Psychology-help

Write a mock dialogue with a suicidal client. You may create a new scenario.

In your dialogue, demonstrate basic counseling skills, including reflective listening, empathy, and summarizing, as well as advanced skills like problem solving and goal setting. You will also need to demonstrate your sensitivity to the diversity characteristics of your client. Once you have agreed on a safety plan with your client, you will go on to develop goals and a treatment plan for future therapy sessions in collaboration with your client.

The dialogue portion of your project should be approximately half of the total length of your final paper. The rest of the paper should explain why you did what you did in the session based on empirical evidence from at least 20 references.

Abstract

Illustrated in this final assignment is a mock dialogue with a client expressing suicidal behaviors. Within the report, writer aims to demonstrate basic counseling skill like summarizing, empathy, reflective listening, problem solving, goal setting and cultural competency for diverse clients. Also included in the report will be treatment planning, goal setting and therapeutic plan developed with the client’s participation.

Counseling, Relationship Building, Goals, Treatment Planning

Introduction

Psychotherapeutic processes are in a constant level of flux across all aspects of psychological study. Amongst the most consistent questions posed by practitioners involves psychotherapeutic efficacy and efficiency. Through this constant intrigue a plethora of therapeutic processes has emerged. Theories rooted in the perspective of common factors to evidence based medical philosophies were being developed. The dimensions of the treatment setting were the only common factor across the varied processes. More specifically contributing procedures like therapist confidence, expectation for improvement and a therapeutic relationship rooted in warmth, understanding acceptance, kindness, trust and human wisdom (Castelnuovo, 2010).

Suicide is a constant concern when conducting psychological assessment for therapeutic considerations. Psychological practitioners should always include a risk assessment that allows them to gauge client’s potential for self-harm. An effectual suicide assessment consists of the following: 1) Mustering information related to the risk factors, protective factors and warning signs of suicide. 2) Amassing information on the patient’s suicide ideation, planning, desire, intent and behaviors. 3) Formulating a clinical resolution of risk with the information collected (Shea, 2009). The suicide rate is something that will also assist the practitioner in developing a sound suicide assessment. Suicide rate differs across all cultural factors. Females are more likely to attempt suicide than males although males are more likely to succeed. Native Americans report the highest suicide rate followed by white males but suicide among African-American males are steadily increasing. Heterosexual youth are about three times less likely to attempt suicide than youth who identify as gay, lesbian and/or bisexual (Debski, Spadafore, Jacob, Poole & Hixson, 2007). Suicide is also not specific to a singular psychopathology. While individuals with depressive disorders account for majority if individuals with suicidal behaviors, anxiety and conduct disorders also experience suicidal ideation and attempts. Other behaviors that correlate with suicidal ideation and attempts include but are not limited to: onset of sexual anxiety, low self-esteem, pessimism for the future, hopeless feelings, onset of sexual activity, tobacco and marijuana use (Debski et. al., 2007).

Patient Demographic

Today we’re introduced Diego Sanchez, a teenage Hispanic male who has recently returned home from an extended stay at a residential treatment center for violating his probation. Diego returned home to his mother who lives in low income government housing with his younger sister. Diego has been in trouble with the law for many years due to a history of violent and drug offenses. He was most recently linked to a Hispanic gang called “La Onda”, although he reports not to be active since being at the residential program. While in the program, Diego struck a relationship with another resident in his similar situation. Diego is animate that he’s a heterosexual male and that participating in any behavior that is even believed to be homosexual was met with violence from fellow gang members. Diego states that he felt the same during his time with the gang, but once he was in the program he made a connection with this other male resident. Diego divulged that his relationship with this fellow inmate remained platonic and mutually respectful. Most of the time they just shared stories about their past and helped each other get through the mundane routine that existed in the program.

