Diagnostically, I would consider Lorena for a Borderline Personality Disorder 301.083 (F60.3) (DSM-5). Lorena meets the criteria for a borderline personality disorder: an enduring pattern of instability concerning interpersonal relationships, self-image and emotional regulation, with increased impulsivity that begins by early adulthood. This pattern of instability and impulsivity is present in a variety of contexts and includes: Desperate efforts to avoid real or imagined abandonment, identity disturbance, impulsivity in shopping and relationships, suicidal or self-mutilating behaviors, inappropriate, intense, uncontrollably anger (DSM-5).
Lorena is displaying great instability, including impulsivity, great shift in moods, and an unstable …show more content…
Next, Lorena would benefit from education regarding domestic violence, including information emergency number, shelters and institutions that can help if she decides her situation has become dangerous. Education regarding CBT and mindfulness can help begin to build the therapeutic alliance that is necessary to get this difficult population to continue in and participate in therapy. Education regarding CBT structure and process (e.g., problem-focused, time limited, with a present moment focus) may facilitate Lorena’s participation in homework between therapy sessions which increases her prognosis for healthy change. The therapist should work collaboratively with Lorena to start investigating the connection between her difficulties and the signs and symptoms of a personality …show more content…
She unaware of how her past is effecting her present life and present behaviors are self-defeating and the cause of her present difficulties. She is unaware of the nature and negative affect her symptoms are having on her life. Motivational techniques can assist in moving Lorena toward a more objective outlook on her present difficulties (Wenzel, 2013).
Since Lorena is unaware of her need for treatment the therapeutic relationship will be especially important so that she will see the need to actively participate in therapy. Mindfulness can help cultivate critical aspects of the therapeutic relationships. Factors, such as empathy, unconditional positive regard and congruence can be cultivated by mindfulness. These factors are essential to the building of a healing relationship and a more positive therapeutic outlook (Germer, Siegel & Fulton, 2013).
Cognitive restructuring techniques can teach Lorena how to identify, evaluate and modify any unhelpful automatic thoughts that are driving her avoidance behaviors. The therapist can teach techniques (i.e., thought recording, cost-benefit analysis, reattribution and coping cards) to begin the process of modifying unhealthy underlying beliefs about work and interpersonal relationships (Wenzel,
Lorena is displaying great instability, including impulsivity, great shift in moods, and an unstable …show more content…
Next, Lorena would benefit from education regarding domestic violence, including information emergency number, shelters and institutions that can help if she decides her situation has become dangerous. Education regarding CBT and mindfulness can help begin to build the therapeutic alliance that is necessary to get this difficult population to continue in and participate in therapy. Education regarding CBT structure and process (e.g., problem-focused, time limited, with a present moment focus) may facilitate Lorena’s participation in homework between therapy sessions which increases her prognosis for healthy change. The therapist should work collaboratively with Lorena to start investigating the connection between her difficulties and the signs and symptoms of a personality …show more content…
She unaware of how her past is effecting her present life and present behaviors are self-defeating and the cause of her present difficulties. She is unaware of the nature and negative affect her symptoms are having on her life. Motivational techniques can assist in moving Lorena toward a more objective outlook on her present difficulties (Wenzel, 2013).
Since Lorena is unaware of her need for treatment the therapeutic relationship will be especially important so that she will see the need to actively participate in therapy. Mindfulness can help cultivate critical aspects of the therapeutic relationships. Factors, such as empathy, unconditional positive regard and congruence can be cultivated by mindfulness. These factors are essential to the building of a healing relationship and a more positive therapeutic outlook (Germer, Siegel & Fulton, 2013).
Cognitive restructuring techniques can teach Lorena how to identify, evaluate and modify any unhelpful automatic thoughts that are driving her avoidance behaviors. The therapist can teach techniques (i.e., thought recording, cost-benefit analysis, reattribution and coping cards) to begin the process of modifying unhealthy underlying beliefs about work and interpersonal relationships (Wenzel,