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This case involves Melinda, a 25-year-old Latina who says she wants to have an abortion. She has been married for three years, already has two children, and says: “We had to get married because I was pregnant. We didn’t have money then. The second kid was not planned either. But now we really can’t afford another child. ” Her husband is a police officer going to law school at night. She works as a housekeeper and plans to return to school once her husband finishes his studies and it is “her turn. ” He should graduate in another year, at which time she is scheduled to enroll in classes at the community college.
Having another baby at this time would seriously hamper those arrangements in addition to imposing the previously mentioned financial burden. But the client reports: `I go to call the clinic, and I just can’t seem to talk. I hang up the minute they answer. I just can’t seem to make the appointment for the abortion, let alone have one. I was never much of a Catholic, and I always thought you should be able to get an abortion if you wanted one. What is wrong with me? And what am I going to do? I don’t exactly have a lot of time. ” Questions:
1) With the information given here, what do you see as the major value issues that need to be explored? Considering the narration of the subject, it is evident that the common issue regarding Melinda’s situation is her assumptions and fears regarding towards the future influences and effects of their third conception. These future fears are mainly directed towards two aspects namely the additional burden that the third child will impose on their financial problems and the possibility of it hindering their plans of which she expressed much interest with.
On this aspect, the discussion should primarily consider the possibilities on this scenario including both the pros and cons of the decision. Indeed, the elements that should be considered on the discussion are the influences of their discussion towards their plans and present condition of which being objectivity equally towards the positive and negative consequences. In this discussion, the moral values involved in the consequences should be explored namely the role of their parental responsibility to both their current family and their third child.
As part of being objective to the issue, the subject must critically consider and evaluate their situation and develop a decision on addressing their dilemma. In addition, the moral values and views of the subject should also be considered in the discussion, as this is relevant in justifying and reasoning out her decision. Claire, Miriam (1995). The Abortion Dilemma: Personal Views on a Public Issue. Insight Books. New York. http://www. questia. com/library/book/the-abortion-dilemma-personal-views-on-a-public-issue-by-miriam-claire.
jsp. 2) How much emphasis would you place on factors such as what is stopping her from making the call? On her ambivalence between wanting to have the abortion and not wanting it? In this discussion, putting much emphasis and concern towards the reason of the subject, ambivalent behavior towards behavior is important. On the humanitarian perspective, this characteristic of the subject is indeed positive as she is dwindling towards the ethical nature of abortion thus, resulting to her indecisiveness towards this action.
Putting emphasis on this will likely uncover subconscious reasonings and perspective towards the action of which she cannot put in verbal aspect. However, evident with her ambivalent behavior, it is obvious that these reasons and humanitarian values are hindering her action making them a significant part of her personality. Through discussing these reasons and significant factors, the author of this paper can likely aid the subject in realizing and understanding these factors and her personality likewise.
It is possible that the subject is much concern of the future consequences of their situation and their financial problems thus, she is unable to manifest her personal opinion on the matter. Through uncovering and expanding these factors, it is possible to influence the subject on withdrawing from the matter of abortion or make her fully understand her views on pursuing the said matter. In addition to this subject, it is also possible that the hormonal changes occurring innately within a woman during pregnancy are likewise affecting her decision on the matter.
In this discussion, the possibility of her already making personal connection between her unborn child should also be considered. Expounding on this matter, might make her fully aware and understand what she is going through and why she is ambivalent towards the said action. Discussing further on this matter might uncover whether post-abortive emotions are the possible reasons to her ambivalent behavior wherein the subject is already experiencing typical emotions of guilt, depression, anxiety disorder and others.
Indeed, expounding on the matter will aid in understanding the personality and ideas of the subject towards the matter both her conscious and subconscious opinions, which is significant in developing her decision towards the said action. Epigee (2008). Women’s Health. HeartStone Communications. http://www. epigee. org/pregnancy/psychological. html Elliott Institute (2007). A List of Major Psychological Sequelae of Abortion. AfterAboprtion. Org. http://www. afterabortion. info/psychol. html 3) If she asked you for your advice, what do you think you would tell her? If you gave her this advice, what might your advice tell you about yourself?
As a professional individual, this therapist’s personal views on the matter of abortion should not be included on this discussion. This principle should be followed so as not to further dissuade or confusion the patient in her process of understanding her situation and decision. As such, this therapy approach must be patient-centered in addressing the problem manifesting the therapist as a medium of assistance for the patient. In this approach, the author of this paper is inclined to follow the ethical decision guideline proposed by Gerald Corey to, `Brainstorm various possible courses of action.
Continue discussing options with other professionals. Include the client in this process of considering options for action. ` (p. 40). In this approach, the discussion will focus on some important elements namely the decision of the couple (both the patient and her husband), her ambivalent behavior towards the action, the consequences of her decision, its effect and influence on their family and marital relationship, and most importantly, the personal opinion of the subject including her inert subconscious views.