Since being released, Diego has complied with the conditions of his probation by going to school and working part-time at a local grocery store. Diego’s probation officer reports that his teachers and supervisor speak highly of him and report no issues now. Diego shares a room with his sister and sleeps on a futon bed so that his sister can have the bed. He is estranged to his father who is a career criminal and has been incarcerated for most of Diego’s life. Diego is really close with his sister who has also been experiencing behavioral issues in the time that he was institutionalized. Most of Diego’s social relationships are with people from the neighborhood, but his interactions with them are limited as he’s not supposed to fraternize with criminals. This has resulted in Diego seeking companionship elsewhere. Diego has begun to socialize with individuals who are out of high school but work low income jobs in the neighborhood. As Diego is not able to indulge in drugs and/or alcohol since his probation officer can order a urine analysis at any moment, he has fallen head first into promiscuity. His friends spend most of their free time hanging out at each other’s houses where parental supervision is practically scarce and have sex parties. Most of the participants are known to each other but there are times that “friends” are introduced. Diego reports having sexual relations with both men and women since participating in these gatherings resulting in anxiety within normal social settings. Diego divulges that these get-togethers feel like a safe place for individuals with mutual appetites to congregate and become familiar with each other. He reports that this isn’t an all-night orgy or “gang bangs”, but a place where young adults who enjoy casual sex can intermingle and explore whether other opportunities manifest. Intercourse routinely occurs on site, but the option to move to a more personal setting is available. On premise meetings occur when individuals meet at a location that sexual intercourse takes place. Off premise meetings occur in a place that intercourse doesn’t transpire ("Swingers Lifestyle Term Definitions", 2018).

Transcript

Diego began seeking psychotherapeutic assistance when his convictions on sexual preference became flexible with his new lifestyle. Diego reports increased anxiety when speaking with individuals outside of his promiscuity community as he feels they will judge him for living this way. Diego also appears unreasonably fretful of being discovered by his family. Diego’s concern is based on his mother’s devout, religious lifestyle and he fears he will be excommunicated from the home resulting in a possible probation violation. Diego was referred to therapy by his probation officer when he divulged that he was experiencing suicidal thoughts during a routing interview. Diego states that these thoughts have not manifested into attempts but he did contemplate consuming a large bottle of over-the-counter ibuprofen seven days prior when the anxiety was severe. Diego presents well dressed in pressed, business casual attire with a bald fade hairstyle, thin square wire glasses and clean shaved. He is accompanied by his mother but they both sign a confidentiality waiver where mother agrees that Diego should meet with the therapist alone.

Transcript of initial assessment with Mr. Sanchez is as follows:

Therapist: Good Day Mr. Sanchez, my name is Manuel Mata and I’m the counselor assigned to your case.

Patient: Hi Mr. Mata, it’s a pleasure.

Therapist: I’ve gone over the information you provided in the initial intake questionnaire as well as the extensive file sent over by your probation officer. As standard protocol I’d like to go over any questions you might have for me regarding confidentiality and to ensure that you understand the extent to which our sessions are considered privileged information. Before all that, do you have any specific way you prefer to be addressed?

Client: I understand the paperwork just fine, I received counseling while at the residential program and Diego works.

Therapist: Alright Diego, so what brings you to our offices today?

Client: Well I don’t exactly know how to come out with this so I’ll just blurt it out. There have been somethings going on that are making me question a lot of stuff I’ve believed in since I was a little kid. It is getting to the point that it might affect my safety.

Therapist: Ok Diego, would you be able to be more specific? Would it be better for you if you gave me examples of what is going on?

Client: I have been doing stuff lately that I feel is taking over my life. It started about a week or two after I got out of the program. It started by joining a group from work and eventually led to me attending parties where I’d meet people who liked the same stuff I did. I was drawn to the females I was meeting at these parties and how they enjoyed the company of various people as I do. When I’m at the get-togethers, I don’t have to worry if I’m making somebody mad or jealous, we just talk and flirt. This type of stuff is very comfortable for me, it’s like I’m surrounded by approval and acceptance. I eventually started to talk to some of the other guys who attend these parties and found myself drawn to them as well. There was one guy who reminded me of my good friend from the program. I’ve never been with a guy before, but talking to him just felt familiar and relaxing. Since then, I’ve had sex with other people, male and female, with no real emotion about it. This basically feels like a big house party where everything goes. The only stipulation is that whatever happens must be consensual. Most of the people are from outside of the neighborhood so that makes me feel safe that I don’t have to see them every day. Some people just like to watch, which I’m cool with as well, and some who are more hands on. I guess the big thing for me is that nobody judges there and we get along. The sex is almost like the cherry on the top. I’ve met people who are new to the group but they don’t tend to stick around. When I meet someone knew who I think will fit in we hit a party and see how it is, if we like the people there we’ll see what we get into. If not, that’s usually the last time we hang out. I’m a very laid-back guy so I don’t have to be directly involved, I can just sit back and watch them do their thing. I really like that part of the whole thing. Being able to meet new people and getting to know them on a sexual level. Almost as though I’m not this fuck up who is still having to deal with all the BS. I’m just a guy who can have fun and who’s only worry in the world is getting that fine redhead to enjoy a fun experience with me.

