More often than not research and studies associated with depression and selective mutism are scarce and text descriptions are usually limited or nonexistent. In many cases, information is misleading and not accurate. In effect, a few individuals candidly understand this condition. Therefore, observation would be an essential source of information that I would use to better understand the client, his problems, and his strengths. Selective mutism occurs when an adult or a child refuses to constantly speak in certain situations where one is expected to speak. In this case, 23-year old Seung-Hui Cho could isolate himself from his peers, perhaps due to shyness (Newman & Fox, 2009). At home, he could speak with his family members but did not speak at all to peers and teachers at school.
In most cases, children with selective mutism demonstrate anxiety, shyness, and fears of negative perception and embarrassment (Newman & Fox, 2009). A child might isolate himself socially, cling to “safe figures” such parents, withdraw from the interaction with peers, and separate himself socially (Newman & Fox, 2009). What is more, a child with selective mutism, just like the 23-year old, demonstrates frequent temper tantrums as well as compulsive and negative controlling behaviors.
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In this case, there are various cross-cultural concerns to be aware of given that Cho, a South Korean, moved to the United States when Seung-Hui was just eight years. Therefore, the 23-year old is of Asian origin. Acculturation is a process a process that involves the members of minority groups (ethnic minorities or immigrants) changing their attitudes and behaviors to resembles those from a majority or host groups. As such, it is a significant aspect associated with concerns and barriers to the provision of therapy services among ethnic and racial minorities and usually transcends social class and gender. Individuals with low levels of acculturation often perceive barriers when seeking mental or psychological help. Therefore, cross-cultural concerns can be categorized into three: cognitive, affective, and value orientation (Leong& Kalibatseva, 2011).
To begin with, people’s understanding of cures, causes, and nature of psychological conditions is culturally influenced. For instance, in certain Asian cultures, there is no significant difference between psychological and physical problems. In such a way, it would be necessary to incorporate cultural values and concepts before kicking off the therapy(Leong& Kalibatseva, 2011). Secondly, one may avoid seeking therapy owing to affective concerns. As highlighted in the case, Seung-Hui was often subjected to mockery from fellow students because of his isolation, accent, and his speech abnormalities. Stigma and shame might influence the willingness of a client to cooperate in a therapy session(Leong& Kalibatseva, 2011). Psychological and mental conditions are stigmatized more in racial and ethnic minorities than in the majority group. Lastly, cultural values shape people’s communication styles and emotional expressions. The process of psychotherapy might seem foreign for Asians and Hispanics since they are, in most cases, oriented toward collectivistic values.
As part of problem analysis, the following questions would be asked:
i. Who does the client (23-year old) speak to often?
ii. What settings or where is he able or likely to talk?
iii. How does he communicate, short responses? Sounds? Writing? Whispering?
iv. How well does he understand others and express himself?
v. What language does he speak?
vi. Can the 23-year old understand different languages spoken to him?
vii. Outside the home environment, does the child successfully speak in his first language?
The early development of Seung-Hui was characterized by extreme shyness and physical illness. Besides, as a young boy, Seung-Hui preferred not to speak. This situation made his parents frustrated and worried. His peers excluded and rejected, although he did not want his parents to find out that he was being ostracized (Newman & Fox, 2009). The 23-year old’s parents had finical difficulties and worked for long hours. They devoted less optimum time to parenting, and this could have had an effect on their child(Newman & Fox, 2009). Before coming to the United States, the medical records did not show a diagnosis of mental illness.
As a youngster, Seung-Hui was diagnosed with depression and selective mutism. The diagnosis would play a significant role in my assessment. A diagnosis is a form of pre-assessment that would allow profession determines the client’s problem and how it can be treated. Mental health disorders exhibit a different set of treatment protocols. Diagnosis would facilitate the assessment as it would determine whether the client has a mental problem and the type of treatment that would be helpful.
Consultation is the process that involves the counselor (consultant) working with administrators, teachers, and parents (consultee) with the aim of realizing positive change in the child (client) (Kahveci & Bulut-Serin, 2017). The process helps individuals to understand problems as a component of the general system. In completing this assessment, the appropriate consultation would be behavioral consultation. Behavior therapy is useful in the treatment of problems that occur in the hospital, clinic, school, and home. The social learning-theory technique to human behavior plays a crucial role in behavioral consultation (Kahveci, & Bulut-Serin, 2017). As such, the behavior of an individual is directly associated with the controlling environment.
References
Kahveci, G., & Bulut-Serin, N. (2017). Conjoint Behavioral Consultation, Cognitive Behavior
Therapy and Schema-based Instruction: Enhancing Mathematical Resilience. Eurasia Journal of Mathematics, Science and Technology Education , 13 (8), 5543-5556.
Leong, F. T., & Kalibatseva, Z. (2011). Cross-cultural barriers to mental health services
in the United States. In Cerebrum: The Dana forum on brain science (Vol. 2011). Dana Foundation.
Newman, K., & Fox, C. (2009). Repeat tragedy: Rampage shootings in American high school
and college settings, 2002-2008. American Behavioral Scientist , 52 (9), 1286-1308.
