Running head: CASE STUDY 1

Case Study – The case of Jose

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Case Study – The Case of Jose

Mental health is increasingly becoming an issue of concern in the world today. Therapists

and clinicians are expected to be alert because these cases ought to be taken with a lot of

seriousness. This paper presents the case of Jose, who is in his middle thirties and he is unmarried

truck driver cum mechanical engineering student who lives with his parents. The paper presents a

critical assessment of Jose’s case, the diversity of issues significant to the case, mode of therapy

for Jose, law, and ethics regarding the case, and the treatment plan. It also offers

recommendations on what could be done to make things work better.

Case Assessment

Most American families, which have Mexican roots, tend to live near each other so as to

preserve their identity. Due to this cultural practice, Jose who is from an extended family finds

himself living in a crowded four-bedroom house with his parents and other relatives. He is

unmarried despite his age and seems to be harboring feelings of guilt for having forced his former

Caucasian girlfriend to commit an abortion. Jose also has quite a busy schedule since he is a

working student. His mother is sick and has to be cared for, yet his father does not care. The

burden seems to be on Jose’s shoulders and all this may be taking a toll on him. Since this family

is made of people who trace their roots from Mexico, it becomes rather hard for Jose’s family to

immediately assimilate into the mainstream American societies for the fear of losing their

identity.

Although America has made important steps towards ensuring there is racial equality,

there is a lot that needs to be done. Evidence of race-related challenges can be seen in Jose

denouncing his Caucasian girlfriend whom he met when he was about 30 years old. He forced her
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to abort most probably because she was a white woman. Moreover, due to José Mexican origins,

which place a lot of responsibilities on males in taking care of their families, Jose feels as if he is

not in control of his life because he has to care of his family members, yet has none of his own

and is getting the pressure to marry. The parents of Jose fear for the future of their son since he is

in his thirties, and yet he has not started his own family, thus has no children who will take care

of him once he becomes old. While Jose’s parents, and Jose himself, may have contributed to his

state of mental disturbance, none can be blamed fully. What Jose requires is therapy and it is

good that he has already decided to take the initiative. After all, he has the right to make

decisions that affect his own life directly.

Another issue that can be noted in the case of Jose is lack of affordable house in the US

especially to the low-income earners like Jose and his relatives. Jose, his sister, and his brother-

in-law cannot afford to rent their own apartments due to lack of enough money.

Diversity Issues Affecting Mental Stability of Jose

One of the issues affecting Jose’s mental stability is the notion of race and origin. Identity

plays a huge rule in America, especially in matters touching on civil rights, laws for jobs

appointment, education opportunities, and housing affordability (Hiraldo, 2010). Due to mistrust

among various races in the US, it is clear that one of the main reasons for Jose breaking up with

his white girlfriend was for him to remain loyal to his Latin race. He feels uncomfortable with her

since he probably wishes to preserve his identity.

The second factor is about Mexican American cultural practices at the family level.

Family togetherness is an important aspect of a Mexican American family (Burt, Obradović and

Leu, 2018). This explains why Jose’s parents are more concerned about his bachelor status at his
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age as well as his missing from family parties during the weekends. When Jose informs his

mother about his actions of forcing his ex-girlfriend to do an abortion, she reveals the secret to

the other family members. This action can be interpreted both positively and negatively. On a

positive note, it can be viewed as a method of promoting family togetherness even during hard

times, while on the negative side; it can be seen as a sign of betrayal of the trust Jose had in her.

This might be one of the causes of his stress and depression. Even after letting out the secret of

her son, Jose’s mother teamed up with the other family members to put more pressure on him to

marry since he is getting old. Such actions have caused a lot of tension in the family, which might

explain why Jose no longer participates in family gatherings, such as family parties and church

services.

The other factor is the pressure to have children. Jose is being pressurized to have

children because of the current discrimination of older people in society. These children are

viewed as important because they might come to help him in the future as per the Mexican

American cultural beliefs where children are expected to take care of their aging parents. This is

because these aging parents will no longer be working due to the rising workplace ageism cases

that have led to many corporations preferring to employ young workers to older ones. Although

many corporations in America like to announce that they need experienced and committed

employees, many studies have found out that they have a tendency to see old labor as less cost-

effective, not flexible and not good for the business image (Macdonald & Levy, 2016). This age

discrimination is likely to cause psychological stress on the victims. From this point of argument,

Jose’s parents might have reasons to fear for the future of their son since he is single and does not

have a good job at that age.