Therapist: From the looks of it, you really enjoy being at these parties. Is that what concerns you? That you might be enjoying them too much?

Client: Probably. It’s like my whole life is revolving around getting to the next party.

Therapist: Can you expand on that? How do you feel about these parties about other things in your life?

Client: Well I used to do work with the homies when I was younger and this is what got me into trouble with the law. When I first started, my friend gave me a couple of 20 sacks and I could make $50 dollars apiece off it. I eventually got to where I was handling kilos at a time and making enough to buy cars and apartments. The more money I made, the more I was willing to sacrifice to keep it going. Now with these parties, I started with one party a month. Now I go two-to-three times a week and have yet to leave unsatisfied. I can’t remember the last time I’ve been out on a “normal” date, much less gotten off to someone who I’ve met outside of this. I haven’t even gotten into the whole gay and straight thing. Lately I’ve been spending more time with guys than girls. I’ve been straight my whole life, but now suddenly getting with guys is what has worked for me. Almost like the weirder the encounter the better it works to get me there.

Therapist: When you say weird, what exactly about the entire experience makes it weird for you?

Client: Well since my release from the program, I fell deep for internet porn. While the standard boy or girl stuff worked initially, I found myself looking for riskier content eventually. First it was threesomes with two girls then two guys and I even saw some bisexual content that got me a little more excited than I thought. I then started buying subscriptions to live chatrooms where people masturbated with each other via live video feed. This is where I was introduced to the parties and stuff. My first party was a trip. A girl at work told me about a party that was happening in another side of town. We met up in the parking lot after work then made our way to the party. I walked in and felt like I was in an old school house party where everyone was just dancing and drinking. The girl I was with introduced me to the guy that was hosting the party and they could give me everything I needed as to how things worked. They respected that I couldn’t drink or indulge in other stuff there, but I felt comfortable and the girl I was with even got me to loosen up and dance with her. Then, like a blink of an eye the fun started. At first, I just watched as the girl I was with joined right in. After a few minutes the girl turned her attention to me and we had sex on a chair while the other people were on the bed. My first few parties were like that until I mustered the courage to take a girl to my mom’s house. I could swing it since my mom works nights and my sister stays with the neighbor since I work also. It has been a while since I’ve only had sex with just another person. I find myself losing interest in sex with only one other person, preferring to get together with a group of people instead. This is how my first encounter with a guy happened. A group of us fell over into a bedroom during a get-together and everything moved quick from there. At first it was just the girl and I in the room while her boyfriend watched from a chair in the corner of the room. This wasn’t the first time a boyfriend watched me with their girlfriend, but then something happened that was a first. Suddenly, he joined in, staying away from me and placing the focus on his girlfriend. Then, unexpectedly, they both switched the attention to me.

Therapist: How did this make you feel, having such an encounter for the first time?

Client: At the time it was going on, I couldn’t tell the difference between male or female. I just sat back and enjoyed the whole thing [grinning excessively]. Even immediately after we were done, we just laid there in a sweaty mess just laughing and reflecting on what just happened. It wasn’t until the next day that I began to truly think about what occurred. It was like I couldn’t get past the thought that I had to hide this because everyone who knows me sees homosexuality in a negative light. If my mother found out I’d be disowned.

Therapist: Did you feel your behavior was a problem now?

