Working With The Aging: The Case Of Francine 983386 ✓ Solved

Working With The Aging The Case Of Francinefrancine Is A 70 Year Old

Working With The Aging: The Case of Francine Francine is a 70-year-old, Irish Catholic female. She worked for 40 years as a librarian in an institution of higher education and retired at age 65. Francine has lived alone for the past year, after her partner, Joan, died of cancer. Joan and Francine had been together for 30 years, and while Francine personally identifies as a lesbian, she never came out to her family or to her colleagues. When speaking to all but her closest confidantes, Francine referred to Joan as her “best friend” or her “roommate.” Francine’s bereavement was therefore complicated because she did not feel she could discuss the true nature of her partnership with Joan.

She felt that there was little recognition from her family, and even some of her close associates, of the impact and meaning of Joan’s death to Francine. There is a history of alcohol abuse in Francine’s family, and Francine abused alcohol from late adolescence into her mid-30s. However, Francine has been in recovery for several decades. Francine has no known sexual abuse history and no criminal history. Francine sought counseling with me for several reasons, including an ongoing depressed mood, a lack of pleasure or enjoyment in her life, and loneliness and isolation since Joan’s death.

She also reported that she had begun to drink again and that while her drinking was not yet at the level it had been earlier in her life, she was concerned that she could return to a dependence upon alcohol. Francine came to counseling with several considerable strengths, including a capacity to form intimate relationships, a successful work history, a history of having maintained her sobriety in the past for many years, as well as insight into the factors that had contributed to her current difficulties. During our initial meetings, Francine stated that her goals were to feel less depressed, to reduce or stop drinking, and to feel less isolated. In order to ensure that no medical issues were contributing to her depression symptoms, I referred Francine to her primary care physician for an evaluation.

Francine’s physician did not find any medical cause of her symptoms, diagnosing Francine with moderate clinical depression and recommending that Francine begin a course of antidepressant medication. Francine was reluctant to take medication and first wanted to try a course of counseling. In order to help Francine meet her goal of reducing her depression symptoms, I employed a technique called behavioral activation (BA), which is drawn from principles of cognitive behavioral therapy and helps to reengage people in pleasant physical, social, and recreational activities. We began with a small initial goal of having Francine dedicate at least 5 minutes of each day to an activity she found pleasant or rewarding.

Over the following weeks, we increased the time. Francine’s treatment progress was monitored through weekly completion of the Patient Health Questionnaire (PHQ-9) in order to determine whether or not her depressive symptoms were improving. I helped Francine address her drinking by reconnecting her with effective coping strategies she had used in the past to achieve and maintain her sobriety. These included identifying triggers for the urge to drink and exploring her motivations for both continuing to drink and for stopping her use of alcohol. Francine began attending regular meetings of Alcoholics Anonymous™ (AA) and found several meetings that were specifically for older women and for lesbians.

In addition, Francine spoke regularly with a sponsor who helped her to remain abstinent during particularly stressful moments during her reengagement in sobriety. Finally, in order to address Francine’s goal of feeling less lonely and isolated, we explored potential avenues to increase her social networks. In addition to spending time with her family, friends, and her AA sponsor, Francine began to visit the local lesbian, gay, bisexual, and transgender (LGBT) center for the first time in her life and attended a support group for women who had lost their partners. Francine also began spending time at her local senior center and went there at least three times a week for exercise classes, other recreational activities, and lunch.

She also began to do volunteer work at her local library once a week. Over several months of counseling, Francine stopped drinking; significantly increased her daily involvement in pleasant and rewarding activities, including social and recreational activities; and reported feeling less lonely, despite still missing her partner a great deal. Francine’s scores on the PHQ-9 gradually decreased over time, and after 16 weeks of counseling, Francine reported that she no longer felt she needed the session to move on with her life. In addition, Francine visited her primary care physician, who found upon evaluation that her depression had lifted considerably and that an antidepressant was no longer indicated.

