Antwone Fisher Movie Analysis
Fisher was given orders to report to Navy Mental Health Services Department on base as Involuntary Command Referral for diagnosis and treatments, to get an evaluation and expert psychiatric recommendation about whether the service member is mentally fit to stay in the United States Navy. SN Fisher is unwilling to begin counseling, expressing to Lieutenant Commander (LCDR) Davenport, the attending psychiatrist, that he has “no problems,” and declaring that the Navy can order SN Fisher to report on prescribed dates, but LCDR Davenport can’t force him to talk about his anger, and rage when taunted by fellow sailors. B. Setting.
The setting is the Navy Mental Health Services Department, Pacific Fleet. Services provided are intended for crisis prevention such as Fitness for duty evaluations, Diagnostic Evaluations, Health psychology assessments, Individual and group therapies, Limited Duty reports, Pharmacotherapy, Medical Board reports and addendums, Temporary Duty Retirement List (TDRL) periodic physical evaluations, Involuntary Command Referral for diagnosis and treatment, Psychological testing, Military Court evaluations, including insanity boards , Department of the Navy Central Adjudication Facility (DONCAF) evaluations and Special assignment evaluations.
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Through the capability of a full range of mental health services including substance abuse treatment to the Fleet and Marines, to all other military beneficiaries and other Tricare Prime patients on a space available basis is the primary mission of the Mental Health Department, utilizing mental health providers from multiple specialties to support the mission of Navy Medicine. The department zealously implements the highest level of training to Psychiatry Residents and Psychology Interns as well as supports and nitiates research that is pertinent to the mission of Navy Medicine, the USN and the Department of Defense (www. med. navy. mil, 2012). C. Reason for Referral/ Presenting Problem.
SN Fisher was given a direct order to report for an evaluation at the Navy psychiatric department before their next underway period by his Commanding Officer. During the Captain’s Mast, SN Fisher was found guilty of article 128 for assaulting a higher ranking non-commissioned officer which resulted in SN Fisher going on restriction for 45 days, with forfeiture of $200. 0 of his paycheck for two months, and a reduction of rank from ship’s serviceman third class petty officer to ship’s serviceman seaman. In addition, SN Fisher was restricted to ship’s boundary for 45 days and was given 45 days of extra duty while on restriction. The ship’s commanding officer was concerned about SN Fisher’s behavior onboard the USS Belleau Wood (LHA-3). SN Fishers’ chain of command has reported that he is mostly a quiet sailor who performs his duties on an exemplary manner congruent to the Navy code of conduct.
For the most part, SN Fisher keeps to himself; he performs well when working alone and associates himself only with a few friends within their division. However, his chain of command is also aware that he is an angry, lonely young sailor, from his uncalled-for altercation with fellow shipmates and his overall character early in his naval career. SN Fisher shows his disregard for authority even during the Captain’s Mast in front of the highest ranking officials on their command. During SN Fisher’s initial visit to LCDR Davenport, he was disinclined to begin the assessment process.
He disputes his disagreement about his anger and rage outburst onboard the ship and made it clear to LCDR Davenport that the Navy can order a fitness evaluation, but the attending psychiatrist is not extracting any word from him during the ordered visit. SN Fisher’s action has prompted LCDR Davenport to make it clear, that the Navy has mandated SN Fisher three sessions, and their actual session will not get counted until he starts cooperating in a manner where LCDR Davenport can perform his fitness for duty evaluations on SN Fisher. D. Client Description and Functioning
SN Fisher is a stocky young man, cleanly shaved with a high and tight haircut. He was wearing a pair of Navy dungarees that looks sharply ironed with crisis that is with in regulations of Navy uniform standard. SN Fisher walks with assertion similar to any young man with self-confidence. SN Fisher does not show any signs of illness, the way he presented himself while on uniform can indicate that SN Fisher takes good care of his body and grooms within the standards if not above average of the Navy regulations. SN Fisher answered genially to LCDR Davenport on their initial contact.
He has the humor to make an argument that because he assaulted a white boy everybody is jumping to conclusions about his mental health. SN Fisher had also made it clear that he is not looking to get discharged from the Navy. SN Fisher showed no interest in sharing with LCDR Davenport what were the precipitating factors that led to his referral for psychiatric evaluation during their initial contact. E. Physical and Economical Environment SN Fisher is residing on board the USS Belleau Wood (LHA-3). Being on board a Navy vessel, everything is provided in regards to berthing space, and guaranteed three meals a day.