Client: Not entirely. It was like my head was telling me that this was wrong and I should stop, but then I would be presented with another opportunity and I’d do it without having a second thought.

Therapist: So, is it bothering at this moment?

Client: I don’t know, maybe??? I guess what bothers me more is how far I’m willing to go to satisfy my desires.

Therapist: What do you think of when you pose that question to yourself?

Client: I just get worried and nervous. Not about what I’m doing but what it might do to mom if she found out. Like I’m having a lot of fun and enjoying myself, but it can’t be good because I can’t even tell my mom about it. How can I feel guilty about something that keeps me out of trouble with the law, but I can share it with the most important people in my life? Then my mind goes downhill quick. Then I feel hot, my hands get clammy, heart feels like it’s about to beat out of my chest. Once the guilt sets in so do the negative thoughts and I start thinking how it would just be better if I wasn’t around. When I get angry everything gets blurry and I get into trouble.

Therapist: So, you’re aware of your violent potential and make decisions to ensure that part of your past doesn’t resurface?

Client: Yes. That’s why I stick to myself in the house. I don’t want to do or say something stupid and get myself in trouble. Like if I do one thing my mom will kick me out, but if I do the other stuff I know my probation officer will revoke me. Either way looks like I’m going to end up locked away somewhere.

Therapist: Well it’s good that you’re knowledgeable of your capacity for violence and can make productive decisions to not go down that road.

Client: Ya, I just feel pressured to do what other people expect from me and not what I really want to do.

Therapist: Okay that’s understandable. We’ll delve into that a little deeper in a bit. Just to make sure we’re on the same page, you are currently spending most of your free time enjoying casual sex with not only various partners, but multiple partners as well. This started with a chance encounter that has now developed into a full on extracurricular activity. You have found yourself focusing more on going to these parties and this has you concerned as you’ve been taking more chances sexually than you have in the past.

Client: Yes, and now I can’t be entirely open with my mom and it is starting to take severe toll on me. This stuff is exciting and scary all at the same time.

Therapist: Well finding events scary and intriguing is normal, but it is also a physiological response to potentially troubling situations. Is it ok with you if we talk a little more about how the homosexual thoughts began?

Client: Well I’d be lying if I told you this is the first time I’ve had these thoughts.

Therapist: Okay, can you elaborate on this?

Client: Well there were several times in the program that some inmates triggered some rather inappropriate thoughts. While in there I just played it off as being without female companionship for so long. Then I was placed in wing for residents on a lower level of care. I was placed in a room with a guy who I’d initially met in the recreational area, but we were housed in separate wings. We got along pretty good and got close. Come to find out his life growing up was like mine and we just had a lot in common. At night I would have thoughts of getting intimate with him but I never acted on them because that kinda thing just wasn’t an option. Some nights I even dreamt about it and they felt so real that I would wake up in a sweat and with my heart racing.

Therapist: And how did you feel about this dream?

Client: Initially I was intrigued by it and considered acting on it. But then reality set in and I just put those feelings away. As the feelings increased so did the guilt and shame. It all snowballed to where I was getting in trouble with staff at the program and my therapist could get it out of me in session. I told him that I wasn’t a queer or anything, but these thoughts just kept creeping in.

Therapist: Is that how you see homosexual men? As queers?

Client: Growing up in the hood queers are weak and we beat on them for shits and giggles. Even in the program, queers were something we’d use to trade for snack from other kids but nobody would be friends with them. There were some dudes who we thought might float that way but if you wanted to get respect you’d nip that in the butt quick.

Therapist: So, to sum all of this up, homosexual men in your past experiences are at best a commodity and at worse a reason for ridicule. Your experience with men was one of a second-rate season who’s only purpose is as a good to barter. This experience led you to suppress any homosexual desires that occurred subconsciously to keep from acting on them.

Client: Yeah, sounds about right. I think that this is what continues to be the problem. Like while I’m in the moment I’m having the time of my life and I’m just enjoying everything that is going on. Then I get back to reality and the anxiety hits. Not that I should stop because it is bad, but that I should stop before I get discovered.