By the end of counseling, Francine’s focused work on identifying her depression symptoms and her triggers for drinking equipped her to better recognize when she might need support in the future and to whom she could reach out for help if she needed it.

Sample Paper For Above instruction

Comprehensive Counseling Approach for Francine's Aging Challenges

Introduction

As the population ages, mental health professionals are increasingly tasked with providing tailored interventions that address the unique cultural, social, and psychological needs of older adults. The case of Francine exemplifies the complexities associated with aging, grief, social isolation, and substance use, highlighting the necessity for a multifaceted therapeutic approach. This paper discusses evidence-based practices employed in Francine’s counseling, integrating behavioral activation, social support enhancement, and relapse prevention strategies to improve her mental health and overall well-being.

Understanding the Context of Francine’s Age-Related Challenges

Francine's age brings both physiological and psychosocial developments that influence her mental health. Age-related physiological changes can affect neurotransmitter systems, leading to depression or anxiety (Blazer, 2015). Psychosocial factors, including widowhood, social isolation, and perceived discrimination, can exacerbate feelings of loneliness and depression (Hawkley & Cacioppo, 2010). Furthermore, her history of alcohol abuse requires careful management to prevent relapse while addressing underlying emotional issues.

Evidence-Based Therapeutic Interventions

Behavioral Activation

Behavioral activation (BA) is a validated intervention for depression in older adults (Ekers et al., 2014). By encouraging Francine to engage in pleasurable activities, BA helps counteract anhedonia and social withdrawal. The gradual increase of activity duration, starting from five minutes, aligns with best practices for initiating behavioral change in seniors, considering potential physical limitations or fatigue (Lejuez et al., 2011).

Enhancing Social Support

Addressing loneliness involves facilitating social engagement, which is critical for mental health (Coyle & Dugan, 2012). Francine’s participation in LGBT centers, support groups for bereavement, and community centers exemplifies effective social integration. Regular interactions with her sponsor and involvement in volunteer work contribute to building a resilient social network, reducing the risk of depression (Hawkley & Cacioppo, 2010).

Relapse Prevention and Sobriety Maintenance

Since a history of alcohol dependence poses a relapse risk, relapse prevention techniques are essential. Identifying triggers, motivating change, and peer support through AA meetings align with evidence to sustain sobriety (Miller & Rollnick, 2013). Additionally, motivational interviewing can further enhance her commitment to abstinence (Hettema et al., 2005).

Integrating Medical and Psychological Care

Collaborating with primary care providers ensures comprehensive care, ruling out physiological causes of depression and adjusting pharmacotherapy as needed (Alexopoulos et al., 2014). Francine’s reluctance to initially pursue medication highlights the importance of respecting patient preferences, emphasizing counseling as a first step.

Conclusions and Recommendations

Addressing aging-related mental health issues requires a personalized, holistic approach. For Francine, combining behavioral activation, social empowerment, and relapse prevention has resulted in significant improvements. Future interventions should incorporate ongoing monitoring, caregiver involvement, and culturally competent practices to sustain mental health gains for older adults like Francine.

References

• Alexopoulos, G. S., et al. (2014). Pharmacotherapy for depression in older adults. American Journal of Geriatric Psychiatry, 22(10), 1143-1153.
• Blazer, D. G. (2015). Depression in late life. American Journal of Psychiatry, 172(4), 319-324.
• Coyle, C. E., & Dugan, E. (2012). Social isolation, loneliness, and health outcomes in older adults. Journal of Aging and Health, 24(8), 1346-1363.
• Ekers, D., et al. (2014). Behavioural activation for depression in adults. Cochrane Database of Systematic Reviews, (10), CD006382.
• Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40(2), 218-227.
• Hettema, J., et al. (2005). Motivational interviewing. Annual Review of Clinical Psychology, 1, 91-111.
• Lejuez, C. W., et al. (2011). Behavioral activation for depression: A clinician's guide. New York: Guilford Press.
• Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change. Guilford Publications.
• Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40(2), 218-227.
• Additional references would follow as needed from current literature.