I want to present concern a 30-years-old woman, suffering from strong anxiety about her exam. I think this case is too much interesting, due to even though she had damaged up his studies in economic for five years, she tried to cope from this deficits, and finally advance effectively and follow further advanced studies in Afghanistan, after finished her cognitive treatment. The persistence of this homework is to present the intellectual map of the patient and the processes that controlled to the achievement of the beneficial areas or goals.
She could participate to talks or go into the address or spe programs. Sadaf could not attention, to learn or sit in for exam it was so difficult for her. She escaped from every things to relevant on exam or speech programs. She had too much or intensity anxiety under depression, but she liked or desired to get her degree from university.
She desired to remove her problems or deficits and finally she could cope from that deficit.
She was not happy and enjoy from her life because she was thinking about her exam every time. She escaped from crowed and she did not willing to participate any program, unfortunately day by day she loosed her energy.
Introduction
Clinical reasoning is the processes of thinking and decision making processes of clinical practice. It has been defined as a method of interactive reasoning, this interactive reasoning is appropriate for dada collection, diagnosis, and management materials [1].
The clinical reasoning provides for us a comfortable life, and conflicting deficits or problems, with many problems, and outcomes they have interactive between each other’s [2].
Students and learning of clinical practice, graduate, undergraduate or students of university they must to know about clinical reasoning and usage of that.
As educators different students come to understand clinical reasoning, validity or which one is usefulness for our study. Some of them include external factors, and some of them include external factors by defining the problems, so the therapist could recognized the main problem to treatment.
From other side, it is essential part of clinical reasoning that we can define the value or non-value of data collection and treatment protocol [1].
Different literature review we have to express the clinical reasoning for development of students [3, 4]. The improvement of classroom learning activities, discussion group working and group or individual knowledge. Also, the students or educators must to know what they are learning for developing. Such as, for judgment of clinical reasoning we need to have exercises, management, scope and multiple practice to become experts.
Professionals or experts can develop their educations, and improve their reasoning after practice of clinical reasoning. However, it is too much difficult to do these multiple exercises. For instance, our expectation are very high because of demand time. Due to, limitation of time, the learners of examiner she had anxiety. Also, the improvement of real clinical reasoning services for acquiring knowledge, awareness of clinical learners need the intervention of rehabilitation.
There are a lot of base clinical reasoning for further investigation, and method of reasoning. The direction between knowledge, and reasoning the interactive reasoning is more useful or appropriate for that. By this interactive reasoning we collect our data very easily.
Goals and objectives of treatment
- a. Explaining the cognitive model, and describe clearly that model
- b. learning or training her to understand the problems, and struggle to bring some changes
- c. She must to solves her problem by struggling, and after that she could improve very well
- d. she has to work without of her parent or her family, and follow her common life
Literature review
Most of improving needs to flexible or adaptable and non-adaptable behaviors and receiving shapes like cognitive processes, the responsibilities of these intellectual processes could be process by some dealing, and the career for a counsellor is that of a distinguish and evaluate reasoning processes to demonstrations such educations and knowledges that alter the current mental forms, and corporation between behavior and cognitive process. [5].
Cognitive process goals are to arrange the functional cognitions and give reasoning when measuring specific situations or culture and to cope from essential deficits and actually to deliver patients with cognitive programs to accept and respond the main problems [6].
Cognitive process organized semi-structured, for a very short term this structured approach. Its physical activities and clinical practice example; anxiety and eating-problems, some conditions of emergencies and complaints related to psychotherapist [4].
And also reasoning treatment or cognitive treatment (CT) is useful for patients, understanding and cognitive model, moods, and performances such that thoughts form actions, and unlikely reasons can lead to inappropriate working and filling [7]. Cognitive treatment is appropriate for anxiety and depression disorders, for example oral and non-oral and those who are crime for our bodies or harmful for society they have to reject [8].
Sadaf was older or the first child in her family. She had one brother and one sister, her brother was rolled, unmanageable and uncontrolled. But her sister was so kind and friendly with her. She had many problems with her family because her families were low income, and many difficulties were her shoulder and he worked very hard to solve those problems, finally she succeeded. When she arrived in to therapist she followed the following:
Her mother and her sister always tried and compelled her to continue or follow her education, due to without of education she will be ignorant like her parent and dark future. So she would be a simple worker forever, their parents do not wanted that. I always kept in my mind that my mother said and my sister called me foolish person, those speech mad me energetic (9).
Her therapist was foreign language and he was too mush respectable she could spoke with her very convenient. Fortunately her parents were not interest to interpret their opinion at foreign language, and also from other side their financial situation was not very good so she had many problems because she could not continue her study and she must to find a job to remove that financial problems.
Even though, she seemed that she could not or there is no way to go outside from this bad situation. Her mother and her sister put too much pressure on her it was so difficult for her to continue her education or acquisition of knowledge (10).
