Isolda is 23 She and her family came to Australia from Bosnia as refugees 15 years ago. In Bosnia, her father was a lawyer and her mother was an engineer. They now run a cleaning business. During the civil war in Bosnia, her older brother was shot and killed, along with several of her cousins and many of their neighbours. Her sister disappeared and the family has never been able to find out what happened to her. Isolda's mother became severely depressed shortly after their arrival in Australia and attempted suicide. She recovered, but these events affected Isolda deeply. Her parents have always had very high expectations of her as their only surviving child.

Isolda completed school and is now studying medicine. At the end of her second year she began to experience panic attacks and bouts of depression. She stopped eating and often spent all day in bed, neglecting to bathe or get dressed and missed most of her classes. She was admitted as a voluntary patient to a psychiatric hospital where she was prescribed medication and encouraged to participate in group therapy sessions. She found this experience profoundly disturbing and begged her parents to allow her to discharge herself. She has recently moved into a community-based accommodation service for people with mental health needs.

Janita is a support worker in the accommodation service. She is an experienced worker and previously worked as a mental health nurse in a large psychiatric hospital. Her training was focused on medical models of care.

She has been delegated to work with Isolda to establish a supportive relationship and help her to settle in and develop a recovery plan. As part of this process she must collect information from Isolda about her experiences, family, values, attitudes and beliefs.

Janita's parents migrated to Australia from Serbia after the second world war and Janita was born in Australia. They came from a village not far from where Isolda's family lived, in a region where there was a long history of hostility between Serbians and Bosnians.

 

1) Identify three legal and ethical considerations that are relevant to the boundaries and responsibilities of Janita's work role.   

 

2) Identify two factors in Janita's personal and professional experience that might have influenced her values and attitudes regarding recovery, mental health and illness. 

 

3) Identify four of Isolda's significant relationships, life events, understandings experiences or cultural factors that must be taken into account when developing a recovery plan.  w o r d s

 

4) Outline three things Janita can do to establish and maintain a safe positive working relationship and environment with Isolda. 

 

5) Suggest two factors in Isolda's history and situation that Janita could focus on to identify her areas of strength. 

 

6) Identify two factors that may affect the power dynamic of the relationship between Isolda and Janita. 

 

7) Identify three attending skills that could be used to indicate interest and empathy. 

 

8) dentify three common differences across cultures in the use of body language that Jacinta may need to adjust to.

 

9) Suggest a motivational interviewing technique Janita could use with Isolda. 

 

10) Why would it be important for Janita to foster hope and belief in recovery in Isolda? 

 

11) Identify a significant impact that a diagnosis of mental illness may have on Isolda's life. 

 

11) Suggest three pieces of information that Janita should share with Isolda about the nature of the new service. 

 

12) Suggest three pieces of information that Janita should share with Isolda about the nature of the new service. 

 

13) List two benefits of discussing, clarifying and using Isolda's preferred language, understandings, analogies and concepts about her experience in all communication. 

 

14) Sum up the approach that should be taken to support Isolda's recovery by all people who have a role in it, including other members of her health care team. 

 

15) When inviting Isolda to tell her story, what principle of narrative therapy should guide Janita? Identify at least one. 

 

16) What will Isolda need before she is ready to self-advocate? 

1) Identify three legal and ethical considerations that are relevant to the boundaries and responsibilities of Janita's work role.
a.) In order to obtain necessary information, Janita must establish rapport with Isolda. It was noted that Isolda is from Bosnia, and Janita's family is from Serbia (in history, there is hostility between Bosnia and Serbia). Despite of that, Janita must maintain professionalism and treat Isolda as a patient regardless of her race. 

b.) Janita must strictly observe confidentiality. Whatever information she has obtained, she must keep it and use it only for treatment purpose.

c.) Janita and Isolda have similarities. Their family came from other places and they just migrated to Australia. Janita might find herself being comfortable as she relate her experience to Isolda. Janita must not engage in multiple relationship (being a friend to Isolda) as it might affect the effectiveness of the treatment.

2) Identify two factors in Janita's personal and professional experience that might have influenced her values and attitudes regarding recovery, mental health and illness. 

a.) Janita more likely experienced difficulties in living in Australia as her family are originally from Serbia. This may be a motivation for her to work for mental health service.

b.) Janita's parents are from Serbia and witnessed the violence of world war. This might have an impact to their mental health and affects how Janita was raised. Janita's values, beliefs and attitude was greatly influenced by ber family.

3) Identify four of Isolda's significant relationships, life events, understandings experiences or cultural factors that must be taken into account when developing a recovery plan.

- First, Isolda's family came from Bosnia. They are refugees who chose to migrate in Australia. She might experienced difficulties especially to adjustments due to cultural differences.

-Second, Isolda experienced the violence of war that has a huge impact on her mental health.

-Third, she lost her siblings. Her brother got killed and her sister disappeared. It must be taken into consideration her grief and she might still not moved on to this.

