Case Vignette: Diagnostic Impressions?
The client is a 25 year old male who has been participating in therapy to address concerns of PTSD symptoms that arose from an event that occurred 6 years prior to therapy. The client recently returned to the area to live with his parents following an intensive inpatient treatment program for drug and alcohol abuse. The client has returned to college to complete his education and pursue a career in the medical field. The client had progressed well in individual therapy regarding the PTSD symptoms for the first 6 sessions and appeared to be progressing in his studies.
At session 7, the client disclosed that he has become “obsessed” with a woman who is presently getting divorced. The client stated …show more content…
The emotional and physical safely of the client needs to be assessed. Substance abuse or substance dependence can cause developmental delays which can diminish a person’s capacity to deal with stressors and may lead to interpersonal challenges (M. DenBoer, personal communication, August 15, 2014). It is important to determine if the client has remained sober or if he has used alcohol or drugs since being discharged from the in-treatment facility. Additionally, more information about the client’s relationship needs to be obtained in order to identify what the client meant when he claimed to be “obsessed” and “in love” with a woman he had not been previously mentioned in therapy. Due to the intensity of the client’s emotions, it would also be prudent to perform a risk assessment for physical or emotional harm that may be present for either individual. For example, it would be important to identify if he is stalking her or exhibiting unsafe behaviors toward her or her child. It is also important to assess if the client has any suicidal ideation or plans for self harm and if the client has access to …show more content…
Provide a safe therapeutic place to discuss those stressors and strategize how to best address them. This could be done with Cognitive Behavioral Therapy (CBT) techniques.
3) Provide psychoeducation regarding culturally sanctioned but disruptive behavior patterns of replacing the addictions with a culturally sanctioned one. For example: a relationship, coffee, food, or workaholic behaviors. Help the client to identify if any of his recent thoughts, behaviors, or reactions could be attributed to this theory.
4) Help the client create a safety plan in case the relationship with his girlfriend or parents become too intense. Ensure that the client has identified a safe place to go to calm down and be physically safe. This safety plan should identify his access to weapons, drugs, and alcohol and help the client create a plan to remove those elements from his surroundings. For example: remove the alcohol or drugs from the house and give any weapons to a friend for