Analysis and Discussion
Most of reasoning guide the professional toward during the assessment and treatment. We should think and make a decision based on own knowledge approach to reasoning frame to achieve the best continuous quality outcome. There are a lot of clinical reasoning methods and because this case was familiar with me, I conducted inductive reasoning.
Observation Pattern Tentative Hypothesis Theory
I had started my treatment from asking questions the family of Sadaf. Because day by day his anxiety increased and also there were a lot of anxious people they could not control there selves [11], Sadaf needed to have stay with bad situation and good facilities or outcome. For example, she believed: if I failed in exam I will have a lot of problems in the future, so I will be cleaner fore ever same to my parents.
Finally, it looked that Sadaf was in bad situations she had a doubt about her future, her main problem was property and university degree she did not think about quality of lessons so from other side her most problem was her familiar or her parents.
Sadaf had intensity anxiety it became difficult situation for her to learn extra things in university, or expand her opinion. Other significant subjects contain views, for example about the worth of the indications of anxiety for example (my mind is not working very good or clearly), so I had to repeat daily these sentences (I will do my work correctly and I will be able to get my degree from university, I will have full of energy and confidence [12]. There is a lot of symptoms include for anxiety it shows the following:
- I could not do anything to unless I got my degree from university
- I could not cope from deficits or problem without of advanced
- Every time I must to spoke with my parents respectably, otherwise I will punish with them
- I always have to do what they wanted or desired
So she had also negative idea in her brain such as:
- I can participate or attend in the exam
- I cannot manage my deficits or problem
- Every things are like a huge difficulty or pain on my shoulder
- I don’t have reexam or next chance to give exam
- I cannot focus in the lessons I am under depression
Sadaf s could not study due to these bad situations related to exam anxiety. The psychoanalyst absorbed this situation and fortunately he could control that situation or manage because that was oriented for him” [13].
Thus, Sadaf’s daily went to in front of her counselor without of depression or anxiety, she was relax the reason was foreign language, successfully at the end she could do very well and known about her responsibilities “If I do not struggle I could not improving, if I do struggle though I have some potentials”.
This method had different purpose and too many, small works to do that ,so at the first time she had to do or learn a few pages to be able to face this condition(learning). When she able to face this condition she could avoid from many anxiety [14].
After that Sadaf could face to exam and university every time she gone to university, she thus able to write the lectures and the schedule of the exams. Lastly, she could stay in the exam and successfully passed the exam without of depression and anxiety.
From other hand Sadaf was not ready or able to sit in the exam or do her homework. This was a part of her life without of struggling she could not pass that bad situations. Finally, she was able to solve her deficits or problems.
Condition Unconscious Believed Feelings
Consequence
Studying for learning, understanding ,and exam I am not able to do it Nervous I am the bet in foreign speaking and language Gratification
I am so confuse, and I do not believe my mind Fearful If I struggled I will sit the exam and passed the university exam “I am afraid to take the risk”
Table 1: Sadaf’s regular best of dysfunctional views.
Treatment improving and successes:
In spite of the problems in therapeutic at the first time she did not do her homework then treatment was effectiveness.
Subsequently six months of treatment containing follow-ups:
- a. Sadaf achieved and she desired to finish or complete her university
- b. She advanced successfully and complete her educations
- c. Her brain was not working too much good because she was under depression and anxiety.
- d. Finally, she graduated from Kabul University in Afghanistan, now she try do follow her education in foreign countries.
Conclusion
The clinical reasoning procedure arrange for a structure to mixing the difficult and flexible components of clinical practice. Information and knowledge of this procedure can increase the effectiveness and efficiency of clinical involvement and certify its significance to customers’ needs. In addition, increasing clinical reasoning services can support clinicians to observe and defend management consistency and strength and obviously connect these to their customers and other clinicians.
This situation education obtainable the key implements considering anxiety disorders and delivered exact theoretical agendas of cognitive treatment that were used efficiently in treatment of this patient and affected her whole life so that she could principal a happy life. Last, but not least in a follow-up conference she said that she has functioned in a business in Afghanistan for the last ten years after having completed her advanced studies and get master degree so step by step she can also follow her PHD.
References
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- 11. Clark DA, Beck AT (2010) Cognitive Therapy of Anxiety Disorders. Science & Practice. The Guilford Press, New York, USA.
- 12. Beck AT, Emery G, Greenberg RL (1985) Anxiety Disorders and Phobias: A Cognitive Perspective. Basic Books.
- 13. Beck AT (1989) Cognitive Therapy and the emotional Disorders. Penguin Books, New York, USA.
- 14. Butler G (1989) Phobic disorders. In: K Hawton, PM Salkovskis, J Kirk, DM Clark (Eds.), Cognitive Behavior Therapy for Psychiatric Problems. Oxford University Press, Oxford, England.
- 15. Burns DD (1980) Feeling good: The new mood therapy. Ney American Library, New York, USA.
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