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This case study involves counselling a 23-year-old African American Male who was incarcerated for seven years and has recently been released from. The study took place at Bronx Connect. Mr. Jones has a long history of mental health issues such as anxiety. The goal for the five-week counseling session was to assist the client in finding the necessary skills that will help him combat his anxiety. In helping the client achieve this goal I found a meditation method that has been proven to work on alleviating his anxiety. The method that was used is called the 478 method (Weil, 2011). The counseling sessions mainly focused on how the client would manage his time more effectively and learn how to mediate to reduce anxiety. The counseling sessions where successful because the client wanted the help that was being offered. Furthermore, he learned valuable skills and how to prioritize his time more efficiently. This is a vital step in minimizing anxiety. The sessions have ended; nonetheless, the client is welcome to request more help through the agency.
Anxiety has become normal in today’s society and has had a large impact on the awareness of the illness. Anxiety and incarceration are reviewed separately here due to the tremendous difference in the two. Anxiety is a mental illness while incarceration is the state in being confined in prison (Merriam-Webster’s collegiatedictionary,1999). Though they well be reviewed separately I will with present findings on how they are relatable.
Anxiety disorder differ in types and intensity but have similar characteristic in common: they all carry unwanted thoughts, affect you physically, and mentally. There are five major types of anxiety disorders. General Anxiety Disorder- GAD, Obsessive-Compulsive Disorder, OCD, Post-Traumatic Stress Disorder, PTSD, and Social Phobia, or Social Anxiety Disorder. The struggle that comes with these disorders can greatly affect a person way of living, communication and relationships (Beck, A. T., Emery, G., & Greenberg, R. L. 2005).
Incarceration in the United States is one of the main forms of punishments and rehabilitation. Mass incarceration has been an on-going issue because of the decisions made by policy makers to increase the use and severity of prison sentences and other contributing factors such as rising crime rates here in the United States (Exploring Causes and Consequences, 2014). Today the US hold the highest incarceration rate in the world. In New York alone the population of people I the prison system is 8.6 million today. (CNN, 2018). To understand who the system impacts and the fact that bring the scope of the criminal justice system into focus. The jail system has become the front door to the criminal justice system because they hold people that haven’t been convicted yet. Also, those who can’t post bail are unavoidably trapped until their next court date. The living condition in prison should not be an additional punishment as these prisoners’ sentence is the sanction that holds the individual accountable for the crime committed and protects society. The living condition in prison plays solely on the dignity and self-esteem of a prisoner. If the goal is to rehabilitate and individual, humane detention conditions will allow prisoner to be more willing and able to respond to rehabilitative programs. Those who experience punitive conditions and mistreatment are likely to return to society psychologically shattered and in poor or worse state of physical and mental health than when they entered. (Mason, Jim 1990)).
If it isn’t hard living in society today can you imagine being in prison for a long time, then reentering society? When in prison you live by protocols. You are told when to wake up, when to eat, when to shower, and when to have down time. All these factors play a major role in a person’s life that has spent a long time in prison and is being released into society. When an inmate is released that has spent a long time in prison can experience “Culture Shock” Culture shock is the disorienting feeling a person can get when they suddenly must adapt to an unfamiliar culture or way of life (Adler, P. S. 1975). Anxiety after incarceration is common. Readjusting to daily life, trying to find a job, and financial stability can be frustrating (Arditti, Parkman 2011). Communication these issues can be difficult as well. Trust is something that must be formed when dealing with a person that has reentered society.
Incarceration and Anxiety Disorders, how are they relatable? As mention above, the living conditions of a prison and the health and safety of a prisoner plays a major part in their release. Many prisoners face assaults daily or are treated poorly. This ultimately affect the mental health of a person. What I will implement into this study are strategies that will help reduce the overall frequency intensity, and duration of anxiety so daily function is not impaired. Anxiety is caused by work; working long hours, being unhappy at your job, having a heavy workload, unclear expectations and poor management, a company that isn’t supportive, and working under dangerous work conditions. Life also is a factor that causes anxiety as well. Whether it is death of a love one, loss of a job, divorce, apartment loss, incarceration and emotional problems just to name a few. To manage anxiety and redirect it there are many things you can do to relive it through stress relieving techniques.