The gender debate is not a major issue among the Mexican America families since the

gender roles, responsibilities and expectations are clearly spelled out in their culture. Cultural

alignment hypothesis argues that culture offers social guidelines on how human being belonging

to a particular culture will behave and how they will view the world (Triandis, 2003). From this

ideology, the Latin man is viewed as the head of the family. Going by his Latin cultural beliefs,

Jose has a reason to be angry with his father for failing to be a symbol of leadership in the family.

Jose dad drinks and shouts at everyone most of the time instead of taking care of his family. Jose

seems to suffer from the lack of a responsible father-figure in his life, and this explains his

reluctance to marry and have a family of his own despite the pressure from his family members.

He fears failure. Still, on the issue of gender, the mainstream American society is more occupied

with improving the welfare of women. Therefore, Jose finds himself in a difficult situation due to

gender roles.

The other factor contributing to Jose’s mental turbulence is his Catholic faith. The

religious association remains a big factor in influencing the assimilation of Mexican American

families into the mainstream American society (Ruiz et al., 2018). Although other Roman

Catholic collections of ethnic associations have integrated into American society, the Mexican

Americans are still holding onto their Catholic beliefs. This explains why Jose still feels guilty

for forcing his ex-girlfriend to undertake abortion, which is not acceptable in the Catholic faith.

He thinks he will be punished by being taken to hell by God for killing an innocent life. This

thought of hell has increased Jose’s stress to the extent that he does not sleep, and he has gained a

lot of weight within a short time. Due to this feeling of guilt, he fears attending the church

service. His mother’s revelation about Jose’s ex-girlfriend’s abortion means people know about
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his past actions, therefore, giving him the more reason for not attending church and family

gatherings.

The best modes of therapy for Jose will be individual therapy followed by family therapy.

The main reason for starting with individual therapy is because the one-on-one talk with a

therapist in a confidential room will enable the therapist to be in a good position to evaluate the

client’s anger, pain, religious and cultural faith, and his personal character traits. The therapist

must be able to link the events such as Jose’s family pressures to marry, abortion guilt, and the

fear of losing his mother to cancer among other issues. Jose seems to suffer from low self-esteem

because he is convinced there is no more happiness in his personal life. With a face-to-face talk,

the therapist will be able to attend to what Jose is narrating and read his body language.

The second stage is family therapy. Since the organization of most of the Mexican

American families makes it easy for the members to live together, most of them blame their

emotional challenges on their family fights and financial shortcomings. This cultural practice can

be witnessed in Jose’s emotional struggles, which are mainly caused by his family conflicts and

lack of money since he does not have a well-paying job. The family also pressurizes him to marry

yet he does not seem to mind about his status as a bachelor. He is not even willing to date again.

Therefore, since the family understands Jose more, it is important for the therapist to work with

them in trying to help Jose realize the root of his stress. In the family therapy, the family of Jose

will learn how to talk, to disagree with one another constructively, and understand their needs so

as to maintain peace and unity. In due course, Jose will most likely be in a position to change

what he can, and accept what he cannot; thus begin the healing process.
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There are some laws and ethical implications of Jose’s case. In the US, there are cultural

laws that reflect on some traditional features like marriage practices of many ethnic groups living

in the US (Sue et al., 2019). Many people view this as government encroachment on their

privacy; hence any topic touching on the law in conjunction with culture evokes feelings of anger

in many citizens. Going by this argument, the Mexican American culture that puts unnecessary

pressure on Jose should be reviewed so as to relieve Jose of any financial and emotional burden.

On the other hand, with the issue of abortion, Jose might have it rough in courts in case his ex-

girlfriend decides to press charges against him. The movement for the right to life organization,

which came to life in 1968, achieved their agenda of pro-life associations; therefore, making it

illegal to commit abortion in 50 states. The United States is a member of the conventional on

whipping out discrimination based on race has the mandate to prohibit any kind of

discrimination.

In the US, the population of people aged 65 years and above is increasing, and this may

cause a lot of stress to many families (Macdonald & Levy, 2016). This worry grows out of the

fear of issues such as the idea that the old and experienced labor is no longer preferred by most

employers. This explains the reasons why Jose elderly parents want him to have kids who will

take care of him in his old days since it is acceptable in Mexican American cultures. Since it is

ethically acceptable for the working kids to take care of their old parents in Mexican American

culture, then Jose has a duty to obey his parent’s wish of having kids.

