Health Psychology
Health Psychology
Health Psychology
Models of Health Psychology
The biopsychosocial model regards illness and health as a product of biological characteristics or genes, social conditions such as social support, family relationships, cultural influences, and behavioral factors such as health beliefs, stress, and lifestyle. According to Straub (2014), it is important to look at health and illness in terms of various contexts. In relation to Juanita, it can be noted that a combination of various factors has caused her condition. Juanita has a history of alcoholism, and when events that she considers stressful, such as the departure of her son and the probability of losing her job, take place, her coping mechanism is re-indulgence in alcohol. Coupled with these stressors, Juanita may have a genetic predisposition to alcoholism. Psychological processes like poor coping skills, high levels of depression and stress, and the possibility of having strong feelings of personal responsibility for domestic abuse might have contributed to her ill health.
Socio-cultural factors such as lack of support, as well as stigma, shame, and fear linked to domestic violence, could explain her inability to talk about the violence and use of alcohol and increased attachment to her son as coping skills. Whereas some mothers develop a poor attachment with their children, others compensate for the abuse by being excessively attached, protective, and attentive to their children (Rogers, 2019). Furthermore, research shows that women in violent domestic relationships tend to experience self-blame, and the stigma associated with the violence, as well as shame for sticking to the relationships, causes them to keep silent about domestic violence (Thapar-Björkert & Morgan, 2010; Overstreet & Quinn, 2013; Patrick, 2018). This explains Juanitas behavior of being adamant about talking about the domestic violence she experiences at home, which has resulted in depression, a ruptured eardrum, constant headaches, and loss of balance. Anxiety and panic attacks could also be linked to domestic violence. Research shows that depression, as well as panic attacks, are common among women experiencing domestic partner violence, and all these factors point to the possibility of post-traumatic stress syndrome (Kop?avar Gu?ek & Seli?, 2018; Health Talk, 2019). These factors work together to result in Juanitas ill health.
The systemic process that contributes to the unhealthy behaviors in Juanita can be explained using the biopsychosocial model. This means that a combination of factors acted together to result in her current condition. Juanita claims that her job is on the line, and her youngest son is about to depart from home, making her feel depressed and resort to alcohol as a coping mechanism. The biological process that could be present in this situation is a genetic predisposition to anxiety as well as alcoholism. The psychosocial process involved in this case is a high level of stress as well as poor coping skills, as observed in her previous history with alcoholism and the current relapse following her inability to cope with the fact that her youngest son is leaving home and her job is on the line. The social influence, in this case, is the lack of support from the husband since she undergoes domestic violence and is even adamant about speaking about it with the nurse. All these processes work together to result in such behaviors as feelings of depression, headaches, racing heart, chest pain, reduced body weight, balance problems, or dizziness.
The mind-body connection is explained in the manner in which such factors as domestic violence, the sons departure from home, and the probability of being laid off result in poor coping skills, depression, panic attacks, and anxiety, which are then manifested through constant headaches, loss of weight, chest pains and relapse.
Clients Needs
The physical problems that are manifested through chest pains, severe headaches, and ear problems, which cause balance problems and dizziness for Juanita, need to be addressed first. Emotional and psychological needs such as panic attacks, anxiety, and depression also need to be addressed. After this, it is important to address the problem of relapsing with the help of the local Drug and Alcohol Treatment Center to make it possible for Juanita to have better-coping mechanisms and also lead a healthy and quality life. The fourth problem should be addressing the issue of domestic violence, and then lastly, it would be important to address the work-related issues to prevent her from being laid off.
To be able to address these needs, there is a need for a collaborative and multidisciplinary team composed of such individuals as a physician, psychologist, social worker, and, if necessary, a case manager to help Juanita make a holistic recovery. A physician will be required to make a medical assessment of Juanita and recommend the necessary treatment for problems such as ruptured eardrum, chest pains, and headaches. Painkillers and antibiotics, among other drugs, can be recommended to help her heal. The second step will be to recommend a psychologist who needs to help Juanita deal with depression, panic attacks, and anxiety. The psychologist is also expected to help Juanita understand various factors, such as her strong attachment to her son and the strong emotions she feels due to her sons departure, and will also guide her through adaptive behaviors that will help her cope with stressful events in her life. Cognitive behavioral therapy is highly recommended in this case. Straub (2014) recommends using a problem-focused coping approach since it results in reduced psychological distress, better health outcomes, and weaker physiological reactions to stressors.
Juanita should then be encouraged to seek help from the local Drug and Alcohol Treatment Center. The doctor is concerned that Juanita might fail to attend these therapy sessions. In this case, offering support will be of great importance since Straub (2014) claims that social support and motivation, as well as readiness to change, are important predictors of the failure or success of the treatment. Helping Juanita understand the need for the therapy and motivating her to attend these sessions, even by offering transportation, could be important. Relapse prevention programs are important in helping individuals remain alcohol-free and deal with circumstances that tempt their relapse. Most acculturated Hispanics are said to have a high probability of drinking alcohol, even though alcoholism is not common among Hispanics (Castañeda et al., 2019). This is increased by such factors as discrimination and low income. As an agent of change, it will be important to advocate for poverty and alcohol reduction strategies among Hispanics in the US and promote education programs that will help Hispanics and other minority groups learn to control their drinking.
