Ethical Considerations
The client is going to be part of a counselling and therapeutic relationship. All goals and objectives of the session have been shared with him. Informed consent, confidentiality, and anonymity of the client have been ensured. Ethical considerations have followed the Data Protection 2018 and are in line with the Nursing and Midwifery Council of the UK (Nursing & Midwifery Council, 2026). Consent was sought to share his case, so this presentation is ethically sound.
Background of the Client
The client is in his mid-adulthood and aged 26 years. He was born in Congo but arrived in the UK when he was 11. He is alone in the UK and is in jail on charges of illegal immigration, drug abuse, and selling. He has developed strong depression, anxiety, self-harm intentions, and suicidal thoughts (Bell, 2021). He is at risk of deportation to Congo, which he does not want. He has experienced seeing his father shot dead in Congo and does not want to return. He does not even know whether his mother is alive in his home country. He was young and vulnerable when he arrived in the UK and joined anti-social elements, which resulted in him selling drugs.
Application of Bronfenbrenner’s Theory
Understanding the client’s case should be empathetic and professional. Bronfenbrenner’s ecological systems theory helps us to understand the environment in which he was living. He did not have stability and trust in his life since his childhood. The microsystem, i.e. family, was not supportive and could not protect him. When he arrived in the UK, mesosystems, i.e. different micro systems, did not guide him towards the right path. Exosystem, i.e. indirect environment like government and society guidance, wasn't there, and he started doing anti-social activities (Navarro and Tudge, 2023). Still, he wants to live peacefully, and thoughts of deportations exacerbate his already high anxiety and depression levels. He might tend to end his life if there is no trustworthy relationship visible in his life.
Evidence-based formulation of mental health difficulties
Mental health issues with the client are clear, especially the tendency towards self-harm and suicidal thoughts. Predescu and Sipos (2023) contend that depression and mixed affective and conduct disorders are associated with suicidal behaviour (Predescu and Sipos, 2023). The client is having conduct disorders as he has been with anti-social drug sellers. He has also developed depressive symptoms. In this case, the client might benefit from empathy and cultural competence so that he can find trustworthiness. Oppedal et al (2020) have found that cultural competence has a positive impact on mental health, and it applies to different immigrant and refugee groups. For this purpose, heritage and majority peer-related culture are helpful (Oppedal et al., 2020). The client needed empathy about his own culture and alignment with the majority culture in the UK to improve his mental health.
Possible mental health nursing interventions
Mental health interventions for the client should focus on self-harm and suicidal thoughts. The first nursing interventions should focus on these risks. Scholarly literature has found different nursing interventions to deal with mental health issues. Prominently, dialectical behaviour therapy is recommended in a hospital setting, and mindfulness-based cognitive therapy is recommended in a community setting in combination with psychoeducation (Putri et al., 2025). Thus, it is better to get approval for the counselling and treatment of the client in a community or group setting. Then, a mindfulness-based stress reduction intervention is recommended along with cognitive behavioural therapy. The focus is to overcome depressive symptoms and thoughts. Disengagement from negative thoughts will bring optimism and keep the client away from suicidal thoughts and self-harm intentions.
Therapeutic Approach and Action Plan
The chosen therapeutic approach for the client focuses on community engagement, cognitive and behavioural dimensions, and psychoeducational attributes. Mindfulness-based cognitive behavioural therapy can help the client boost their cognitive skills and behavioural stimulation. Mindfulness enriches from within through mindful formal exercises like mindful stretching, sitting meditation, and yoga. It is effective to do it in a community along with others seeking the same intervention. Psychoeducation arm of intervention means focusing on thought patterns that thoughts are temporary, and events are passing. The client should not be stuck with them (Putri et al., 2025). Cognitive behavioural therapy focuses on helping the client to identify and modify negative and irrational thoughts. Self-harm intentions and suicidal thoughts are irrational ones. The focus is to improve mood and function. The action plan is also to introduce these interventions so that the client can recover from the adverse situation and can think of being a normal person. If he shows healthy signs of improvement, it can be requested to set him free from jail and make him part of society like a normal person.
Reflective Practice
Reflective practice is useful for practitioners in the counselling profession, like the one this case is helping, a 26-year-old client. The counsellor and practitioner should be involved in reflective practice as it provides confidence and enables self-improvement (Priddis and Rogers, 2018). It can also cause stress and uncertainty in some individuals, but it offers positive outcomes generally. The counsellor will be self-accountable for the interventions and methods devised for the client. He should be self-aware regarding strengths and weaknesses. The same should be for the client to know how much he is capable of following the interventions introduced. Ethical compliance and professional competence are an important part of reflective practice. Such a professional revision of actions and views from the counsellor can help to make the whole approach credible and trustworthy. The client should also be encouraged to be part of the reflective practice because it is a very good guide.
Conclusion
The presentation concludes that the client is still vulnerable and there should be a proper supportive environment around him. A counselling session with him can serve this purpose by guiding him towards improvement and change in his thoughts and actions. Devised interventions have focused on overcoming his self-harm and suicidal intentions. Depression and anxiety have also been the focus of resolution. This plan helps him to recover from negative thoughts and develop the foundation towards healthy actions.
References
Bell, L. (2021). Helping People Overcome Suicidal Thoughts, Urges and Behaviour. Abingdon: Routledge.
Navarro, J. L. and Tudge, J. R. (2023). Technologizing Bronfenbrenner: neo-ecological theory. Current Psychology, 42(22), pp. 19338-19354.
Nursing & Midwifery Council (2026). About us. [Online] Available at: https://www.nmc.org.uk/about-us/
Oppedal, B., Keles, S., Cheah, C. and Røysamb, E. (2020). Culture competence and mental health across different immigrant and refugee groups. BMC Public Health, 20(1), p. 292.
Predescu, E. and Sipos, R. (2023). Self-harm behaviours, suicide attempts, and suicidal ideation in a clinical sample of children and adolescents with psychiatric disorders. Children, 10(4), p. 725.
Priddis, L. and Rogers, S. L. (2018). Development of the reflective practice questionnaire: preliminary findings. Reflective Practice, 19(1), pp. 89-104.
Putri, T. H. et al., (2025). Therapeutic Nursing Interventions to Reduce Self-Injurious Behaviour: A Scoping Review. Journal of Multidisciplinary Healthcare, pp. 8267-8276.
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