Therapeutic Relationship

For Jose to realize full recovery, he must have a good relationship with his therapist. A

good therapist-client relationship provides a strong foundation for treating the client’s mental
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challenges, and the help needed for the evolving insights into the personal character trait of the

client (Monger, 2018). For this relationship to be fruitful, components such as warm-heartedness,

geniality, goal-oriented, optimism, and moderation must be encouraged. In Jose’s case, these

building blocks of a good relationship will be realized through Jose paying attention to what the

therapist will say, being optimistic about life by going through the observed results by the

therapist, and the therapist allowing Jose to take charge of his own healing process.

Theoretical Model

By using psychological concepts and models, the therapist will be able to support his

intervention in treating Jose. The theory of occupation therapy will provide guidelines on how to

comprehend and use the data to assist Jose on how to handle the lack of motivation apply social

skills such as making friends and meeting his family at parties. Moreover, the therapist should try

to use theoretical ideology to improve the self-esteem of Jose. By understanding the main pillars

in a theoretical model, the therapist will use his or her theoretical knowledge to assist a client. For

instance, this will help Jose not to feel guilty over an abortion mistake that happened five years

ago, and encourage him to persuade his mother to join the therapy sessions so as to live a joyful

life again.

Treatment Goals

The process of achieving treatment goals requires professionalism and patience. Any

therapeutic treatment is classified into three stages of goals: the early stage, the middle stage, and

the late phase. First is the early stage which will involve Jose receiving a safe environment at

home with little pressures, building of a good therapeutic relationship and aiming to decrease

symptoms of the stress he is going through such as not having a girlfriend, not making friends at
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his workplace and school, and the lack of hope in his life. The second is the middle phase which

will involve the therapist pointing out the dysfunctional chain of events in Jose’s life such as the

antisocial behavior and failure to meet all the expectations from his family. The third is the late

phase which will involve linking the symptoms of Jose’s stress to his family problems and

financial challenges. Jose has to be made aware of his defensive mechanism, especially when he

is in his normal senses. This awareness will enable Jose to link his past actions to his present

behavior thus begin the journey of self-realization and healing.

In the case of inadequacy, the therapist could refer Jose to a well-experienced therapist or

relevant organization within his neighborhood to help solve the mental issue. Another choice of

referral is directing Jose to online therapy websites such as GoodTherapy.org.

Recommended Interventions

The therapist will utilize congruent character traits. Congruent traits can be used by a

therapist to get close to each family member of a client as he or she notes down how they

communicate with each other, their duties and their degree of self-esteem, in this case, Jose. In

the next step, the therapist will need to talk about the important events in the Jose family, such as

a family gathering. As the family members will be talking as individuals, the therapist will be in a

position to point out the various intentions. Finally, the therapist will teach them about practicing

new patterns of behavior which are helpful in Jose’s healing process. The family will be able to

brainstorm and congratulate one another on their positive progression in the therapeutic process

as they impact a positive change in their lives.

References

Burt, K. B., Obradović, J., & Leu, J. (2018). Self-construal, family context, and the cortisol

awakening response in first-and second-generation Asian American college

students. Emerging Adulthood, 6(2), 104-117.

https://journals.sagepub.com/doi/abs/10.1177/2167696817706039

Hiraldo, P. (2010). The role of critical race theory in higher education. The Vermont

Connection, 31(1), 7. https://scholarworks.uvm.edu/tvc/vol31/iss1/7/

Macdonald, J. L., & Levy, S. R. (2016). Ageism in the workplace: The role of psychosocial

factors in predicting job satisfaction, commitment, and engagement. Journal of Social

Issues, 72(1), 169-190. https://spssi.onlinelibrary.wiley.com/doi/abs/10.1111/josi.12161

Ruiz, B., Guerra, R. S., Lomeli, A. S., Longoria, R. R., & Ulibarrí, B. J. (2018). The Catholic

Church and Mexican American social mobility in the postwar Midwest: evidence from

life and family histories. Social Currents, 5(1), 32-48.

https://journals.sagepub.com/doi/full/10.1177/2329496517704870

Triandis, H. C. (2003). The future of workforce diversity in international organizations: A

commentary. Applied Psychology, 52(3), 486-495.

https://onlinelibrary.wiley.com/doi/abs/10.1111/1464-0597.00146
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