The issue of domestic violence needs to be addressed with the help of a psychologist and a social worker. Undergoing counseling will be important to help deal with the consequences of the abuse, such as trauma, stress, panic, and depression. The psychologist can help educate Juanita on appropriate interactions in relationships and help her vocalize concerns whenever she is harmed or disrespected. It would also be important to offer training on psychoeducation and how to stay safe in the event that Juanita is willing to remain in her marriage. However, if she chooses to leave, a social worker should be employed to guide her through the process. Hispanics are known for their values of familism, which encourages family closeness and places emphasis on family cohesion (Taylor et al., 2012). As an agent change, it would be important to educate Juanita about the dangers of sticking to an abusive relationship and help her to air her concerns and not be afraid to make a decision that might go against her cultural values. Lastly, it will be important to help Juanita with other problems, and a case manager can be assigned to her case to help her through the alcohol rehabilitation, housing, and employment needs.
Treatment Plan for Juanita
Diagnosis
Based on the history of Juanita, she is diagnosed with alcoholism, depression, anxiety disorder, and domestic abuse.
Treatment Goals
In 1 year, it is expected that Juniata will have made a full recovery from alcoholism and will be able to show adaptive coping behaviors. It is also expected that Juanita will have normal relations with her spouse, report domestic abuse or separation from the spouse, and have appropriate measures taken against the husband. Full physical, emotional, and psychological recovery is also expected. To attain these goals, Juanita is expected to maintain her attendance at therapy sessions for alcohol use and relapse, as well as counseling for domestic abuse and psychological problems like depression and anxiety. She is also expected to maintain a healthy routine in which she indulges in proper self-care by eating healthy, exercising, and maintaining a normal weight.
The short-term goals are as follows:
Short Term Treatment Goals | Time Frame | Steps to Achieve Goals | Rationale for Treatment Recommendation |
Recovery from chest pains, headaches, and the ruptured eardrum is expected. | 3 weeks | Antibiotic treatment and painkillers are to be administered by a physician to treat the ruptured eardrum and the chest pain and headaches. An x-ray should also be conducted to determine if Juanita is responsive to treatment and whether additional damages are present. | Antibiotics are commonly used in the treatment of ear infections, whereas painkillers are important for headaches and chest pains. |
Alcohol avoidance is expected. | 2 weeks | Given her previous history with alcoholism, it is expected that relapse prevention programs will be incorporated into the Drug and Alcohol Treatment therapy.
Juanita should also engage in complementary and alternative medicine, such as meditation, yoga, and CBT treatment (Patterson, 2019). |
Relapse prevention programs help patients gain control over scenarios that may precipitate relapse in drinking (Straub, 2014).
Meditation helps in general well-being, and together with CBT, it can facilitate adaptive coping mechanisms and prevent relapse (Edenfield & Saeed, 2012; Ali et al., 2017). |
Reduced depressive symptoms | 6 months | Through CBT, Juanita is expected to show reduced depressive symptoms.
She is also expected to start a supervised workout regime since research shows great efficacy of exercise in lessening depressive symptoms (Harvey et al., 2018). Antidepressants are also recommended in small dosages. |
CBT is highly effective in the treatment of anxiety and depression, and this is even more effective when coupled with a small dosage of antidepressants, particularly when the patient works out (Harvey et al., 2018). |
A report of the domestic abuse is expected. | 1 month | Juanita needs the help of a social worker to help her report domestic violence in case it continues.
Support from family is also expected to guide her through her decisions in case she chooses to separate from her husband and report him. |
Mandatory reporting will help end the abuse and could prevent the perpetrator from continuing the behavior by seeking help for the behavior or encountering harsh penalties for the abuse. |
Improved productivity at work and job stability. | 1 month | Juanita is expected to go to work regularly or take a leave to recover and report back with increased productivity. | Taking a leave can be helpful in the recovery process, allowing Juanita to go back to work and be more productive. |
Recovery of normal weight | 2 months | A proper diet and constant exercise regimen need to be incorporated into Juanitas daily life to enable her to regain her weight. | Exercise and a proper diet are essential for holistic health since exercise can help reduce stress and facilitate mental health. |
References
Ali, S., Rhodes, L., Moreea, O., McMillan, D., Gilbody, S., Leach, C.,& Delgadillo, J. (2017). How durable is the effect of low-intensity CBT on depression and anxiety? Remission and relapse in a longitudinal cohort study. Behavior research and therapy, 94, 1-8.
Castañeda, S. F., Garcia, M. L., Lopez-Gurrola, M., Stoutenberg, M., Emory, K., Daviglus, M. L., & Talavera, G. A. (2019). Alcohol use, acculturation and socioeconomic status among Hispanic/Latino men and women: The Hispanic Community Health Study/Study of Latinos. PloS one, 14(4), e0214906.
