7) You are assigned to work with a 36-year-old patient who has shown up to a cli

Question

7) You are assigned to work with a 36-year-old patient who has shown up to a clinic seeking psychotherapy. He confides in you that he believes that he may have "OCD" symptoms that negatively impact his daily functioning. When you question him about his symptoms, he mentions that he “is really compulsive about stuff , yet provides few details when pressed. As you continue work with him he brings up concerns about having experienced past trauma. When you ask if he has ever been sexually abused he responds that he has, yet again he cannot provide clear details. Some other healthcare providers have expressed concern about the accuracy of his diagnoses. In a well-written essay discuss and consider potential diagnoses from the textbook chapters (i.e., chapters 5-8). What would be needed to support or disconfirm such a diagnosis or set of diagnoses?

Explanation / Answer

In the given case, careful analysis and comprehensive differential diagnosis may have to be carried out in order to arrive at an accurate diagnosis for this person. This 36 year old may be showing visible signs of Post Traumatic Stress Disorder (PTSD) and the compulsive behavior which he claims to be having may be simply be a culmination of that. Since the client has expressed undergoing sexual abuse, the same may have had a devastating impact on his functioning. Revealing few details and not being forthcoming will have to be challenged by the therapist so that a detailed insight can be gained into his situation. This can be done by using a very non-intrusive, non-judgemental and flexible approach wherein an openness in the environment can be created for the client. This space allowed to him must make him confide in the therapist with the belief that he will not be judged or looked at critically by any means. In fact, unconditional positive regard may be provided to the client wherein his dignity and self-worth is of utmost importance. Showing empathy and compassion can lead to more openness regarding the past. Therefore, in order to confirm/disconfirm a disorder it would be important to gain a detailed insight into the life experiences of the client before a conclusion can be made. Once more details and facts are uncovered, the assisting manuals like DSM V could be used to see which diagnostic criteria are being met in the case of this client. The conditions could also show comorbidity wherein two disorders are simultaneously occuring in a person and the same possibility must be explored after a tentative hypothesis is made by the therapist. Moreover, in case of challenges, working in collaboration with a team to get supervisions and engage in case meetings to rule out confusion may seem like a wise choice.

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