Application: Matching ESTs to Client's Presenting Problems
As you may have discovered in this week's Discussion, it is not always easy to identify which treatments are empirically supported and which treatments are not. The Society of Clinical Psychology (SCP) of the American Psychological Association (APA Division 12) has put together a good summary of current empirically supported treatments. These treatments have various levels of empirical support and they are grouped by the disorder that the treatment purports to help. In addition, clinical research literature contains many studies that provide empirical support for a variety of treatments that may not have been cataloged on the SCP Web site. In this week's Application, you examine three case studies and match one empirically supported treatment to each case.
To prepare for this assignment:
Review Case Studies: Alex, Sam, and Mary.
Make a preliminary diagnosis for each client in the case studies. Review that diagnosis in The Complete Adult Psychotherapy Treatment Planner or DSM-IV TR.
Review the SCP Web site https://www.div12.org/PsychologicalTreatments/treatments.html. Focus on treatments that match the preliminary diagnosis you developed for Alex, Sam, and Mary.
Justify your ESTs. Be sure to use treatments from randomized controlled clinical trials.
The assignment: (2-3 pages)
1. Write a brief description of your preliminary diagnosis for the client in each case study.
2. Select an empirically supported treatment for each client and justify your selection.
Psychotherapy Interventions II
Case Studies: Alex, Sam, and Mary
Alex is a 32-year-old Caucasian female who presents to psychotherapy due to repeated "failures" (as she described them) in relationships. She describes herself as "losing herself" in relationships and "giving them her all" so that when they are over, she feels very abandoned, anxious, depressed, and empty. She reports that she is never the one who breaks up with others; she is always the one who is "dumped." She admits that she can be emotionally intense and that she secretly wonders if she scares people off, but at the same time, she believes that love should be "all consuming." Alex has a history of substance abuse, primarily cocaine, and usually at parties. She also admits that when not in a relationship, she seeks numerous sexual partners and doesn't always practice safe sex. She, also, after telling you that you are the best and most understanding therapist she has ever met (and she has had five therapists in the last three years), shows you some superficial cuts on the upper part of her left arm and you observe some significant scarring indicating that this is not the first time she has injured herself.
Sam is a 42-year-old Asian male who owns a real estate business; he comes to therapy because of repeated episodes of heart palpitations. He has been in the emergency room three times this month alone and doctors have suggested that he has an emotional or mental issue rather than a physical one as they can find nothing indicating heart disease. Sam reports that his business is suffering and he fears that his marriage is heading toward divorce due to financial stress. He tells you that he has episodes in which his heart races, he feels like he is "in a movie or not real," he sweats profusely and feels nauseated, and he honestly believes at the time that he is having a heart attack. Sam said that the episodes come "out of the blue" and that he is so fearful of having another one in public that he has started staying home more, which is further disrupting his business and straining his marriage. Sam takes no medication and has no history of substance abuse.
Mary comes to your office stating that she is feeling very sad and lonely. She tells you that she just doesn't have energy anymore and that she has lost interest in spending time with friends and family, her job, which she used to find very rewarding, and her hobby of scrapbooking, which used to occupy most of her free time. She reports that she lies on the couch most of the day when she is not at work and flips through TV channels. Mary states that while at work, she is absentmindedly surfing the Web rather than completing job tasks. When you ask about her memory and ability to concentrate, Mary admits that she has a hard time focusing on what to do each day and she rarely completes tasks she starts. Mary is worried that she is going to lose her job because of the way she is feeling. She also reports that she wakes up early in the morning and can't get back to sleep, and that she cries for long periods, often with no warning. Mary discloses that she was divorced six months ago, and that things have become progressively worse for her emotionally since that event. She also admits that she has lost about 25 lbs. and that she just doesn't seem to taste food anymore.