If SN Fisher does not have any credit card, he banks every single penny of his paycheck, because when a sailor resides on board a ship there are no expenses. SN Fisher’s day-to-day activities revolved around his job in the Navy. As a ship’s serviceman his duties are to operate the ship’s laundry facility, barber shop, ship’s store and vending machines. When the USS Belleau Wood (LHA-3) is in port, it is moored on the piers of the 32nd St Naval Base in San Diego, California. SN Fisher’s environment has access to all the basic needs of a young man. F. Current Social Functioning (as reported by client or gleaned from other reports)
SN Fisher claims no knowledge of his biological parents. He was placed in the Tate’s foster home at the age of two. The foster home belongs to Reverend Tate. They attended church three times on Sunday, bible study on Tuesday, YPWW meeting on Wednesday and choir rehearsal on Friday. SN Fisher expressed during their conversations that Reverend Tate would beat Dwight because he was too proud but the reverend never laid hands on him because he pitied SN Fisher and he liked him for that. Mrs. Tate would tie SN Fisher and his foster brothers whenever they made a mistake in the house, and beat them with a wet towel. Mrs.
Tate would also mentally abuse SN Fisher by scaring him with paper burning because he was afraid of fire. SN Fisher and his foster brothers were also verbally abused by Mrs. Tate through racial slurs, SN Fisher explained that Dwight ended up in Lucasville State Penitentiary and Keith was picked up by his mother, then was raped by one of his mother’s boyfriend. SN Fisher has also expressed that Mrs. Tate made them hate each other. SN Fisher wished that he was Dwight because he was half white, the verbal abuse has affected SN Fisher by thinking his inferiority due to his skin color. When SN Fisher was left alone with Nadine (Mrs.
Tate’s cousin) she would sexually molest him. SN Fisher is currently dating Cheryl. They have not been sexually active, but SN Fisher is emotionally attached and cared to be with Cheryl. SN Fisher is taking language courses and showed no learning inadequacy. SN Fisher’s relationships with his peers are difficult. His inability to control his rage when taunted has been the main issue that landed him for the evaluation and assessment by LCDR Davenport. SN Fisher has no record of any substance abuse. No record of any medication being taken. His anger issue has affected his naval career that has led to his restriction and reduction of rank.
When SN Fisher enlisted in the Navy, he finally recognized the pain that his childhood has produced, he started confronting his problem by the rage and violence he presented when taunted by his fellow shipmates. F. Personal and Family History SN Fisher was born in prison from a convicted mother who had no means to care for him. His father was killed by his ex-girlfriend before he was born. His father was also unaware that his mother was pregnant while serving a sentence. Fisher was turned over to the state and was placed in an orphanage and was only supposed to stay until his mother claimed him when she was released from prison.
SN Fisher’s mother never came for him. He spent two years at the orphanage, then when SN Fisher was two years old, he was placed at the Tate’s foster home. Mrs. Tate was the primary caregiver and he had two foster brothers named Dwight and Keith. There is no written medical record and history of his mother’s pregnancy. SN Fisher was physically, verbally, mentally and sexually abused from his childhood to mid-teenage years. He was also tied and left in the dark basement of their foster home after receiving disciplinary action. SN Fisher also witnessed the death of his best friend while his friend was trying to rob a local store.
II. ASSESSMENT A. Psychological Functioning SN Fisher seems to be an intellectual sailor as demonstrated by his ability to learn new languages, his drawing skills, and the ability to move up ranks in a timely manner. His cognitive thinking ability was demonstrated to be exceptionally high as evidenced by his clear and concise explanations of how his childhood and teenage years were polluted by Mrs. Tate’s abusive parental care. His memory and recall are good. There are major anger management problems evidenced by his fighting with shipmates, and disregard of superior rank when upset.
His decision making abilities with peers who taunt him are clearly impaired to such a degree that SN Fisher is unaware on how to manage his emotions which often turns into rage. B. Emotional Functioning SN Fisher has no problems expressing his feelings about himself, and his foster parent. His relationship with Mrs. Tate was a total disaster even when he tried to connect and soothe her. After taking all the abuse at an early age, he finally came to a point where he needed to stand against her abuse resulting in SN Fisher leaving the foster home.
He evidently wanted a person to confide with and reacted very well to the counseling session provided by LCDR Davenport. When the third meeting was coming to an end, SN Fisher wanted to continue with their weekly meeting. He admitted to the frustrations of losing and not being around the people that he trusted in life. C. Social/Behavioral Functioning SN Fisher demonstrated that he is capable of forming relationships as evidenced by having a girlfriend. He has the social skills to make friends with fellow sailors.
His interaction style was mainly passive, but he does not tolerate any taunting from his peers and even from his superiors. SN Fisher does not have any substance abuse problem. D. Environmental Issues It is clear that SN Fisher’s future in the navy is contingent upon the outcome of his assessment, but SN Fisher refuses to talk. Having only been given an arbitrary three sessions in which to make a diagnosis, illogically mandated three sessions will be completely insufficient to deal with SN Fisher’s outburst of rage and anger in addition to his experiences of past trauma and feelings of abandonment.
Residing on board the ship gives SN Fisher an environment that is adequate and stable. Although SN Fisher does not have any immediate relatives to confide his feelings and emotions, the ship gives SN Fisher access to recreational facilities such as gym for lifting weights; access to health care and a chaplain for spiritual needs. E. Motivation for change and commitment to services After verifying that his clinical appointment with LCDR Davenport was limited to three meetings SN Fisher started communicating and openly expressed his feelings.
