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.)Links to an external site..

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.

PSY650 Week Four Treatment Plan

Behaviorally Defined Symptoms: Karen displays extreme emotional reactions at the hint of perceived abandonment in a relationship. There is a history of unstable and intense interpersonal relationships, impulsive behaviors, and recurrent suicidal gestures.

Diagnostic Impression: Borderline Personality Disorder

Long-Term Goal: Terminate self-harming behaviors (substance abuse, cutting, and suicidal behaviors).

Short-Term Goal: Reduce the frequency of maladaptive behaviors, thoughts, and feelings.

Intervention 1: Dr. Banks will outline the process of Dialectical Behavioral Therapy.

Intervention 2: Karen will commit to attending group behavioral skills training and individual psychotherapy.

Intervention 3: Karen will participate in imaginal exposure to trauma, until the memories no longer cause marked distressed.

For additional information regarding Karen’s case history and the outcome of the treatment interventions, please see Dr. Bank’s session notes under Case 15 in Gorenstein and Comer’s (2015), Case Studies in Abnormal Psychology

References: (Should be utilized)

Gorenstein, E. E., & Comer, R. J. (2015). Case studies in abnormal psychology (2nd ed.). New York, NY: Worth Publishers.

· Case 15: Borderline Personality Disorder

Sneed, J. R., Fertuck, E. A., Kanellopoulos, D., & Culang-Reinlieb, M. E. (2012). Borderline personality disorder. In P. Sturmey & M. Hersen (Series Eds.), Handbook of evidence-based practice in clinical psychology: Vol. 2. Adult disorders. (pp. 507-529) [E-book]. Hoboken, N.J.: John Wiley & Sons.

Rizvi, S. L., Steffel, L. M., & Carson-Wong, A. (2013). An overview of dialectical behavior therapy for professional psychologists. Professional Psychology: Research and Practice, 44(2), 73-80. doi:10.1037/a0029808

Harned, M. S., Tkachuck, M. A., & Youngberg, K. A. (2013). Treatment preference among suicidal and self-injuring women with borderline personality disorder and PTSD. Journal of Clinical Psychology, 69(7), 749-761. doi:10.1002/jclp.21943

Luxton, D. D., McCann, R. A., Bush, N. E., Mishkind, M. C., & Reger, G. M. (2011). mHealth for mental health: Integrating smartphone technology in behavioral healthcare. Professional Psychology: Research and Practice, 42(6), 505-512. doi:10.1037/a0024485

Miller, T. W. (2006). Telehealth issues in consulting psychology practice. Consulting Psychology Journal: Practice and Research, 58(2), 82-90. doi:10.1037/1065-9293.58.2.82

***Each response needs to be ½ page or more***

RESPONSE 1

Respond to two colleagues who discussed a different leadership skill. Explain the importance of building these skills and how they relate to facilitating the group process.

Colleague 1: Farren

Facilitation of Group Processes

During the PTSD group session the social worker played an important role in facilitating the group. While observing the group, the social worker’s facilitation of the group’s process could be seen as both positive and negative. She engaged with the members and appeared to be sympathetic and used non-verbal cues to show the members that she really cared about the feelings that they were expressing. However, she did not engage all 6 of the members that were in the session as she pointed out that only a few of them were home from the war. According to Toseland and Rivas (2017) social workers are to be mindful of their input when running group session. This is evident in the group session with Levy as he became really offended when she had input regarding his drinking (Laureate Education, 2013).

Assessment & Action

The social worker did a great job of communicating with the members of the group who were very vocal and from her nonverbal cues she was able to pick on the conflict between the 2 group members. However, she did not address the confrontation which turned out to be a good thing as Levy was able to reflect on how his drinking is affecting his life and marriage. One action that could have been improved by the social worker was that she could have asked for addition input from the other group members who have not said anything. That would have been a great time to open up a discussion for the group and get the other members to share how they are coping with now being a civilian.

Suggest another way the social worker might have initiated the group conversation.

