The movie Girl Interrupted is a memoir about Susanna Kaysen’s battle with mental illness. It is set in the sixties and seventies, in a medium security psychiatric ward. After Susanna attempts suicide, her parents bring her to speak with a psychotherapist who suggests and end up convincing her to commit herself to be institutionalized and eventually diagnosed with borderline personality disorder. During the course of the film, which seems to take place within well over a year, she undergoes treatment in the forms of therapy, analysis and pharmaceutical drugs.
During her stay at the psych ward she meets and builds relationships with the other females who are undergoing treatment for other forms of mental illness. I believe that the individual that I would be intervening with would be Susanna in this case. Based on the fact that she has been institutionalized I would be interacting or intervening hopefully within the first few weeks of her stay in the hospital so as to start building a relationship with the client as soon as possible. Gathering information/Assessment Forming Partnerships
Susanna Kaysen is the service user in this film, she is an eighteen year old female who has willingly admitted herself to a mental institution after a suicide attempt. When approaching this individual in an appointment type setting I would keep an open posture and be very aware of my non verbal communication as someone at that age can be easily offended or put on the defense if they feel judged. Along with this I would also try to invite her to speak more than myself by asking non invasive open ended questions at first, and validating any strong emotions that were to come up to encourage her to speak more.
Knowing, based on her body language that she does not want to be where she is, I would ask her what she feels would be positive goals that would bring her closer to being release. The unique aspects of this individual that I would highlight to the client would be her intelligence. Based on her verbal communication skills and her ability to hold a conversation in the film supports the fact that she is extremely intelligent. Also I would acknowledge her empathy towards other people and her willingness to try and make others around her feel better.
You see in the movie when one of the girls get physically put into a locked room she goes and gets some instruments and starts singing to her. Describing Situations In describing the situation I believe that Susanna is very emotionally unstable, and is dealing with deeper seeded issues that are based from her home life. Some of the present issues she is face are her depression, possible boarder-line personality disorder and her inability to properly regulate her emotions. I also believe that her being institutionalized is aggravating any kind of mental illness or distress she is going through.
Some of the supporting reasons why she may have these problems would be the environment she grew up in. In the film her parents are portrayed as very uptight and proper and Susanna makes it apparent that appearances are more important to them than her health and or happiness. One other relationship in Susanna’s life that plays a role, is one of her professors that she had an affair with. Although they do not show much of the interaction between the two of them it does cater to showcasing some of Susanna’s emotional insecurity as well as possible underlying issues with her father. Define Direction
I believe that my purpose in working with this individual would be to aid her in seeing her strengths and showing her ways to overcome her weaknesses. In helping Susanna realize that she had strengths I would be able to show her how to build from that and use those strengths to become a more functional human being. If my attempt to do either of these things were to be unsuccessful I would ask her to create goals of her own and support her in any way I was able to. As well as being supportive to her throughout any failed attempts to attain goals, and providing encouraging support and pressure to succeed.
Identifying Strengths Susanna’s has many strengths both basic as well as more in depth as an individual. In terms of general functioning she is able to carry on an intelligent conversation as well as take care of herself in leu of personal hygiene. Although she did attempt suicide she appears to cope with stresses in her life by putting up an emotional wall, as well as using an abrasive attitude to mask any kind of mental or emotional anguish. In terms of her cultural identity, I believe she is trying to portray herself as someone who may have grown up in a prominent and well off family but never fit in.
She carries herself in the film as someone with a chip on her shoulder because her parents cared more about appearances than the actual well being of their daughter. Also she mentions throughout the film that she feels she is weird, and that no one in her regular life outside the institution understands her. By the end of the film Susanna has overcome the adversities she faced more than most people in her situation would. Although she dragged her heels for a large portion of the film in the end she seems to understand that to get out and to get better she needed to make changes.
Some of the changes you witness in the film are her actively participating in her psychotherapy sessions, and her overall demeanor go from overly negative to more positive. Planning and Resources Assessing Resources If I were dealing with this situation in my community I would start by exploring my resources in the areas of counseling. Assuming Susanna would not be very open to paying for the services I would provide her with connections to these service providers who do not charge their clients.