What I will implement in this case study is different ways a person can deal with symptoms of anxiety such as, Meditation by breathing. The 4 7 8 breathing technique is a technique that is easy to use anywhere. It consists of 1) Exhale completely through your mouth, making a whoosh sound. 2) Close your mouth and inhale quietly through your nose to a mental count of four. 3) Holding your breath for a count of seven. 4) Exhaling completely through your mouth, making a whoosh sound to a count of eight. This is all done in one breath. Using this technique will enable the individual the tools to cope with stress that is caused form work and life events (Weil, 2011). These meditation techniques have been proven to work.
Another form of an anxiety reduce strategy is time management. What is time management?
Time management means to optimally use the time available (Bl, Huston 2012) and that includes aspects of planning, goal setting, prioritizing goals and activities, communications and delegation. When dealing with everyday life it is important to manage time appropriately. In relations to time management there are some time management strategies that can help reduce anxiety. 1. Morning strategy- what is asked is that you take 15-20 minutes each morning, either when you wake up or get into work, to plan your day. 2. Deep work- what is suggested is that you set time where you focus solely on one task. Shut the door, take the phone of the hook and put the headphones in. Aim for a period of 45-50 minutes followed by a break of 10 minutes. 3. Recognize the difference between “Urgent” and “Important”- A sense of urgency is what raises our stress and anxiety. By removing ourselves from this urgent need to respond to impetuses as soon as possible, we want to play smart and raise our satisfaction and fulfilment by working on what’s important (Heap, 1979).
Bronx Connect is a community and faith-based program that offers alternative-justice, cure violence, and re-entry programs to help communities build from within. They believe that every young person has gifts, talents and interests that need to be nourished and supported. When young people experience growth, competency and purpose in exercising their gifts and pursuing their interests, they will be far less likely to continue with risky behaviors that could lead to re-arrest or gun violence. The organization draws on its deep roots to develop community as the only Bronx-based alternative justice program with close to two decades of experience. They build on the strengths of the community, identifying those who are its pillars and working with them to change the atmosphere. Bronx Connect organizes community events around issues that affect our youth and overall wellbeing. Their goal is to awaken the voice of the urban community to speak out against injustice. The near 2,000 Bronx Connect youth we have served, and their families’ voices, are being organized to be heard.
Mr. Jones sought out help at Bronx Connect due to past imprisonment. He currently battles with depression and anxiety and is seeking a therapist that he deems fit for him based on knowledge of his depression, anxiety, active listening, and close therapeutic relationship. He will choose a clinic that fits best through Bronx Connects referral. Mr. Jones is a 23-year-old male who’s is average height and weights 140 lb. Mr. Jones is a well-groomed individual. Presently Mr. Jones is a single man with no children. When Mr. Jones was fourteen, he committed a violent crime, which lead to his imprisonment. Mr. Jones spent seven years in jail his only know relationship was while he was in prison. After his release, Mr. Jones attempted to finish his high school equivalency at Monroe College but faced distractions due to drugs and alcohol. His current relationship with his family is not great but he’s looking to repair his relationship with them. When Mr. Jones was young his mother was addicted to cocaine and most of his family members where alcoholics. Because of his mother’s addiction, Mr. Jones was abused often. Mr. Jones currently suffers from seizures due to a car accident that happened when he was thirteen leaving him with a metal rod in his right leg. Mr. Jones suffers from asthma which requires him to take his inhaler as prescribed. Mr. Jones believe he’s bipolar but has not been properly diagnosed. Mr. Jones is a hardworking person who wants to complete his high school equivalency degree and go to college but continues to battle with distractions that’s stopping him from doing so.
Mr. Jones primary need and what I will help him work on is how to combat anxiety. Anxiety is a normal reaction to stress. Anxiety disorders can cause people to avoid situations that may trigger or worsen their symptoms. This actively affects job performance, school work and relationships. Mr. Jones’ fist notice his anxiety when he was released from prison. Mr. Jones spent seven years in prison where he became accustom to prison life. However, spending a lengthy time in prison. He gained a positive perspective from his experience. He feels he’s more punctual.
The goal I’m aiming to reach with John is reducing his anxiety after five counseling sessions. John will learn what make him anxious and how to manage his time. John will learn how to meditate using Dr. Wails breathing technique. John will keep a journal and write down and describe situation, thoughts feelings and actions associated with anxieties and worries, their impact on functioning, and attempt to resolve them. John seems frazzled and doesn’t manage his timewell. John will learn time management to reduce anxiety (Willms,2016). John will learn how to implement calming skills to reduce overall anxiety and manage anxiety symptoms using the 478-breathing technique (Weil, 1994).