Edenfield, T. M., & Saeed, S. A. (2012). An update on mindfulness meditation as a self-help treatment for anxiety and depression. Psychology Research and Behavior Management, 5, 131
Harvey, S. B., Øverland, S., Hatch, S. L., Wessely, S., Mykletun, A., & Hotopf, M. (2018). Exercise and the prevention of depression: results of the HUNT cohort study. American Journal of Psychiatry, 175(1), 28-36.
Health Talk. (2019). Womens experiences of Domestic Violence and Abuse: Impact of domestic violence and abuse on womens mental health. Retrieved from https://healthtalk.org/womens-experiences-domestic-violence-and-abuse/impact-of-domestic-violence-and-abuse-on-womens-mental-health
Kop?avar Gu?ek, N., & Seli?, P. (2018). Depression in intimate partner violence victims in Slovenia: A crippling pattern of factors identified in family practice attendees. International journal of environmental research and public health, 15(2), 210.
Overstreet, N. M., & Quinn, D. M. (2013). The intimate partner violence stigmatization model and barriers to help-seeking. Basic and Applied Social Psychology, 35(1), 109-122.
Patrick, W. (April 9, 2018). How Social Stigma Silences Domestic Violence Victims. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/why-bad-looks-good/201804/how-social-stigma-silences-domestic-violence-victims
Patterson, E. (November 4, 2019). Complementary and Alternative Treatment for Drug Addiction. American Addiction Centers. Retrieved from https://www.rehabs.com/complementary-alternative-medicine-for-addiction/
Rogers, S. (2019). Domestic Abuse, Attachment, and Cedar. Retrieved from https://www.cedarnetwork.org.uk/wp-content/uploads/2013/07/EDITED-attachment-write-up-21.pdf
Straub, R. O. (2014). Health psychology: A Biopsychosocial Approach, 4th Edition. Worth Publishers, Macmillan.
Taylor, Z. E., Larsen?Rife, D., Conger, R. D., & Widaman, K. F. (2012). Familism, interparental conflict, and parenting in Mexican?origin families: A culturalcontextual framework. Journal of Marriage and Family, 74(2), 312-327.
Thapar-Björkert, S., & Morgan, K. J. (2010). But sometimes I think they put themselves in the situation: Exploring blame and responsibility in interpersonal violence. Violence against women, 16(1), 32-59.
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Question
Juanita is a middle-aged Hispanic female. She goes to her doctor because she is having severe, frequent headaches, heart racing, chest pain, and dizziness/balance problems. Juanita has a long history of other health issues that her doctor has not been able to explain from a physical point of view. She has also had frequent accidents, falls, etc. Juanitas doctor has decided that it is time for her to have a complete physical. Her doctor asks her if there is anything else he should know. Juanita tells her doctor that all is fine. Juanitas doctor is aware that about 8 years ago, Juanita attended and completed an inpatient rehab for alcohol use. Sensing that Juanita might be resistant to opening up with him, her doctor asks her how her recovery is progressing. The doctor wonders if Juanita is eating okay and exercising since she has lost a lot of weight. Juanita finally tells her doctor that her job is on the line, her youngest child is about to leave home, and she feels depressed. Juanita admits that, as a result of her problems, about six weeks ago, she relapsed into alcohol and has been drinking regularly since then.
The doctor suspects possible anxiety-related problems or panic attacks but is puzzled by the balance problems. He examines her inner ear and finds that her eardrum has been ruptured. However, when inquiring about ear infections, Juanita reports nothing of that nature recently. He tells Juanita that the next logical explanation is head trauma and that, based on the numerous unexplained injuries, he expects physical abuse. Reluctantly, she admits that there is physical violence in her marriage. The doctor states that he knows that there is a major problem with the relapse, and she needs help; she also needs treatment for domestic violence. The doctor makes an appointment at the local Drug and Alcohol Treatment Center, which specializes in trauma-informed care. Juanita agrees to keep the appointment; however, the doctor is concerned that Juanita may not go.
Read the case study. Begin your paper with a brief overview of at least three of the concepts covered in the course. Include these concepts as you address the following:
Evaluate how specific models of health psychology apply to the client in this scenario. Explain in your own words the systemic process that contributes to your clients healthy or unhealthy habits. Evaluate the mind-body connection between your client and her health.
Please make a list of at least five of your clients needs, prioritize them, and develop a plan for meeting these needs. Include two specific actions through which you could become an agent of change to meet the culturally based aspects identified in the above section.
Using the clients needs and plan identified above, create a treatment plan for your client. A treatment plan typically includes a diagnosis of the problem based on the clients history, treatment goals, and steps the client will take in order to achieve the treatment goals. Make sure your plan is specific, measurable, and achievable and that it contains timeframes for the goals to be achieved.
Explain your rationale for the treatment recommendations in the treatment plan, ensuring that your explanation is thorough enough to demonstrate sound reason.