable, and adjustments can be made as necessary.
Personal Reflection on Social Location and Potential Biases
As a Psychology graduate analyzing April’s case, I recognize that my academic expertise and personal experiences shape my viewpoints and evaluations. My identity both improves and limits my understanding. Being close in age and having a similar educational background to April might lead to my identifying too strongly with her experiences, perhaps affecting my impartiality. I may unintentionally make assumptions based on my personal beliefs about illness, independence, and family dynamics. My cultural background might influence how I see her interactions with her family and medical decisions.
Analysis of ADEI Elements in April’s Life and Systems
Diversity and Intersectionality
April’s presence as a young woman with a severe illness intersects all aspects of her identity and societal responsibilities. As both a student and a patient, she faces challenges in accessing resources, meeting society standards, and forming her self-perception. Multiple factors contribute to her hesitancy in disclosing her illness and seeking assistance, affecting her mental well-being and the social interactions at play. Her instance exemplifies how intersectionality influences individual experiences in managing healthcare and societal involvement.
Forms of Oppression and Discrimination
April is influenced by unspoken cultural norms around health and productivity, which might be affecting her sense of isolation and her choice to hide her sickness. Viewing sickness as an obstacle to meeting academic and personal obligations might result in withdrawing from social interactions and facing mental health difficulties (Ning et al., 2022). Society’s perspectives exhibit nuanced bias against those with health issues, affecting their cognitive and social welfare. Stigmas can lead to reduced social ties and a lack of empathy from peers, exacerbating feelings of loneliness and stress.
Impact of White Supremacy and Privilege
White supremacy and privilege may still impact her treatment options and the support she receives from society. Racial and socioeconomic statuses frequently determine the quality of care and the range of support services offered in the healthcare system (Karanth et al., 2019). April’s access to a high-quality therapist like Dr. Weston implies economic advantages that are not universally accessible, highlighting structural inequalities. This difference highlights the significance of acknowledging the impact of privilege and structural obstacles on the availability of mental health resources and supportive services, which can subtly but significantly affect results.
Cultural Structures and Values
April’s experiences are shaped by cultural values that prioritize autonomy and self-sufficiency. Her reluctance to inconvenience others and her initial decision to manage her illness on her own are influenced by cultural standards that value privacy and independence. Cultural factors may cause the medical system to overlook the holistic requirements of individuals by separating emotional treatment from physical therapy in patient care. Systemic biases and cultural beliefs may impede the delivery of thorough care and assistance for patients such as April, impacting their emotional well-being and illness management.
References
Karanth, S., Fowler, M. E., Mao, X., Wilson, L. E., Huang, B., Pisu, M., Potosky, A. L., Tucker, T., & Akinyemiju, T. (2019). Race, socioeconomic status, and healthcare access disparities in ovarian cancer treatment and mortality: Systematic review and meta-analysis. JNCI Cancer Spectrum, 3(4).
Orzechowska, A., Maruszewska, P., & Gałecki, P. (2021). Cognitive behavioral therapy of patients with somatic symptoms—Diagnostic and therapeutic difficulties. Journal of Clinical Medicine, 10(14).
Mao, J. J., Pillai, G. G., De Andrade, C. J. C., Ligibel, J. A., Basu, P., Cohen, L., Khan, I. A., Mustian, K. M., Manohar, P. R., Dhiman, K. S., Lao, L., Ghelman, R., Guido, P. C., Lopez, G., Gallego-Perez, D., & Salicrup, L. A. (2021). Integrative oncology: Addressing the global challenges of cancer prevention and treatment. CA: A Cancer Journal for Clinicians, 72(2), 144–164.
Ning, X., Wong, P., Huang, S., Yi-Na, F., Xiao-Jie, G., Li-Zeng, Z., Hilario, C., Fung, K., Yu, M., Poon, K., Cheng, S., Gao, J., & Jia, C. (2022). Chinese university students’ perspectives on help-seeking and mental health counseling. International Journal of Environmental Research and Public Health/International Journal of Environmental Research and Public Health, 19(14).