-Fourth, the pressure from her parents. She is now the only child and the only hope of her parents.

All of these factors must be a basis and taken into consideration when creating a treatment plan for Isolda.

4) Outline three things Janita can do to establish and maintain a safe positive working relationship and environment with Isolda. 

-First, establish rapport while maintaining professional relationship. She can do it by extending a warm greetings do everything that will make Isolda comfortable.

Second, give empathy to Isolda. If Isolda will feel the empathy, then she can open up easily about her thoughts and feelings.

Third, be a good listener to Isolda. Good listening and sincerity in creating safe space for patient will establish a good working relationship.
 

5) Suggest two factors in Isolda's history and situation that Janita could focus on to identify her areas of strength

First factor that Janita can focus is Isolda's strength in adjusting and living in a foreign country, away from her mother land. Second, is Isolda's strength to continue her life and to live for her parents despite of all the difficulties she encountered.

6) Identify two factors that may affect the power dynamic of the relationship between Isolda and Janita. 

-First factor is, Isolda came from Bosnia while Isolda's family came from Serbia. This might have an impact on their therapeutic relationship because in history, there's hostility between the Bosnian and Serbian race. On the other hand, which is also a factor, Janita might relate her experience to Isolda as they are both migrants from other country. Due to their background, they are prone to transference.

7) Identify three attending skills that could be used to indicate interest and empathy.

-First is to to be a good listened and let Isolda say whatever she feels at the moment. Second, is be patient. It will take a while before Isolda will become comfortable in opening up. Third, is through non verbal actions. Like nodding, Good eye contact, and making sure that Isolda is comfortable in the environment.

8) Identify three common differences across cultures in the use of body language that Janita may need to adjust to. 
-Isolda came from Bosnia. Bosnian people maintain their personal space. They usually keep their distance but it doesn't mean that they don't want to establish rapport with you. 

-When talking to a bosnian, you must be careful in using fingers to point as it might offend them.

-Janita must be careful in beckoning as it might be offensive for a bosnian like Isolda.

9) Suggest a motivational interviewing technique Janita could use with Isolda.

-The motivational interviewing technique that could be used with Isolda is, supporting to boost her self-efficacy and optimism in order to be motivated in living and facing the problems. Janita must also extend her patience in Isoldas's resistance tendency and display empathy and listening.

10) Why would it be important for Janita to foster hope and belief in recovery in Isolda? 

-It is important to foster hope and belief in order for Isolda to continue living. To see her parents as motivation, and continue her life in studying medicine. To make her realize that the dark chapter of her life is done and she can have a fresh start. She must learn how to handle pressure and solve future problems.

11) Identify a significant impact that a diagnosis of mental illness may have on Isolda's life. 

-Diagnosis of mental illness may have a significant impact on Isolda's life in a way that it will bring awareness. Because treatment starts with awareness and understanding. She must be aware with her symptoms and what she is experiencing right now. Her family must understand her situation and serve as support system.

12.) Suggest three pieces of information that Janita should share with Isolda about the nature of the new service. 

-First, Janita must make sure that Isolda understands the nature of new service. She must orient her with the process. Second, Janita must observe informed consent. So Isolda will have an overview of what she will experience in the new service and treatment approach.  Third, is the outcome of the new service will rely to Isolda's willingness to participate.

13) List two benefits of discussing, clarifying and using Isolda's preferred language, understandings, analogies and concepts about her experience in all communication

-The benefits are: First, to easily establish rapport with Isolda. She will feel that the Janita's intention is to make her feel comfortable especially in opening up about her experience. Second, is to avoid misunderstanding. Differences in culture can cause unintentional offense.

14) Sum up the approach that should be taken to support Isolda's recovery by all people who have a role in it, including other members of her health care team. 

Psychotherapy can be used as a treatment approach to Isolda. This is a talking therapy wherein the patient can freely say whatever she wants to say and the therapist is there to listen with empathy. While analyzing the messages and possible root of maladaptive behavior. Support system and psychoeducation are alo important. Her parents must understand her situation.

15) When inviting Isolda to tell her story, what principle of narrative therapy should guide Janita? Identify at least one. 
-Narrative therapy is helping Isolda to separate herself from her problems. It will make her focus on herstrengths and rely on her skills and capabilities to improve self-efficacy. This will boost Isolda's motivation to continue her life.

16) What will Isolda need before she is ready to self-advocate? 
-Isolda needs high self-efficacy and motivation. This is her belief that whatever she experienced is already part of the past. She can now handle pressure and problems gracefully. She can also share her experience and serve as inspiration to other people.

Step-by-step explanation

Hello! There are some discrepancies on questions and the case presented. Like on the case reference, the name was Janita. But on question, the name was Jacinta. Anyway I used the name Janita and based my answers on the case given. Please note of the race and cultural differences of Janita and Isolda. There was a war between Bosnia (Isolda's origin) and Serbia (Janita's) which can cause a potential conflict on their dynamic relationship.