Case Analysis at Treatment Format
Prior to beginning work on this weeks journal, read the PSY650 Week Four Treatment Plan ,Preview the document Case 15: Borderline Personality Disorder in Gorenstein and Comer (2014), and Borderline Personality Disorder in Sneed et al., . (2012). Please also read the Rizvi, et al. (2013), “An Overview of Dialectical Behavior Therapy for Professional Psychologists,†Harned, et al. (2013), “Treatment Preference Among Suicidal and Self-Injuring Women with Borderline Personality Disorder and PTSD,†Miller (2006), “Telehealth Issues in Consulting Psychology Practice,†and Luxton, et al. (2011), “mHealth for Mental Health: Integrating Smartphone Technology in Behavioral Healthcare†articles.
Assess the evidence-based practices implemented in this case study. In your paper, include the following.
Explain the connection between each theoretical orientation used by Dr. Bank’s and the interventions utilized in the case.
Describe the concept of dialectical behavior therapy, being sure to include the six main points of this type of treatment.
Explain Dr. Banks’s primary goal during the pre-treatment stage and how Dr. Banks related this to Karen in her initial therapy sessions.
Describe the two formats that Dr. Banks told Karen would be part of her treatment program.
Describe the focus of the second and third stages of treatment.
Assume the role of a consulting clinical or counseling psychologist on this case, and recommend at least one technology-based e-therapy tool that would be useful. Explain liability issues related to delivering e-therapy consultation, supporting your response with information from the Miller (2006), “Telehealth Issues in Consulting Psychology Practice†article.
Evaluate the effectiveness of the treatment interventions implemented by Dr. Banks supporting your statements with information from the case and two to three peer-reviewed articles from the Ashford University Library, in addition to those required for this week.
Recommend three additional treatment interventions that would be appropriate in this case. Use information from the Sneed, Fertuck, Kanellopoulos, and Culang-Reinlieb (2012), “Borderline Personality Disorder†article to help support your recommendations. Justify your selections with information from the case.
The Case Analysis – Treatment Format
Must be 4 to 5 double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center (Links to an external site.).
Must include a separate title page with the following:
Title of paper
Student’s name
Course name and number
Instructor’s name
Date submitted
Must use at least two peer-reviewed sources from the Ashford University Library in addition to the article required for this week.
Must document all sources in APA style as outlined in the Ashford Writing Center.
Must include a separate references page that is formatted according to APA style as outlined in the Ashford Writing Center.
TO BE RE-WRITTEN FROM THE SCRATCH
Evidence-based practice: borderline personality disorder
Theoretical orientation of interventions
Oneintervention used by Dr. Banks is dialectical behavior therapy(DBT) which is based on biosocial theory. This theory posits that disorders, disabilities and mental illnesses are personality traits determined by biology reacting to environmental factors. Developed by Marsha Linehan, DBTis evidence based treatment approach that combines cognitive behavioral therapy techniques, reality testing and Buddhist meditative concepts for cognitive and emotional regulation.
Dr. Banks also utilizes behavioral skills training (BST) to equip Karen with the skills necessary to cope with the BPD and to improve her life. BST has the steps of instructions, modelling, rehearsal and feedback to teach the learner new skills. It is based on applied behavior analysis that assesses the functional relationship between a targeted behavior and the environment so as to develop a desired alternative behavior.
The doctor also applies individual psychotherapy with a psychodynamic slant as posited by Sigmund Freud where the doctor developed a close therapeutic relationship with Karen with a view to exploring and positively influencing the latter’s thoughts, feelings and behaviors.
Another psychodynamic approach employed by the doctor is imaginal exposure where the doctor made Karen confront her feared childhood memories regarding physical and sexual abuse. This approach can be traced to the behavioral psychologists James Taylor and Joseph Wolpe who employed it with response prevention for such situations as anxiety and phobias.
Dialectical behavior therapy
Dialectical behavior therapy (DBT) is based on a recognition that the failure to have stable and easily controllable emotions emanates from invalidation during childhood, where the thoughts and feelings of the person were not taken seriously or were not supported. Developed for borderline personality disorder and chronic suicidal thoughts, it has been successfully used in treatment of depression, substance use, binge eating, among other diagnosis. The evidence-based treatment intervention is employed to incessantlysteady and fuse acceptance and change-oriented strategies.
There are six main points that differentiate DBT from other behavioral therapies. These points include support where the psychologist assists the client to appreciate, develop and utilize their strengths and attributes. Another point is behavioral where the client learns to analyze problems and or negative behavior pattern, replacing such problem or behavior with positive and healthy behaviors. There is also the cognitive point where the client aims to change ineffective or unhelpful thoughts, beliefs and behavior. The fourth main point of DBP is the client learning new skill sets so that they are able to improve their life. Acceptance and change is a point that involves the client accepting themselves, their emotions and their lifein general. They are also able to make positive changes in their behaviors ad relationships. Collaboration is the sixth main point of DBP and involves learning and effecting communication and teamwork.
Pre-treatment goal
The aim of the pretreatment stage was to get Karen to commit to dialectical behavior therapy for a minimum period. This is because persons afflicted by borderline personality disorder are predisposed to “impulsive, premature terminations of therapy”.
Obtaining the commitment involved Dr. Banks gaining Karen’s trust so that thepatient can easily accede to the doctor’s recommendation. Consequently, Dr. Banks got Karen to narrate her history, with the doctor empathizing with the traumatic experiences and……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..
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