First of all I would refer her to Family Services North Shore, where they provide extensive counseling programs for youth both in person and by phone or text (call 1-888-988-5281 or text 778-887-6687). Another sound resource for Susanna to take advantage of would be Hollyburn Family Services, specifically the ‘Youth in Transition’ services that they provide. This program provides specialized assistance to youth in the areas of developing independent life skills, finding living accommodation, obtaining employment/job training as well as connecting the youth with other external resources (eg. ental health, medical drug and alcohol counseling).
Framing Solutions and Activating Resources My plan of action for Susanna would be based on what she feels are realistic goals, as well as implementing some goals I feel she is able to attain based on a one-year plan. I would start by speaking in depth with her about what steps got her to where she is right now and what she feels she would like to do to better her situation. I would also try to gain perspective on where she would like to be in the next year and help her outline what changes she would like to make to work towards this.
Once the goals have been clearly stated, both Susanna’s goals for herself as well as a few goals that I have added to her one year plan, I would ask her to write out in detail what she feels are small milestones or steps she needs to take each month to support her moving towards her one year goals. Also, I would ask her to tell me or write down what she feels she would need from me as a service provider to help her attain these things. After this has been established my first step would be to set up appointments for her to see me either once a week or every other week.
My second step after this would be to break down the goals we had developed into one or two week segments so she was able to work towards something for each appointment she would have with me. My third step would be to develop a meaningful and appropriate incentive for each goal Susanna accomplishes to help encourage and support her growth as a person and her ability to obtain her goals. Action and Evaluation Creating Alliances To support Susanna in seeking out and taking advantage of the resources I have provided to her I would ask if she would prefer for me to set up her first appointments with the organizations.
If she agreed that this would be simpler for her I would also set up a second appointment or meeting for her to help maintain momentum in her using the resource. Not only would I book those appointments for her but I would also offer transportation options to her. One transportation option I would make available to her would be to provide bus tickets for public transit for her to get to and from the appointments. Another option that would be made available if possible at the time of the appointments would be for me to drive her myself.
In either instance it minimizes the opportunity for Susanna to bail on the appointments or make up excuses to prevent her from participating in them. Expanding Opportunities Although there are resource in my community that would greatly benefit the service user in this instance I believe that there is one resource that should be make more readily available to individuals like Susanna who have attempted suicide and are dealing with mental illness in varying degrees.
The resource I am speaking of is art therapy, and even though many people feel it is only beneficial to young children to help them relax and open up to counselors I feel that it can be extremely beneficial to anyone dealing with mental illness and or stress. The casual approach is a surprise to a teenager and helps to minimize the fears of exposure and pain that they expected, but the materials used in art therapy are more than meets the eye. (S. Riley, 2001)
An art therapist understands the evocative strengths of oil pastels, clay, paint and felt pens, so while the individual undergoing therapy does not feel verbally cross examined the therapist is analyzing the opinion of their world as expressed through imagery. (S. Riley, 2001) Recognizing Success and Integrating Gains Once Susanna has reached her goals and no longer needs my services or support we would celebrate her success based on the incentives we developed together when we created the one-year plan.
In providing this last incentive, which would be more substantial than the ones chosen for milestone goals, I believe it would be a positive support for her to move forward and continue making good choices in her life. As well as show her a way to encourage herself by creating incentives for goals made later in life. In order to help Susanna and her family recognize and identify her successes at the close of our relationship I would start by asking them to define in their own words where Susanna was at the beginning of our relationship and or when we had first met.
Once she had outlined where she was emotionally and mentally in her mind when we had first met, I would pull from my files the written one-year plan that we had developed together. From this one-year plan I would outline briefly the major milestones that she had accomplished along the way as well as involve Susanna and her family by asking and confirming about those achievements. By asking them to remember where she had started and then re-iterating to them and with them the goals she has accomplished it will help them clearly recognize her successes.
Reflection In using this problem-solving model I found various aspects very helpful and others fairly repetitive. On the negative side of my opinion for this model I don’t know if I would agree with creating a plan of action in how you would end the relationship with the client unless it was to happen quite soon. As time passes the needs of each client can and usually will change and a lot of the time they will change as an individual so this plan to show them how they have succeeded would need to be changed all the time.
I do believe though, that breaking it down into smaller sections of need for the client is good as you are able to expand on each and every aspect of the client’s needs as well as their strengths. Also with creating alliances, I do feel that when working with youth you really do need to be the one to set up the initial appointments. As well as find other effective ways to make sure your client and they resources you have sought out and provided for them get utilized.
http://www. ncbi. nlm. nih. gov/pmc/articles/PMC1071468/