Therapist: While you were in the program, did you ever have the suicidal thoughts that you’re experiencing now? (probing)

Client: Not that I can remember. But then again, I was acting up and stuff with the staff so maybe that’s why?

Therapist: That is a possibility that you were displacing your negative emotions onto other people in the program rather than on yourself. Is that the biggest difference this time around?

Client: Well yeah, I don’t want to do something that will put my sister or mom in danger. In there I didn’t care about the staff so I could take it out on them.

Therapist: You don’t think that hurting yourself will hurt you sister and mother?

Client: I never really thought about it that way. I guess they’ll be sad and stuff but they will get over it. Hell, I’ve been away for long stretches at the program and juvie so it’s not like they ain’t used to it.

Therapist: Diego I think that your family would miss you a lot. I wouldn’t be surprised if your mom notices the positive changes you’ve made and your sister looks up to you in this manner as well.

Client: I guess I never really put much thought into their point of view.

Therapist: Since you bring it up, how do you feel about finding ways to channel these negative emotions but in more productive ways than acting up or thinking of hurting yourself?

Client: Sure, I’m down for that

Therapist: Well Mr. Sanchez I think we’ve gone over enough for this session and I feel that I have a firm grasp on what it uses you’re seeking help for. Before our next session I would like you to write down a list of problematic behaviors and behaviors that are potentially problematic. By problematic I mean behaviors that come to mind when your anxiety is at its most concerning. Another goal is to abstain from any sexual behavior, including masturbation, for the next 30 days. This will allow us a more transparent platform to identify potential risky environments, triggers and stressors. This abstinence will also allow us to experiment with potential coping skills to serve as behavioral interventions and attempt to impede the cycle of maladaptive behavior. A final goal will be to document your daily activities focusing on emotions and thoughts surrounding your sexual desires and thoughts of guilt and shame. to reveal potential habits and customs. The objective of this is to develop a sexual autobiography (Louie, 2016) which we will discuss later.

Client: Really!? 30 days!? You want me to keep me from doing anything for a month? I’ll do my best but I promise nothing.

Therapist: Think of this as a sexual cleansing and that doing this will serve as a resetting your sex life.

Client: Ok I’ll try my best.

Therapist: Also, just as a practice, jot down some things you like to do that will allow you to release pent up energy that doesn’t involve sex or aggression. Options like physical exercise or drawing will work for this. This doesn’t have to be very specific, just some general ideas and we’ll elaborate on them during the next session.

Client: That seems easy enough. I feel like you give me more homework than my teachers at school.

Therapist: I know it seems like it now, but once you start working on this stuff maybe you’ll experience some sense of relief.

Interview Processes and Diagnosis

Every therapeutic session is an opportunity for the therapist to not only become knowledgeable of the client and their situation but also strengthen the therapeutic relationship. Practitioners have a vast tool chest with attentiveness being the tool that therapists use to develop rapport with the patient. Attentiveness is conveyed through eye contact, body positioning & movements, facial expressions and verbal responses (Cormier, 2014). Research shows that communication is 55% non-verbal, 38% voice tone and 7% verbal substance (Thompson, 2011). Verbal and Non-verbal cues serve essential to the communication process and demonstrates evolution of hominids to other organisms (Mandal, 2014). To accomplish effective communication between the client and practitioner there must be a sense of true trust and consistency within the therapeutic relationship. Online educational programs are a good example of how the administrator/consumer relationship can waiver when the lack of personal interaction exists. Studies prove that while all pupils log into the discussion forum at least one time over the course of a discussion; about the same number of students exist who actively participated in the discussion as those who only participated minimally or not at all. (Wise, Hasknecht & Zhao, 2014).

In clinical psychology, therapists work continuously to gain a functional knowledge of their client. This information exists in a cultural context and the practitioner must effectually acquaint themselves with said context (Wedding, 2014). Counselor’s learning to gauge the consumer’s cultural history, comportment, emotions and expansive habits. These factors are not just identified but configured on how they influence the individual’s psychopathology. What often occurs is that the therapist fails to configure how their own cultural history, comportment, emotions and expansive habits influence their objectivity (Reddick, Heiden-Rootes & Brimhall, 2016).

