Due by 11/5/19

Running head: TREATMENT FORMAT 2

TREATMENT FORMAT 2

Treatment Format

Student’s Name

Institutional Affiliation

Treatment Format

Explain the connection between each theoretical orientation used by Dr. Banks and the interventions utilized in the case.

Dr Bank theoretical orientation explains how Karen’s problems develop and how he can resolve or treat them. Through this orientation, Dr Bank focuses on counselling sessions, its goals, and interventions he will experience in his counselling process. Dialectical Behavioral Therapy looks at Karen’s self-awareness, distress level, and emotion regulation to treat her Borderline Personality Disorder. Through it, it helps Karen to reduce suicidal thoughts and attempts, self-injury, and increase behavioral skills (Bishop, 2015). This therapy teaches a patient about coping skills such as interpersonal effectiveness and emotion regulation. It is a safer and appropriate intervention approach for treating Karen’s problems. Additionally, cognitive behavioral therapy, as used by Dr Bank, is evidenced by the skills training technique that requires Karen to attend behavioral skills training and individual psychotherapy. This training helps her gain coping skills with substance abuse and suicidal behaviors.

Describe the concept of dialectical behavior therapy, being sure to include the six main points of this type of treatment.

Therapy stems from philosophical process referred to as dialectics. Dialectics relies on a concept that all things are composed of opposites and that any alterations occurring is due to one strong opposing force than the other. It treats people who satisfy criteria for borderline personality disorder based on some principles and techniques. It is an outpatient-designed cognitive-behavioral treatment with four treatment modes that address five functions (Rizvi et al., 2013). The modes include skills training, therapist consultation team meetings, individual therapy, and a therapist outside of a session. Functions such as increasing a patient’s motivation to change, promoting a patient’s capabilities, structuring an environment to strengthen a client’s gains, enhancing therapist motivation and skills, and generalizing a patient’s gains over his or her environment.

The six fundamental points of dialectical treatment include

· It is supportive; its providers help clients to decrease problem behaviors, substance abuse, and self-destructive behaviors. It helps a client recognize his or her positive strengths and attributes in life.

· It is behavioral; it concentrates on teaching a patient how to evaluate problem behavior cycles and replace destructive behavior with effective ones.

· It is cognitive; it emphasizes changing beliefs, assumptions, and expectations that not helpful or productive.

· It is skill-oriented; the treatment is designed to teach a patient how to acquire new skills and promote his or her capabilities.

· It balances acceptance and change; it embraces on accepting a client and difficulties of his or her current situation while assisting her or him to make changes. It strengthens a person’s ability to tolerate painful feelings of his or her present life.

· It needs a collaborative relationship; both a patient and a counselor should work and cooperate as a team to attain treatment objectives. They should shape their communication and collaboration to be successful.

Explain Dr. Banks’s primary goal during the pre-treatment stage and how Dr. Banks related this to Karen in her initial therapy sessions.

Dr Banks’s goal was agreeing on goals with Karen at their pre-treatment stage. Under this stage, Banks aims at informing and orienting Karen to Dialectical Behavior Therapy (DBT) as well as securing her commitment treatment. He outlined the treatment therapy and explained it to Karen and set arrangements for the treatment’s administration. As a result, Karen was expected to state whether she is okay with Dr Banks, the treatment therapy, and sessions to attend. Also, she was to affirm her commitment to the therapy process. After acceptance of the process, Dr Banks was supposed to set initial goals to be agreed upon by his client, Karen.

Describe the two formats that Dr. Banks told Karen would be part of her treatment program.

Group behavioral skills training: This format makes part of Dr. Banks’s treatment program for Karen. This DBT format is a weekly group, operating like a class, and equips skills across topics such as interpersonal effectiveness, emotion control, distress management skills, and mindfulness. Under the format, Karen is expected to do homework assignments, where she practices skills learned from training lesson (Rizvi et al., 2013). Also, group behavioral skills training involves an extensive set of fundamental skills that can be acquired without a high level of functioning to equip a person with appropriate skills of changing behaviors by adopting desired ones.

