Psychotherapy
Introduction
Psychotherapy is a field of medicine that entails the treatment of mental disorders using more profound psychological approaches instead of prescribing medication. In this practicum journal, a case study is presented of a client who I counseled after she had suffered from intimate partner violence that progressed to Post Traumatic Disorder (PTSD). The description of the client is developed within the confines of the HIPAA privacy regulations that establish the universal measures involved in the protection of a patient’s medical records as well as other personal information. As such, the patient’s description includes their pertinent history as well as medical information such as their current prescribed medication. The diagnosis of the client is based on the DSM approach, which leads to the development of the most appropriate therapeutic approach to be applied while considering the legal and ethical implications that affect the counseling process.
Client Description
The client presented in this case is a neighbor, a 26-year-old woman of the African American descent by the name Carol, within our community who I had to counsel following her incident that leads to her suffering from trauma. She had suffered spousal and domestic abuse and needed psychotherapy. Upon getting married, Carol had moved from another state two years ago and is a housewife without any marketable skills. According to her report, her husband, Anthony, had been both emotionally and verbally abusive to her on a regular basis. Anthony does not allow Carol to have any contact whatsoever with her family, and neither is she allowed to have friends. She adds that the abuse had intensified to the extent that she has become afraid of her life due to the threats made by her husband. The neighbors had to intervene by calling the police due to the frequent wrangles and fights, a move that helped her separate from her husband. Nonetheless, Carol is currently afraid that she might be manipulated again by her husband, considering that she does not have any social support system. Furthermore, her lack of marketable skills also makes her vulnerable to Anthony. She is also traumatized in such a way that she perceives all men to be manipulators, exploiters, and unreliable due to her past experiences. The client is not under any prescription medication.
Applying the DSM Model
Using the Diagnostic and Statistical Manual for Mental Disorders (DSM) approach, Carol’s diagnosis is that of a person who has PTSD based on intimate partner violence. Such a diagnosis is structured around the predetermined criteria of the exposure to aggression and violence from her husband, who is the intimate partner. Over the course of her marriage, Carol has experienced intense and severe episodes of violence. As such, she meets a considerable number of conditions based on the DSM to facilitate the aforementioned diagnosis. In this case, Carol has been frequently subjected to psychological aggression based on emotional abuse (Sperry, 2016). Such an aspect of her situation influences the development of the diagnosis.
Therapeutic Approaches
From the learning resources, Cognitive Behavioral Therapy (CBT) would be the most effective therapeutic approach to be used in this case. Because the client is a victim of psychological abuse that was geared towards manipulating and controlling her, the CBT approach proves to be relatively effective. The victim’s situation and occurrences have had adverse effects on her behaviors, thoughts, as well as her emotions. As such, the CBT approach focuses on the application of a stepwise methodology to address the adverse implications of abuse. The stepwise methodology begins by identifying the problem and reflecting on the abuse itself, thereby determining the justification methods applied to the abuse. Subsequently, this approach reflects on how behavior was ultimately affected by the change in thoughts and emotions while developing competent measures to transform negative emotions (Wheeler, 2013). As a result, the use of CBT guarantees the client’s protection regarding her emotions, behaviors, and thoughts.
Legal or Ethical Implications
The approach used towards counseling Carol is structured around the legal implications of disclosures and confidentiality. In this regard, since the abuse contains legal implications, the details presented by the client could oblige the counselor to involve law enforcement officers (Fisher, 2016). This is more likely to happen when the abuse persists, and the law enforcement personnel are not aware of the same. According to Cautlin and Lilienfeld (2015), such a situation could be relatively challenging considering that the client has been assured of confidentiality in the sense that no information can be shared with another individual without her being informed prior to providing consent.
Conclusion
Based on the diagnosis made for Carol of PTSD influenced by intimate partner violence, the most appropriate therapeutic measure was the CBT. The client had been subjected to a significant level of trauma due to violence and aggression from her husband. However, counseling this client would be limited by the legal implications established through patient confidentiality and disclosure. In case the client did not want the sensational details provided to be disclosed to any third party, then the intervention process would be inhibited, and its effectiveness suppressed.
References
Cautin, R. L., & Lilienfeld, S. O. (Eds.). (2015). The Encyclopedia of Clinical Psychology, 5 Volume Set. John Wiley & Sons.
Fisher, M. A. (2016). Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals. American Psychological Association.
Sperry, L. (2016). Handbook of diagnosis and treatment of DSM-5 personality disorders: Assessment, case conceptualization, and treatment. Routledge.
Wheeler, K. (2013). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Springer Publishing Company.