One way that the social worker could have done a better job of initiating the group conversation would be to ask a question and include all of the group members by going around and having them answer if they were comfortable. She could have had each group member also share a coping mechanism that they are using and each share how effective/no effective their coping skills are.

Reference

Laureate Education. (Producer). (2013d). Levy (Episode 6) [Video file]. In Sessions. Baltimore, MD: Producer. Retrieved from https://class.waldenu.edu

Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston, MA: Pearson

Colleague 2: Denise

The social worker had good attending skills. She had good eye contact with everyone in the circle. She was empathic and respectful. Her voice was soft and warm and her body language was relaxed. She did hear what Levy was saying, however I do not feel that she correctly responded to him. “effective attending skills include repeating or paraphrasing what a member says and responding empathically and enthusiastically to the meaning behind members’ communications” (Toseland & Rivas, 2017, p. 131). I’m not sure that I would have asked Jake if he finds himself drinking more now than usual. I think I would have asked Jake why he felt his struggle was between two six packs or a case of beer.

She did have good responding skills. She asked open ended questions. The gentlemen in the group were not able to respond to her with a yes or no. I think in a group like this one, it is important to ask questions that will get them to open-up. I also liked how she didn’t intervene when Jake got upset with the gentleman next to him. I feel that the gentleman next to Jake was the one that softened him enough to begin to open-up about why he was in the group. A good leader is going to know when to intervene and when to allow the group members to talk.

I think she did a great job with identifying and describing skills. She opened the group by stating that she knew some served in Iraq and some served in Afghanistan. I think through her opening statement it allowed the guys to know they were somewhere where others will understand them. She also did a good job of requesting information, questioning, and probing. She did get a little bit of anger from Jake when she asked about his drinking. However, I feel it was an important issue to address, and it led to Jake opening-up as to why he was there. The way she handled Jake’s response and the gentleman next to him, led to Jake feeling vulnerable and willing to open-up.

Disclosure was used by the social worker. “Disclosure is an action skill that should be used sparingly by the worker for the specific purpose of deepening the communication within the group…workers should remember, however, that their main role is to facilitate communication among members” (Toseland & Rivas, 2017, pp. 139-140. She knew her place during this session. She spoke when she felt she needed to and she was quiet and listened when she knew she needed too. She also used confrontation skills. After Jake opened-up as to why he is drinking, she asked the group what their coping skills were to help them deal with their experiences. She was soft spoken and empathic throughout the session and I feel like her demeanor is one of the reasons why the guys were willing to open-up.

Reference

Toseland, R.W., & Rivas, R.F. (2017). An introduction to group work practice (8th ed.). Boston, MA: Pearson. “Leadership” (pp. 114-152).

Laureate Education. (Producer). (2013d). Levy (Episode 6) [Video file]. In Sessions. Baltimore, MD: Producer. Retrieved from https://class.waldenu.edu

RESPONSE 2

Respond to a colleague who identified a different benefit in the video. Describe how the social worker’s role as leader impacts the effectiveness of group intervention.

Colleague 1: Denise

There were many benefits In the Levy group discussion.

1-“One of the distinct advantages of group work over individual work is the ability of group members to rely on one another for help in solving problems and accomplishing goals” (Toesland, Rivas,2017). The worker was able to allow the group members to work through the issues they were experiencing. She used simple guided example and questions to help move the conversation along

2- Another benefit of the group was the ability of the member to call out each other for not being honest. Through this there group has been effective in helping the member of the group, as there was a sense of realization for one of the members that was struggling to process what he was experiencing. The members of the group were able to work on their confrontation skills. “Confrontation is the ability to clarify, examine, and challenge behaviors to help members overcome distortions and discrepancies among behaviors, thoughts, and feelings”(Toesland, Rivas,2017).

3- The leader of the group asked probing questions that kept the group moving along. She did this gracefully as she did not rush the group.

References

Laureate Education. (Producer). (2013d). Levy (Episode 6) [Video file]. In Sessions. Baltimore, MD: Producer. Retrieved from https://class.waldenu.edu

Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston, MA: Pearson.