It is evident from SN Fisher’s physical reaction on the third meeting that he wanted to continue his sessions with LCDR Davenport. F. Worker’s Understanding of Presenting Situation/Problem SN Fisher’s outburst of rage and anger are major difficulties that he currently faces are related to his experiences of past trauma and feelings of his mothers’ abandonment. He is also battling shame and guilt, and yet too prideful to admit that help is needed. This was expressed when SN Fisher asked to be send to the brig; his idea of incarceration is an acceptable utcome of life’s tragedy, while therapy is shunned as a safe haven of the weak. He never experienced the feeling of being loved from his foster home, this is evidenced when he explained on what to expect from Mrs. Tate will depend on the scent of morning food. If he smells grits and eggs, he needed to watch his every move, if he smells pancake it should be a sign of better day. His antagonistic behavior with his peers is a defense mechanism he uses to release the anger that has been suppressed his whole life.
He never had a male figure to emulate himself and he never learned how to cope and be resilient on the trauma that he experienced as a child. SN Fisher’s life from birth until the day he enlisted in the Navy has been a tumultuous. He never had a narrative mechanism as stated by Tuval-Mashiach, R. , Freedman, S. , Bargai, N. , Boker, R. (2004), that a person permeate meaning into their lives, into the incidents they have experienced, and into the choices they have made, through the stories they tell about themselves.
As such, the life-story is not only a format for telling oneself about one’s life but is also the processes by which an individuals’ identity takes place. SN Fisher’s job will always be filled with interaction with fellow sailors who will constantly probe him with questions, taunting and jokes. His emotions are filled with sorrow and questions on why his mother never came back for him. It is apparent that he cannot manage his emotions as a result of frequent altercations. Supplementary activities during free time would be very helpful to channel his anger.
SN Fisher shows that he wanted to continue his therapeutic relationship, to talk more about his feelings about his childhood abuse and to resolve his unanswered question of why his mother never came back for him. His current individual therapy is perfect for that. Cognitive behavioral interaction therapy would help him acquire better interaction skills with his shipmates and to cope more effectively with his aggressive and impulsive behavior. G. Intervention Plan An empirical based research was performed based upon SN Fisher’s presenting problems and description of functioning.
An initial Google Scholar search on evidence-based treatment for depression, anger management, trauma and resilience through guided practice theory was conducted, as was expected, a vast number of resolution was acquiesced. A succinct examination of these pointed the search in the direction of cognitive behavioral therapy (CBT), and Post-Traumatic Stress Disorder (PTSD) more refined explorations followed in particular attention to Strengths-Based Cognitive-Behavioral Therapy (SBCBT). The realization of CBT across such a wide range of disorders has led the search to Integrating Positive Psychology Into Counseling and Intervention techniques.
Mooney & Padesky suggest that CBT therapy models also might be employed to help people develop positive qualities and attributes (Fava & Ruini, 2003; Mooney & Padesky 2002; Padesky 2006). Strength Based CBT is a four-step approach for helping people build positive attributes. The plan is to use Strength Based CBT to help SN Fisher build resilience. Established upon SN Fisher’s attending problems and description of functioning an evidenced-based practice research was performed.
An initial USC proxy library search on evidence-based treatment of anger management, and the lack of support system generated more than enough results. After a thorough analysis the literature review produced few articles attending the use of anger management, but the few that did address anger management distinguished that cognitive approaches are better in dealing with insufficiencies in cognitions to control impulses (Escamilla, A. , 1998). SN Fisher’s anger management problem will be treated by using the cognitive approaches to control his impulsive behavior.
In addition, a Cognitive Behavioral Therapy (CBT) and Personal Development (PD) treatment will be added. The goal of CBT therapy will be to help SN Fisher develop skills to manage his predominantly reactive aggression while PD therapy will be aimed to help SN Fisher in enhancing his motivation to develop less aggressive identity with less use of proactive aggression. The treatment plan was found to be effective based on the evidenced based research of the literature have shown that participants were cross-examined pre- and post- intervention; records were subjected to Interpretive Phenomenological Analysis.
The aftermaths from the treatment illustrated major improvements in anger coping and self-esteem. Qualitative analysis identified factors associated with improved outcomes (Down, R. , Willner, P. , Watts, L. and Griffiths, J. , 2011) To conclude, the search was directed toward SN Fisher’s lack of social and emotional support. Since this is very vague, the search began with evidence-based social support therapies. The results were extensive and indistinct, so the search was refined to types of therapies that promote social support.
The search proceeded toward solution-focused brief therapy (SFBT), which is applicable to a variety of presenting problems. Stams, Dekovic, Buist, and de Vries (2006) performed a meta-analysis of 21 international studies including 1421 clients to achieve quantitative evidence for the value of SFBT. They found that although SFBT does not have a larger effect than problem-focused therapy, the positive effects happens in less time and fulfills the client’s need for autonomy more than do customary forms of psychotherapy.