For Diego, the primary diagnosis would be Generalized Anxiety Disorder 300.02 (F41.1) is also recommended for Diego. This manifests when Diego is confronted with the possibility that his mother will discover his sexual transgressions. Diego experiences the psychophysiological symptoms consistent with anxiety and this feeling triggers his suicidal ideation. Major Depressive Disorder (MDD) 296.22 (F32.2) was considered but Diego’s symptoms do not reach the two-week requirement. Diego’s depressive symptoms persist while he’s contemplating his sexual transgressions, but are non-existent while committing the behaviors. Anxiety disorder is the most common mental health disorder followed by depressive disorders. Anxiety is defined as the anticipation of future threat. While fear and anxiety can develop normally, anxiety disorders differ in that the anxiety is excessive or persists for an inordinate period. Individuals with anxiety disorders tend to overestimate the hazards of fearful situations, the clinician will have to determine whether the anxiety is excessive or inappropriately persistent. Majority of anxiety disorders develop during childhood and endure if left untreated (APA, 2018).

A secondary diagnosis of sexual addiction would also be appropriate but according to the DSM-V Hypersexual Behavior Disorder has been excluded from the manual for psychiatric disorders. This condition may be a “sex-negative” diagnosis but without a formal diagnostic criterion, therapists might conduct therapy in a way that could worsen the condition (Katehakiz, 2012).

Therapeutic Goals and Approach

Moving forward a client-centered therapeutic approach is highly recommended. CCT assumes that everyone is conscious of deleterious conduct and can take ownership of their own recuperation. This is a refreshing new take on the previous therapeutic model in that practitioners treat the individual and not just the symptoms. Everyone is deserving of dignity and respect as people are nonreducible “ends” (Wedding, 2014). For Diego, sexual addiction is obviously the premeditating factor, but with the view on sexual addiction transitioning to a positive stigma approach, there is no viable treatment for treating sexual addiction (Reddick, et al, 2016). I felt that CCT was the most effective psychotherapeutic method to provide therapeutic relief for maladaptive behaviors. This process will also prove to assist the client in modifying how he sees certain aspects of his sexual behavior as normal within the context of moderation. He is currently using sexual fantasy and emotional detachment as a means of distracting from more stressful life occurrences (Louie, 2016). By focusing on Diego’s anxiety disorder, he may learn to accept aspects of his sexual life that trigger his fear and trust his family to confide in them about the personal discoveries he has made.

The goal for Diego is to develop constructive coping skills when faced with inapposite anxiety. These skills will afford Diego the with the opportunity to return to baseline behavior when peaked anxiety is presented. Some existing coping skills include: Breathing exercises, eat well-balanced meals and limit caffeine consumption ("Tips | Anxiety and Depression Association of America, ADAA", 2018). The skills will be put in place to combat the onset of an anxiety episode. Therapist will also work with Diego to develop activities and habits that could not only help with the anxiety episodes, but prevent the suicidal ideation as well. By assisting Diego in identifying and implementing lifestyle change to divert his anxiety outbursts from delving into the suicidal realm, the therapist can put safeguards in place that will provide an outlet for the repressed emotions.

Conclusion

On the next clinical session, Diego presented with his list of triggering behaviors and potential activities to channel regressive emotions. Diego divulged to therapist that completing the tasks assigned provided a sense of accomplishment and purpose. Diego also stated that he reduced his participation in promiscuous activities substantially. Diego identified working out and basketball as activities that allow him to express himself without judgement. Diego states that whether he’s mad, sad or just flustered, the gym and the court are always there to take that from him. Diego worked with the therapist on breathing exercises and proper diet to combat his anxiety episodes. Diego stated that he feels comfortable with this approach and will give it a try. The counselor also encouraged Diego to make time to go to the local park at least one time a day. Diego was encouraged to utilize the walking trail at the park to begin a regimen of physical activity. Diego was also encouraged to acquire a basketball and schedule time to utilize the basketball court at the park. Resources are limited in Diego’s neighborhood and this approach provides the best viable option. With these measures in place, Diego will now seek to create a routine that allows for transference from existing maladaptive behaviors to productive behaviors. Diego will meet with therapist at the next session to monitor therapeutic progress.

