Axis IV Case Study

DSM-V Diagnosis
Axis I 304.30 Cannabis Dependence, With Physiological Dependence, Early Full Remission – In a Controlled Environment
292.11 Substance-Induced Psychotic Disorder, Cannabis, with Delusions with Onset during Intoxication
302.82 Voyeuristic Disorder
302.4 Exhibitionistic Disorder
Axis II 301.83 Borderline Personality Disorder with Narcissistic features
Axis III 71.09 None
Axis IV is currently unemployment, history of substance abuse; familial history of mental illness, attempted suicide, difficulty is maintaining long term relationships, poor impulse control, unstable emotional state, unpredictability, and manipulative and volatile behavior.
Axis V GAF = 55 (at time of assessment)
Conceptual Formulation
There
In order to confront one’s career identity they experience challenges such as having to draw upon their personal feelings, and finding one’s purpose that is different from those around them (Mcllveen & Patton, 2007). Narrative emphasizes the social processes in creating knowledge, connecting it to the individual of such knowledge, and this mode of thinking and organizes our thoughts. The main principle in relational theories is that these relationships are central to human functioning throughout one’s life (Patton, Mcllveen, & Schultheiss, 2012). The language use of this style involves interpersonal relationships for example authenticity, mutual respect, mutuality, embeddedness, relational connections, disconnections, and reconnections (2012). Stages of narrative exploration are as followed: Stage 1 - negotiating a contract which involves asking question such as how can I be useful, tell me why is this important, indentify topics and related issues; Stage 2: exploring the story which involves asking questions about role models when young, hobbies/free time interest, books, favorite school subjects or disliked subject; and Stage 3 – identified goals, agreeing what action is required for example identifying potential
Identified Problem: Borderline traits
Treatment Goals: Long-term goals include developing a plan of recovery that reduced the impact of borderline traits on abstinence, to develop and be able to demonstrate coping skills to reduced mood swings and control impulses, to understand how borderline traits can cause relapse in addictive behaviors, to reduce any self-damaging behaviors such as suicide ideation, and to terminate dichotomous thinking, unmanaged anger, and/or fear of being abandoned (Perkinson & Jongsma, 2009).
Interventions: Interventions in the treatment of borderline traits include exploring history of abandonment during childhood years, validate distress and difficulties in thoughts and feelings; assess the client’s need for and arrange for a prescription, if appropriate; and use behavioral strategies to teach identified skills, strengthen them, and facilitate incorporation into everyday life (Perkinson & Jongsma, 2009). Additional interventions include reinforcing the client’s positive, reality-based cognitive messages that enhance self-confidence and increase adaptive action and facilitating the client’s personal growth by helping him choose experiences that strengthen self-awareness, personal values, and appreciation of life (Perkinson & Jongsma,