What Are the Challenges That Face a Psychotherapist Working with Self-Harm or Eating Disorders?

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“Using the case study provided develop a treatment plan for this client. Justify your assessment and proposed actions in terms of the relationship models and concepts introduced in the module” Word count 3163

I begin this study by assessment of the presenting problem and significant issues pertaining to his mental health state at this point in time. Mr G is at present suffering from depression. Due to the depression he will have a lack of motivation, self neglect, low self esteem, and at times hopelessness, and helplessness. He will possibly have anxiety, which, due to his fatigue with his illness, will be exacerbated because of the stress reaction and increase in adrenalin. This will cause him to be exhausted and possibly in need of sleep most of the time. His self esteem issues will have an impact on his relationship with his wife due to the fact that he will become more reliant on her. This will make him feel disempowered. Mr G will have to get used to the idea that his wife has to care for him more, and this will have an impact on his own personal values and beliefs. Within their relationship there may be frustration from both parties, but there might not be opportunity to discuss such issues because of the embarrassment or depression that Mr G has at present, or it may be that doesn’t happen in their relationship whereby they discuss their feelings and emotions. Due to the stress surrounding these issues, Mr G finds the impact of this affects the sexual part of their relationship and now has a dysfunction causing him more distress and making him feel a failure. He doesn’t feel he can become intimate with his wife because of this factor and feels there is a large part of their relationship missing at present. All these factors become heightened at times, making the depression more intense, leaving him feeling vulnerable and worthless. Before looking at a care plan for Mr G, I need to assess the importance of all these issues and how they impact on him as a person. Then using my theoretical knowledge put those in order of preference to enable Mr G begin to take control of his life and increase his self worth. As a therapist I would begin to explore the relationship Mr G has with his wife and how he sees the relationship. Mr G will have his own thoughts and pre conceptions as to how she sees the relationship but he may not have explored that with his wife. The therapist at this point has to remain neutral as it would be easy to collude with the client with their presenting issues. The therapist is there to support the client and help the client explore and evaluate the relationship for themselves. We may begin by looking at the balance of the relationship. I would use the `set of scales´ theory to explore this. Mr G would have to identify where the relationship was on a set of scales. Would the balance be even or would one side be higher than the other? Who is putting most energy into the relationship? Was one person more committed than the other? Is there equity in the relationship? By using this method I would gain insight as to the issues concerning Mr G and if they were negative statements because of his depression or self defeating in context, or if Mr G has communication problems with his wife or other issues. This would help with his explorations with his perceptions of the presenting issues or self awareness of how he alone sees the problem and the evidence he has to back up the thought s he is having. The therapist can also talk through with the client their perceptions of their own contributory factor to the present problem with the relationship which is very important to regain empowerment. As a therapist working with only one person in the relationship may not bring about great change but explorations with the one party can make that person look at the relationship and challenge or discuss with their partner the changes that need to come into play to enable the couple to function together, making their...
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