Imaginal Exposure: It is typically carried out across multiple treatment sessions undergone by Karen. This exposure enables a client to identify his or her trauma-related symptoms to gain fresh memories that are not associated with trauma. Besides, it includes treatments such as prolonged exposure to treat Borderline Personality Disorder patients who are not severe. Dr. Banks will expect Jaren to imagine any traumatic event and describe it aloud, together with the thoughts and feelings that took place during the event

Describe the focus of the second and third stages of treatment.

The second and third treatment stages emphasize decreasing avoidance of emotional experience and post-traumatic stress and increasing self-respect and achieving a client’s goals, respectively. In stage two, avoidance is achieved through limiting contact with triggers for memories, thoughts, and fear about a traumatic event. A client can take a week monitoring his or her behavior by observing what triggers him or her Posttraumatic Stress Disorder (PTSD) symptoms and leas to avoidance behavior. In stage three, a therapist is concerned with helping a client with ways of improving well-being and achieving goals through meaningful, well-informed choices, and interpersonal skills.

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.

Technology-assisted care (TAC) is a behavioral health treatment that helps a client to heal and recover quickly. It is an appropriate therapy for people with symptoms of mental illness, such as substance abuse, suicidal behaviors, and poor interpersonal relationships like Karen. When incorporated into substance use disorder treatment and intervention methods, it supplements current approaches and helps to reach more clients who might face challenges when receiving treatment (Miller, 2006). However, the delivery of e-therapy consultation faces challenges that undermine clinical evaluation. For instance, an assessment of diagnostic quality that involves observance of the behavior is difficult because the system does not capture subtle nonverbal communication (Orman, 2018). Also, the problem of a therapist being physically present with a client interferes with clinical evaluations of a client’s responses and behaviors; hence, there is no delivery of reliable results.

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.

Through Dialectical Behavior Therapy, Karen has reduced self-injury and suicide behaviors after attending various training skills sessions. The severity of borderline symptoms and psychopathology have improved, as evidenced by the positive results when compared to the previous period. Imaginal exposure and psychoeducation improved helped Karen in recalling her last traumatic events, where she was able to identify elements that caused fear and suicidal thoughts in her life, hence, finding new ways of avoiding such incidences and behaviors (Harned, et al. (2013). Through this avoidance mechanism, she reduced self-injury, maladaptive behaviors, thoughts, feelings, and suicide behaviors leading to Borderline Personality Disorder.

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.

Additional treatment interventions are Schema-focused, mentalization-based, and transference-focused therapies. Schema-focused therapy is conducted individually or in a group. It helps a client identify some of unmet goals and needs leading to negative behaviors such as substance abuse, suicidal thoughts, and self-injury behaviors. These unfulfilled desires are helpful to such a particular person in his or her life. This therapy focuses on assisting a client get his or her needs met healthily to enhance positive life patterns. On the other hand, mentalization-based therapy is a talking treatment the enables a client to identify his or her thoughts and feelings while creating an alternative to the situation. It focuses on a client’s thinking before reacting. It can incorporate DBT concepts such as imaginal exposure. The other treatment therapy is Transference-focused psychotherapy that provides a client with an opportunity to understand his or her emotions and interpersonal difficulties. The understanding is based on a developed relationship between a client and his or her therapist.

References

Bishop, E. (2015). Dialectical Behavioral Therapy. The Wiley Handbook of Eating Disorders, 788-800.

Harned, et al. (2013). Treatment Preference Among Suicidal and Self-Injuring Women with Borderline Personality Disorder and PTSD.

Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., ... & Murray-Gregory, A. M. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA psychiatry, 72(5), 475-482.

Luxton, et al. (2011). mHealth for Mental Health: Integrating Smartphone Technology in Behavioral Healthcare.

Miller, (2006). Telehealth Issues in Consulting Psychology Practice.

Orman, J., & O’Dea, B. (2018). e-Therapy in primary care mental health. Australian journal of general practice, 47(4), 168.

Rizvi, et al. (2013). An Overview of Dialectical Behavior Therapy for Professional Psychologists.