HP Indi Asg
.docx
School
Tunku Abdul Rahman University College, Kuala Lumpur**We aren't endorsed by this school
Course
PSYCHOLOGY BHPY
Subject
Psychology
Date
Dec 16, 2024
Pages
5
Uploaded by CoachPencilSquid35
1IntroductionNicole was sent to receive psychological intervention. Initially, Nicole remained silentbut was willing to open up after several sessions. Nicole married at 18 with hopes of love andcare from her husband due to her parent’s divorce when she was young. However, Nicole’shusband’s attitude changed drastically after three years of marriage. For example, Nicole’shusband would isolate her from her family and friends. If Nicole showed dissatisfaction, herhusband would blame her and even call her a crazy person. Nicole’s husband would also criticiseNicole as oversensitive and make her look like she had mental health problems. Even worse, herhusband would spread false rumours about her mental health. Besides, whenever Nicole’shusband is drunk, he would physically abuse Nicole and become more violent if Nicole showssadness. To overcome the negative emotions, Nicole turned to smoking. She later met a man whohelped her to feel relaxed and happy by injecting a substance into her body. Unfortunately, thiscaused Nicole to contract the human immunodeficiency virus (HIV). Due to fear of abandonmentand stigma, Nicole refused to inform her husband about this diagnosis. In this case, one factorthat led Nicole to seek help from the psychologist is that she cares for her physical safety andmental well-being. Furthermore, one factor that caused Nicole’s substance abuse is her desire torelieve negative emotions within her problematic marriage.Explanation of Factor 1Nicole’s positive health behaviour in this case is seeking help from the healthpsychologist. This behaviour can be observed when Nicole initially was reluctant to disclose anyinformation but willing to discuss her experience and concerns with the health psychologist afterseveral sessions. Nicole is willing to seek help mainly because she values her physical safety andmental health. This can be explained by the Health Belief Model, which maintains individuals’
2health behaviours such as seeking treatment are influenced by their perceived susceptibility,perceived severity, perceived benefits, and perceived barriers (Shahnazi et al., 2020). Perceivedseverity involves how individuals associate negative outcomes with an event, whether it isforeseeing future consequences or dealing with current health problems (Al‐Metwali et al.,2021). In this case, Nicole’s circumstances are highly severe as her husband would alwaysphysically abuse her and sometimes even become more violent. These violent acts have causedNicole to experience physical harm and might threaten Nicole’s life if her husband suddenlyloses rationality due to his drunken state. At the same time, Nicole’s husband would alsoemotionally abuse Nicole by calling her a crazy person, telling everyone that she is mentally ill,and isolating her from her family and friends. If Nicole keeps enduring her husband’sproblematic behaviours, her self-esteem and social competence could be undermined slowly butsurely and may lead to depression in the long term. Most importantly, Nicole’s HIV diagnosishas intensified the severity of her situation as it has escalated to a life-and-death matter.However, due to fear of being abandoned and stigmatised, Nicole had no one to confide in andthis may trigger a sense of hopelessness and powerlessness in her. According to Jose et al.(2021),individuals are more inclined to engage in health-promoting actions when they have highperceived severity of their circumstances. Since Nicole’s physical safety and mental health are ata highly serious status, this has motivated her to actively seek help from the psychologist.Motivational Interviewing will be effective in increasing Nicole’s help-seekingbehaviour. Motivational Interviewing (MI) is a person-centred counselling style that helpsindividuals express their desire for change (Bischof et al., 2021). The reason for choosing thisintervention is that Nicole has shown reluctance to express herself during the first session andthis may indicate that she lacks the motivation to confront and change her circumstances. MI will
3be effective because it can boost personal motivation and commitment to change behaviour byprompting individuals to articulate their reasons for wanting change, helping them to explainthese reasons in their own words, and transitioning from these reasons to creating a plan forchange (Tolchin et al., 2020). When applying MI, the psychologist can use affirmations, whichis one of the elements of MI. For example, the psychologist can affirm Nicole’s behaviour bysaying, “I am happy to see you taking the first step. I understand that it must have taken a lot ofcourage to reach out to me. I am always here to support you.”. Through affirmation, Nicole mayfeel reassured that she has made the right choice in opening up herself, and this can encourageher to continue this behaviour in future sessions.Explanation of Factor 2On the other hand, one negative health behaviour Nicole has demonstrated is substanceabuse such as smoking and taking drugs. The reason why Nicole engaged in substance abuse isthat she wants to relieve stress within her marriage. Nicole’s stress mainly originated from herhusband’s domestic violence. To avoid further harm from her husband, she had to suppress herreal emotions all the time and lacked the freedom to express herself. Gradually, these stresseshave eroded Nicole’s autonomy. However, Self-Determination Theory (SDT) maintains thathuman beings have the desire to demonstrate autonomy by making their own decisions, strivingtoward personal goals, and generating their original ideas (Guay, 2021). Since smoking andtaking drugs provided Nicole with temporary relief from suppression and allowed her toexperience moments of happiness, she turned to substance abuse as a way to reclaim some senseof autonomy in her life. Through abusing substances, Nicole can gain a sense of control over heremotions which have long been controlled by her husband. In addition, SDT suggests that peoplehave a fundamental need for belongingness, seeking meaningful connections with others rather
4than experiencing isolation or rejection (Szulawski et al., 2021). However, Nicole’s husband’sexcessively controlling behaviours have isolated her from social connections such as her familyand friends. Additionally, adolescents from divorced families tend to have a lower level ofbelonging (Rejaän et al., 2024). The experience of witnessing her parents’ failed marriage hasmade Nicole crave more care and belongingness. This desire for care and belongingness greweven stronger especially when she faced physical and emotional abuse from her husband.Therefore, when a man treated Nicole kindly and was willing to offer substances that could makeher feel happy, she became susceptible and readily accepted his invitation since it met her desireto feel accepted and connected.According to Keilholtz & Spencer (2022), joint couple treatment can create change in thecouple’s dynamic by fostering perpetrators’ responsibility and reducing victims’ vulnerability,thereby facilitating the emergence of new relationship dynamics. Hence, couple therapy will beeffective in reducing Nicole’s substance abuse as it provides a safe space for Nicole and herhusband to address the stresses within their marriage. Before the therapy starts, the psychologistcan encourage the couple to sign a “no-violence” contract, which commits them to refrain fromviolence in their relationship while they are undergoing therapy (Keilholtz & Spencer, 2022).This contract can prevent Nicole’s husband from continually abusing Nicole and ensure Nicole’ssafety outside the therapeutic setting. During therapy sessions, the psychologist can facilitateopen communication on Nicole’s husband’s problematic behaviours so that he can recognise theimpact of his behaviours and subsequently adopt healthier ways to interact with his wife. Oncethe relationship between Nicole and her husband improves, the psychologist can encourageNicole to discuss her HIV diagnosis with her husband when she is ready. However, solelyrelying on couple therapy may not be effective enough. Therefore, the psychologist should also
5connect Nicole with a rehabilitation centre to overcome her substance addiction and mostimportantly, to help her to gain social support from her peers and addiction recovery groups.This is because abused women who obtain tangible and emotional support are less susceptible tothe psychological harm caused by their partner’s violence (Mahapatro & Singh, 2019).ConclusionIn conclusion, Motivational Interviewing can enhance Nicole’s willingness to engage intherapy by acknowledging her courage and fostering her motivation for change. Conductingcouple therapy can also reduce Nicole’s substance abuse effectively since her poor relationshipwith her husband is the underlying cause of her negative behaviours.