References

APA. (20130522). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®), 5th Edition. [Bookshelf Online]. Retrieved from https://online.vitalsource.com/#/books/9780890425572/

Anxiety | Resources To Recover. (2018). Resources To Recover. Retrieved 16 March 2018, from https://www.rtor.org/anxiety/

Castelnuovo, G. (2010). Empirically supported treatments in psychotherapy: towards an evidence-based or evidence-biased psychology in clinical settings?. Frontiers In Psychology, 1. http://dx.doi.org/10.3389/fpsyg.2010.00027

Cormier, S. (12/2014). Counseling Strategies and Interventions for Professional Helpers, 9th Edition. [Bookshelf.Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781323243695

Debski, J., Spadafore, C., Jacob, S., Poole, D., & Hixson, M. (2007). Suicide intervention: Training, roles, and knowledge of school psychologists. Psychology In The Schools, 44(2), 157-170. http://dx.doi.org/10.1002/pits.20213

Ethics in Psychology. (2018). http://www.apa.org. Retrieved 12 February 2018, from http://www.apa.org/topics/ethics/index.aspx

Henkes, A. (2013). A Party for the “Freaks”: Performance, Deviance and Communitas atClub Fuck! 1989-1993. The Journal Of American Culture, 36(4), 284-295. http://dx.doi.org/10.1111/jacc.12050

Katehakis, A. (2012). Sex Addiction Beyond the DSM-V. Psychology Today. Retrieved from https://www.psychologytoday.com/blog/sex-lies-trauma/201212/sex-addiction-beyond-the-dsm-v

Louie, S. (2016). The Everyday Clinician's Guide to Sex Addiction. Psychology Today. Retrieved 12 February 2018, from https://www.psychologytoday.com/blog/minority-report/201601/the-everyday-clinicians-guide-sex-addiction

Merrill, G. (2013). Assessing Client Dangerousness to Self and Others: Stratified Risk Management Approaches. Berkeley Social Welfare. Retrieved from http://socialwelfare.berkeley.edu/sites/default/files/users/gregmerrill/Assessing%20client%20dangerousness%20to%20self%20and%20others%2C%20stratified%20risk%20management%20approaches%2C%20Fall%202013.pdf

Mandal, F. (2014). Nonverbal Communication in Humans. Journal Of Human Behavior In The Social Environment, 24(4), 417-421. http://dx.doi.org/10.1080/10911359.2013.831288

Reddick, G., Heiden-Rootes, K., & Brimhall, A. (2016). Therapists’ Assessments in Treating “Sex Addiction” and Their Relationship to Clients’ Gender, Relationship Status, and Exclusivity Status. Journal Of Marital And Family Therapy, 43(3), 537-553. http://dx.doi.org/10.1111/jmft.12210

Shea, S. (2009). Suicide Assessment. Psychiatric Times, 26(12), 17-22. Retrieved from https://search-proquest-com.library.capella.edu/docview/204588471/fulltextPDF/983035DA13954D89PQ/1?accountid=27965

Swingers Lifestyle Term Definitions. (2018). Love Voodoo. Retrieved 12 February 2018, from https://lovevoodoo.com/public/swingersdictionary.asp

Thompson, J. (2011). Is Nonverbal Communication a Numbers Game?. Psychology Today. Retrieved 12 February 2018, from https://www.psychologytoday.com/blog/beyond-words/201109/is-nonverbal-communication-numbers-game

Tips | Anxiety and Depression Association of America, ADAA. (2018). Adaa.org. Retrieved 16 March 2018, from https://adaa.org/tips#

Wedding, D. (2014). Current Psychotherapies (10th ed.). [Bookshelf.Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781285821085

Wise, A., Hausknecht, S., & Zhao, Y. (2014). Attending to others posts in asynchronous discussions: Learners' online “listening” and its relationship to speaking. International Journal Of Computer-Supported Collaborative Learning, 9(2), 185-209. http://dx.doi.org/10.1007/s11412-014-9192-9