Work Case Study Examples

Working Hypothesis
Josh’s fiancé being struck and killed by a drunk driver as they were about to meet for lunch and her dying in his arms, is the participating situation that triggered the start of Josh’s symptoms. The subsequent anxiety that developed, as Josh held himself responsible for his fiancé’s death as well as the death of his sister 4 years’ prior, resulted in the current maladaptive thought patterns, anxiety, and depressive symptoms Josh presented with for treatment. Josh learned through the conditioning that occurred through the traumatic event he experienced, that avoiding experiencing those memories by not going to that side of town, as well as drinking alcohol until he blacks out, reduces his symptoms of anxiety, rumination,
An initial goal is to (1) increase Josh’s desire to live without his fiancé. Another initial treatment goal is (2) to decrease his recurring thoughts and nightmares. The third initial treatment goal (3) is to decrease Josh’s avoidance behavior related to him not being able to go to the side of town where his fiancé was killed. It is anticipated that increases/decreases in these symptoms will result in subsequent increases/decreases in (a) Josh’s desire to live without his fiancé, (b) Josh’s drinking to cope with his recurring thoughts/nightmares, (c) Josh’s flat affect and withdrawn symptoms and (d) Josh’s anhedonia (loss in pleasurable
First, Josh will be socialized to the treatment process; that is, he will be educated regarding the cognitive and behavioral models of PTSD and the rationale for the various treatment methods will be used. Early in treatment Josh will be taught, relaxation techniques so he is better able to cope with his anxiety. He will be taught to engage in controlled breathing and muscle relaxation. Also, Josh will be taught cognitive restructuring techniques, so that his distorted automatic thoughts, dysfunctional schemas, and maladaptive assumptions related to guilt, his own death, and the death of his fiancé can be challenged. Furthermore, prolonged exposure will be taught to Josh, in order to reduce association with memories related to the trauma he experienced. Josh will be asked to emotionally expose himself repeatedly and for a prolonged period of time to memories and cues that provoke his anxiety related to the trauma he experienced. The exposure of Josh’s memories that provoke his anxiety over time, will gradually decrease the strength of his associations, resulting in better ability to cope,