Case Conceptualization

Theory/Theorist: Name your theory (Adlerian, Person-Centered, Gestalt, Family systems, etc.—-pick one according to the directions in class)

Presenting Problem: Describe the client (name, age, gender, ethnicity, family, etc.) and the client’s issues in terms of how you perceive problems/issues (e.g., client exhibited symptoms of anxiety – pressured speech, tense features, agitated or restless). Be sure to include contributing factors.

Hypothesis: Explain why the client is experiencing these problems. If you see client as socially disconnected (indicating low social interest) from an Adlerian view, explain the evidence for this from the details in the case study. If you are posting for person-centered, provide evidence from the case that suggests the client is living incongruently. Be sure to always relate how you see the client to the features of the theory.

Goal: Explain your goal for your client in terms of the theory you are using. In other words, what would an Adlerian counselor want to see happen for the client and why? Be sure to cite your reference(s). For example, an Adlerian counselor might want to encourage the client to engage in a lifestyle that meets their social needs; whereas a person-centered counselor might want to see clients live congruently.

Interventions: List a minimum of two intervention from the approach you have chosen (outlined in readings), explain each intervention and why it might be useful in meeting goals.

· Intervention 1: Explain your method (and cite your source) and why it would be useful for your client in meeting goals

· Intervention 2: Explain your method (and cite your source) and why it would be useful for your client in meeting goals

Expected Outcome: The goal of xxxxx therapy is . . .. . Explain what outcome(s) you hope to achieve for your client using the interventions above. Support your thoughts with citations from our textbook and/or other resources.

References: List your references here. See Doc Sharing on proper citing and referencing. Remember you must cite and reference the chapter author(s) NOT the editors of our textbook.

Copy and paste your conceptualization into the Discussion Board. Do not use a title page and do not attach the document. Your post must be able to be easily seen in the Discussion Board. Delete these instructions. Thank you.

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This is an example of what you are being asked to do in Weeks 2, 3, 4, 6, 7, 8 and 9.

DO NOT apply psychoanalytic to any of the case studies.

Case Conceptualization

Case of Deidre – Psychoanalytic Theory

Presenting Problem: Deidre, a 22-year-old college senior of mixed African American and Latina heritage, was referred by her MD for symptoms of anxiety. She practices meditation but does not identify as religious. Her parents divorced when she was 9 and she reported a stormy relationship with her “moody” mom. Her dad was a calming presence but died suddenly 5 years ago of a heart attack. Deidre reported using drugs (marijuana preferably) and alcohol to cope. When she was 18, she became pregnant at a party and chose to have an abortion. This complicates her present relationship with Tom, her boyfriend of 4 years as he is prolife and they are considering marriage.

Hypothesis: Deidre’s anxiety is rooted in her early childhood experiences, her lack of secure attachment to her mother, the sudden death of her father, and her abortion. Much of her distress comes from unconscious struggles as her ego tries to balance her instinctual drives (her id) and her superego (Johnson, 2016). Deidre’s defense mechanisms of repression, avoidance, and rationalization help cope with her fear that if she tells Tom of her abortion he will abandon her. This is an unconscious attempt to bolster her fragile ego, likely linked to her early childhood experiences, her father’s death, and her fear of losing Tom.

Goals: The primary goal for Deidre is to increase awareness of unconscious drives and past experiences (Johnson, 2016) as related to her anxiety, drug and alcohol use, and feelings of guilt. Bringing deeply buried feelings and thoughts into consciousness will allow them to be examined and worked through building insight.

Interventions:

Free Association: Deidre will be encouraged to state any thoughts or feelings that come to mind in response to a word prompt, without censoring them. The goal is not to uncover specific memories but uncover patterns of thought. Then, she will be assisted to analyze the underlying unconscious feelings associated with these disclosures (Johnson, 2016).

Analysis of Resistance: When Deidre unconsciously reacts to keep unpleasant or perceived negative experiences hidden by changing the topic, refusing to respond, or giving up on counseling, her resistance will be analyzed (Johnson, 2016). These behaviors indicate that she is unconsciously trying to avoid threatening thoughts or feelings. These acts interfere with the ability to accept changes that could lead to a more satisfying life. Deidre will be encouraged to consider what these thoughts and feelings might be as well as how they are an important influence on the client’s mental health (Psychoanalytic theory and approaches, n.d.).

One example of Deidre’s resistance is keeping secrets from her boyfriend, Tom, and using drugs as a way of coping with her anxiety.

Expected Outcomes: Deidre’s anxiety will diminish because of her increased insight into her unconscious drives. She will be empowered to make decisions based on the insight she has gained. Her id, ego and superego will be more balanced and healthier.

References:

Johnson, A. L. (2016). Psychodynamic theory. In D. Capuzzi & M. D. Stauffer (Eds.),  Counseling and psychotherapy: Theories and interventions (6th ed., pp. 73-96). Alexandria, VA: American Counseling Association.

Psychoanalytic theory and approaches. (n.d.). Retrieved November 18, 2018 from http://www.apsa.org/content/psychoanalytic-theory-approaches.

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Olivia

Olivia is 15 years old and lives with her father, Luis (age 40), her younger sisters, Catrina (7) and Elena (9), and her brother Sancho (11). Olivia’s mother, an Irish American woman, and her father met and married after Luis moved from Honduras to the US mainland, but their marriage ended when Luis’s wife, Sinead, chose to pursue a new romantic relationship and abandoned the family. Olivia’s mother has had little contact with her children since she left when Olivia was 9 and a year after Catrina was born. Sinead sends birthday and Christmas cards from different places where she is living and working as a traveling nurse. Although she makes good money, she pays no child support, nor does she pay spousal support although she makes twice as much money as Luis.

Olivia’s father, Luis, works two jobs to make ends meet. He is a full-time truck driver on weekdays (having to leave for work before his children are awake) and does maintenance for a retirement center on weekends to support his family. The family rents an apartment, and Luis struggles to manage his family’s living expenses due to rising costs. Olivia assumes much of the responsibility for housework and caring for her siblings because her father is often working away from home. Luis is proud that Olivia can manage so many household duties and tells Olivia she is fulfilling a vital role now and in her future as a wife and mother.

Olivia has been referred to you due to her failing grades and school attendance issues. Olivia has begun to struggle in her classes at school and has missed many days because she is often tired and unfocused. When in school, Olivia is very quiet, keeps to herself, and doesn’t have many friends. When asked about her performance, she tells her teachers that she worries constantly about her siblings and tries to help them with their homework and learning while keeping up with cooking, cleaning and laundry duties at home. She says that she feels like a disappointment to her teachers and is sad about this. Olivia says she would like to become a veterinarian, but does not see how she will ever be able to attend college because of her father’s expectations for her both in the home and the future. Olivia enjoys reading about the animals of the world in the evenings when her chores are done. Olivia shares that she misses her mother, and she has not seen or talked to here since she left 6 years ago. Although she is proud to be able to help her family, she wishes she had more friends her own age at school and feels as though she has taken her mother’s place at home. She says she does not dare to dream about her future because it seems so bleak.

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