I will evaluate Mr. Jones by counting and record the amount of time he shows up late for his counseling sessions. I will do this by creating a log that will require sign in with date and time when he’s scheduled to come in. Researchers found that poor time management can increase anxiety. When dealing with your everyday life it’s important that your time is managed accordingly, or your life will be in disarray. People that tend to have heightened anxiety normally don’t function as well. The inability to function is based on the amount of stress/ anxiety the client is facing.
Mr. Jones and I discussed his goal for our sessions. He specified that he’s willing to learn the necessary strategies in order to combat anxiety. Those strategies will include meditation time management and journaling. John has suffered from anxiety after his release from prison. He never took the necessary steps to try and get help until he enrolled into Bronx Connect. Our work began by giving him a journal. In the journal he was to write what he did on a day to day basis. It was up to him if he wanted me to read it. During our counseling session he briefly discussed what made him anxious and one of his triggers was time management. Therefore, I suggested after he wrote in what he did on a day to day basis that he prioritizes his schedule. From there, I had him sit at a computer to generate a schedule. This schedule will alleviate some of the anxiety he’s experiencing. We also discussed a breathing technique to help reduce anxiety. Prior to ending our session, I briefly discussed what we would be focusing on during our next session and gave him homework. I asked that he look up a meditation method called on the 478-breathing technique (Weil, 2011). Towards the end of our session Mr. Jones seemed more relaxed and interested in my ideas.
His negative attitude towards following a schedule, journaling, and meditating was apparent in the first session. Despite his temperament towards keeping a schedule, Mr. Jones showed the willingness to receive help. Mr. Jones was willing to accept homework I gave him. He also looked interested in looking up the method that will help reduce his anxiety.
In the second counseling session with Mr. Jones, I reiterated what we discussed as far as the goal in helping him managing his anxiety and the different method that will help him combat it. We met in and empty room in the building. I sat at the desk with him adjacent to me. This session was different from the last because Mr. Jones seemed calmer from our last session.
- Student Intern: Have you started following the schedule you put together and has it been working?
- Mr. Jones: Yes! Oh my god I’m able to get so much done.
- Student Intern: Did you look the mediation exercise by Dr. Wiel?
- Mr. Jones: The breathing technique? Yes. I have trouble understanding and want to know if you can explain more?
- Student intern: Sure, how about we look it up together
- Mr. Jones: ok.
Mr. Jones seemed more eager and interested to learn about mediating. He expressed that though he’s leaning how to manage his time better he still has periods where he becomes anxious. I explained that it will take time and he has to get used to doing things different form when he was in prison. This can also be a reason why he’s anxious. He doesn’t have anyone to dictate what he does. I expressed for the following session we will practice the exercises.
For the third session he seemed a bit uncomfortable. He seemed bothered and didn’t want to sit and talk with me. Prior to us meeting he sent me an email asking if he could meet me on a later day and replied sure I will reschedule. When Mr. Jones sat to speak with me, I was surprised.
- Student Intern: We can sit here and just relax if you want
- Mr. Jones: I know I said I wanted to reschedule but I really need to talk to someone.
- Student Intern: Ok. I’m here. When you’re comfortable to talk we can start.
- Mr. Jones: I don’t Really have nothing to talk about I just want to sit here
- Student Inter: Ok
For the remaining time spent with Mr. Jones We sat. Mr. Jones was bothered and upset. I can see he has been working on meditating because he would close his eyes and breathe while we were seated. After his departure he assured me that we could pick up where we left off the following session
For the fourth session Mr. Jones suggested that we met outside. I was okay with it. He explained to me that he really didn’t have enough time to just sit outside. Prior to us meeting Mr. Jones sent me an email apologizing about our last session. He mentioned that he’s been looking for work but he’s still having issues with his anxiety. This would be the perfect time to go over the meditation method by Dr. Weil.
- Student Intern: Good day Mr. Jones, I would like to show you the meditation method to help with your anxiety.
- Mr. Jones: Sure. But, outside?
- Student Intern: This is something that you can do anywhere
- Mr. Jones: Ok. I’m ready when you are!
- Student Intern: This method requires you to breath in for a count of 4 and exhale for a count of 7, 8 times
- Mr. Jones: Ok can you show me?
- Student Inter: Okay.
After showing Mr. Jones the meditation method, he seemed calmer and more excited. He reported that he can feel himself becoming calm. He requested that we do the meditation method for our next session that that he may become more familiar with the technique. I assured him that with practice he will get used to it and will be able to do this alone.
