COU356 James, an intelligent project director educated in the UK, has been residing in the Middle East since 2020: Crisis Counsel Assignment, SUSS

Case Vignette

James, an intelligent project director educated in the UK, has been residing in the Middle East since 2020. He is a Singaporean who would visit his parents in Singapore once or twice a year. He is the only son and sole breadwinner for the family. He resides in the same house as his parents in Singapore. Due to his heavy work commitment, he has not been home since January 2022.

A week ago, he received news from his cousin that his elderly mother aged 85 had a stroke, resulting in partial paralysis. James’s cousin lives in the same apartment block as his parents. The elderly father aged 90, a heart transplant patient, is now unable to care for her.  His mother used to be the caregiver for his father.

He was shocked by the news and overcome with guilt that he was not able to go back immediately. It takes a week to travel back to Singapore. There is only one available flight for him to travel back to his country from his current work location. Furthermore, he was unable to request time off during this period due to his responsibilities overseeing a critical project. This was a mandatory stipulation set by his company for the project. He can request leave after April 2024 at the earliest.

He found it difficult to explain to her elderly parents that he would not be able to make the trip now. He was afraid to lose his job if he applied for immediate leave during the major project.

He believed he had let his parents down and felt useless all these times. Since then, he has been making daily video-calls to his parents, his cousin, and the healthcare staff to ensure that his parents are well taken care of in Singapore. He also commits to pay for all medical costs and home care services for his parents, such as daily nursing care services and meals via an online platform. He has no other immediate family member at home.  His cousin has helped to arrange for the recruitment of a helper for his parents.

James was advised by one of his good friends who is working in the same company to look for counselling therapy. James has not seen a doctor for low mood, headache, backache, lack of motivation, tiredness, appetite loss, irritability, and he isolated himself from his good friend of many years. James constantly reflected on his upbringing with his parents, and would shed silent tears as he looked at their photographs.  He finds it challenging to focus on his work, often feeling unproductive and susceptible to panic attacks. In a foreign land, he feels lonely. His good friend is deeply worried about him and tries to manage his fluctuating moods.

Question 1       

Based on the case vignette, discuss and illustrate what kind of a crisis James is experiencing, as well as his crisis reactions in the physical, affective, cognitive and behavioural domains.  (You are to identify a maximum of two crisis reactions in each cluster.)

Question 2

Formulate and discuss FIVE (5) crisis intervention goals for James.

Question 3

Use the ABC Model of intervention to assist James with his crisis. Use excerpts of your conversation with him to showcase how you develop competence in helping him.  Identify and illustrate two of James’s cognitive keys.  Display concrete examples of therapeutic interaction statements you would use in your conversations with him.   

(20 marks for effective application of ‘A’ and 15 marks for effective application of ‘B’ and 15 marks for effective application of ‘C’ using the ABC Model. These must include dialogues demonstrating appropriate use of micro-skills in each phase.)

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