In guiding this approach, this therapist must strongly be open-minded and objective in analyzing the issue and guiding the involved patient. Corey, Gerald (2005). Basic Issues in Counseling Practice. Theory and Practice of Counseling & Psychotherapy. Ed. Lisa Gebo. Brooks Cole, Belmont CA. pp. 40. 4) How would your views on abortion influence the interventions you made with Melinda? On the professional and ethical perspective, the therapist’s opinion towards abortion should not intervene with the decision of the patient.
On this case, the views of the author of this paper should not influence the subject as the matter particularly involves her and not the former. Secondly, on the professional side, therapeutic assessment should aid the patient in understanding herself and her decision thus, the discussion on this matter should proceed in accordance to this principle. As part of the job, this therapist would mainly proceed through two approaches first through guiding the patient in understanding her situation and the possibilities of her decision and second, through her the options in her decision.
The latter will involved explaining to the subject her possible options including the statistics on abortion, the medical side of the issue, the options she could take on this action namely the abortion pills (Mifepristone and Misoprostol), other help she can also consider, and the option of adoption if she decided on continuing her pregnancy. Feminist Women’s Health Center (2008). Medical Abortion with Mifepristone and Misoprostol. www. fwhc. org/abortion/medical-ab. htm – abortion pill Abortion Clinic LLC (2007). Abortion Clinic Online. www. gynpages. com/ACOL/choice. html – abortion
AdoptHelp. Inc (2007). AdoptHelp. http://www. adopthelp. com/index. html-adoption Johnston, Robert (2008). United States abortion rates, 1960-2005 . Abortion Statistics. http://www. johnstonsarchive. net/policy/abortion/graphusabrate. html- statistic chart on abortion 5) How would you deal with this situation if you had already established a therapeutic relationship over many months with Melinda? Approaching the analysis of the situation with a previous background of a therapeutic relationship with the patient will indeed be different from the previously stated opinions and approaches.
Indeed, having this previous therapeutic relationship, the therapist can use those records of previous history in the analysis of the patient’s situation and psychological condition. Based from which, the therapist can identify and understand the problems and the ambivalent factors of the subject, which are significant to her present dilemma. Consulting also the history from the therapeutic relationship, the therapist can develop a probable effective reasoning and suggestion to her problem based on her previous reactions and opinions as her situation is somehow related to her previous condition particularly the financial burden.
However, consulting the records from previous therapeutic consultations will also have its own limitations particularly because much of the concern of the involved subject is towards the future on which she is scared to what might happened and how that will affect their plans. Indeed, the previous therapeutic relationship with the subject can only likely outline a plan and probabilities based on her previous experiences and situation namely before having her first and the second child.
Yet, it must be noted that her situation with the third is significantly different with her past experiences thus, this approach must be focused on the subject, her reaction, and the likely effect of its result unto her. Parks, Jennifer A. (1998). A Contextualized Approach to Patient Autonomy Within the Therapeutic Relationship. Springer Netherlands. http://www. springerlink. com/content/nv1486j747560432/. March 28, 2008. 6) What values would present challenges in working with this client? What values would present challenges in working with this client?
One of this particular issue, one significant factor that poses challenges in this approach is religion wherein its influences on the moral and belief of the patient will somehow adversely affect the decision of the subject towards the subject of abortion. In this perspective, it is indeed unethical thus, the adhering to this principle will limit the contemplation of the patient. In the pursuit of giving her unbiased and open-minded approach towards her analysis, it is important to sway her analysis away from this aspect and guide her into facing the reality of their situation.
This can be done through reminding the patient of her situation and the present condition and their current responsibility with their family. However, on this aspect, this approach will likewise be problematic for the therapists likewise as dissuading away from the religious aspect is indeed hard. Yet, on focusing on guiding objectively the patient on her dilemma, this approach is indeed needed. Another problematic factor on this situation is the personal objectiveness of the therapist wherein personal opinion might likewise hinder and influence the approach towards the issue.
As such, bring in opinion from other colleagues in the same field can alleviate this hindering factor. Indeed, in the approach of pursuing a balance and objective advice, other opinions must also be solicited to ensure that all intricate elements are pondered and included in the discussion. This problem will also involved the personal view of the patient in which, based from her narrative report, has already started developing maternal connection with her child. This emotional and moral attachment will likewise complicate the discussion.
Included in this challenge are the personal morals and sociological aspect related to the concept of abortion, which are related to this dilemma. In addition, another possible challenge in this discussion are the possible effects on the patient particularly on her personality and emotional state including the elements of guilt, depression, and the toll on her personal views. On the material side, the financial sustainability of their family and their responsibilities must also be considered wherein whatever decision she makes will significantly affect the reality of these concerns.
Indeed, the aftermath of the event will include long-term changes and bearing this factors on the present discussion is indeed significant. The American Journal of Psychiatry (2001). Abortion: Facts and Feelings. University of Iowa Press. http://ajp. psychiatryonline. org/cgi/content/full/158/6/985-a. March 25, 2008. Fisher, B. & Castle, MA & Garrity, JM (1998). A cognitive approach to patient-centered abortion care. Washington, DC. http://www. popline. org/docs/1393/161730. html