For our fifth session Mr. Jones seemed so eager to talk to me. He seemed calm and full of life. This is the most positive I’ve seen him since I met him. For this session, we met in the conference room at Bronx Connect Mr. Jones sit in and we began. Before our session began, I wanted to set the tone to a more relaxing setting. I played some mediation music to flow with our session
- Student Inter: Good afternoon Mr. Jones
- Mr. Jones: hello! It looks so relaxing in here.
- Student Inter: how’s your scheduling coming along?
- Mr. Jones: it’s coming along well. I find that I’m able to actually get things done without stressing myself out
- Student Intern: That’s great! Do you want to start off where we left off?
- Mr. Jones: Ok. But, can I lead?
- Student Intern: Ok.
The Session with Mr. Jones went smooth. He took lead for this session showing that he’s become familiar with what triggers his anxiety. He showed that he’s been managing his time and overall, he seems calmer.
In the human service field, it is important that you possess the qualities of attaining self-knowledge, a positive attitude, and proper skills set in order to work in this field. These qualities are vital to your clients. There will be people you deal with and situation that will test your judgment, strength and weakness. As a result, if I’m not in the state of mind to help myself, problem solve, or knowledgeable how to help my client it will greatly affect Mr. Jones.
My values class taught me that it’s imperative to be attentive of my own values prior to counseling a client. Knowing what my vales are it was important that I didn’t force that on the client. There were so many similarities I seen in the client that reminded me of my brother, so I had to make sure I didn’t display emotions in our sessions. In the beginning he had a very obnoxious and loud personality that reminded me of my brother. His attitude towards learning how to cope with his anxiety was not always positive. If anything, he had a lot of doubt, but as the sessions wen on he gained positive outlook on what I was trying to help him achieve.
In my system class I learned that certain systems could help a person in acting a form a support. Being able to use what I knew and what the organization offered helped him with knowing his triggers and helped him with managing his time more effectively. As a counselor I was able to help him address the underlying issues that was causing him to have anxiety. As a result, he was able to use the internal system in achieving his goal.
Throughout the course of the case study I was able to learn that people go through things in life that are relatable. As people we tend to judge people without knowing what that person is going through. My perception of Mr. Jones was that he was a man that was gong though a lot. Men that are exonerated form prison face many hardships once they are released into the community. Not only are they being stigmatized as an ex-offender they are also implicated as a major barrier to a successful community reintegration. Criminals are one of the most stigmatized groups in society, yet the large body of research on stigma rarely considers offenders. Mr. Jones and I worked extensively to help him combat his anxiety.
- (2018). Incarceration. Retrieved from https://www.encyclopedia.com/social-sciences-and-law/law/law/incarceration
- Beck, A. T., Emery, G., & Greenberg, R. L. (2005). Anxiety disorders and phobias: A cognitive perspective. New York, NY, US: Basic Books.
- Kann, D. (2018, July 10). The US still incarcerates more people than any other country. Retrieved from https://www.cnn.com/2018/06/28/us/mass-incarceration-five-key-facts/index.html
- Mason, J. (1990, Dec 07). INMATE GLAD TO ESCAPE PRISON’S LIVING CONDITIONS. Richmond Times – Dispatch Retrieved from http://ezproxy.mcny.edu/login?url=https://search-proquest-com.ezproxy.mcny.edu/docview/423423411?accountid=38814
- Adler, P. S. (1975). The transitional experience: An alternative view of culture shock. Journal of Humanistic Psychology, 15(4), 13-23.
- Human Services Administration, University of Baltimore, 1420 N. Charles St., Baltimore, MD 21201.
- Conrad, A., Müller, A., Doberenz, S., Kim, S., Meuret, A. E., Wollburg, E., & Roth, W. T. (2007). Psychophysiological effects of breathing instructions for stress management. Applied Psychophysiology and Biofeedback, 32(2), 89-98. doi: http://dx.doi.org.ezproxy.mcny.edu/10.1007/s10484-007-9034-x
- Marquis BL, Huston CJ. Leadership Roles and Management Functions in Nursing. 7th ed. Philadelphia: Lippincott; 2012
- Heap, N. (1979). Time Management–an effective tool for management development. Journal of European Industrial Training, 3(3), 27–28. Retrieved from http://ezproxy.mcny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=eue&AN=5230564&site=ehost-live
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