Learning Objectives: Students Will Develop Diagnoses For Cli

Learning Objectivesstudents Will Develop Diagnoses For Clients Recei

Describe the client and identify any pertinent history or medical information, including prescribed medications.

Using the DSM-5, explain and justify your diagnosis for this client.

Explain whether existential-humanistic therapy would be beneficial with this client, including expected outcomes based on this therapeutic approach.

Explain any legal and/or ethical implications related to counseling this client.

Support your approach with evidence-based literature.

Reflect on your clinical supervision experiences, including how often you receive supervision, the nature of the sessions, what your preceptor emphasizes, and how these sessions influence your clinical practice.

Paper For Above instruction

Introduction

Developing accurate diagnoses and selecting appropriate therapeutic approaches are fundamental components of effective mental health practice. In this paper, I will present a comprehensive case analysis of a client I observed, applying the DSM-5 criteria for diagnosis, evaluating the suitability of existential-humanistic therapy, and discussing relevant legal and ethical considerations. Additionally, I will reflect on my clinical supervision experiences and how they influence my clinical development.

Client Description and Medical History

The client, a 34-year-old female, presented with symptoms of persistent feelings of emptiness, difficulties maintaining interpersonal relationships, and episodes of intense anxiety. She reported a history of childhood trauma, including emotional neglect and familial instability. Her medical background includes a diagnosis of generalized anxiety disorder (GAD) and recent prescription of selective serotonin reuptake inhibitors (SSRIs). She also reported occasional use of non-prescribed anxiolytics to manage acute anxiety symptoms.

Diagnosis Justification Using DSM-5

Based on the DSM-5 criteria, the client demonstrates symptoms consistent with Borderline Personality Disorder (BPD), characterized by frantic efforts to avoid abandonment, unstable interpersonal relationships, identity disturbances, impulsivity, and recurrent suicidal or self-harming behaviors. The persistent feelings of emptiness and intense, unstable relationships support this diagnosis (American Psychiatric Association, 2013). The client’s history of trauma may underpin some of these features, aligning with established diagnostic criteria for BPD. While her anxiety symptoms are prominent, they appear comorbid rather than primary, making BPD the more accurate diagnosis at this stage (Zanarini et al., 2012).

Suitability of Existential-Humanistic Therapy

Existential-humanistic therapy emphasizes personal growth, authenticity, and finding meaning, which aligns with this client’s struggles with identity and emotional emptiness. This approach encourages clients to explore their values and become more authentic in their lived experiences (Wheeler, 2014). For this client, therapy focusing on self-awareness and meaning-making could foster resilience and reduce symptoms of emotional dysregulation. Expected outcomes include increased self-acceptance, improved ability to manage interpersonal relationships, and a reduction in self-harming behaviors (Yalom, 1980).

Legal and Ethical Implications

Counseling clients with Borderline Personality Disorder involves significant ethical considerations, especially regarding boundaries and confidentiality, given the risk of self-harm and suicidal behaviors. Legal considerations include safeguarding the client when there is imminent risk, necessitating clear safety plans and possibly involuntary hospitalization if required (Nagy, 2011). Ethical practice demands maintaining informed consent, respecting client autonomy, and documenting all clinical interactions meticulously. It is essential for counselors to be familiar with state laws governing involuntary treatment and crisis intervention procedures (Nagy, 2011).

Supporting Evidence-Based Practice

Research supports the efficacy of Dialectical Behavior Therapy (DBT) for BPD, but existential-humanistic techniques can complement other modalities by enhancing self-awareness and promoting personal meaning (Linehan, 2015). Literature suggests that fostering authenticity and personal growth can improve emotional regulation and reduce self-destructive behaviors (Wheeler, 2014). Integrating existential-humanistic principles into practice provides a client-centered pathway to healing, emphasizing empathy and understanding (Yalom, 1980). This approach aligns with evidence indicating that clients benefit from therapies emphasizing meaning, presence, and personal responsibility (Frankl, 2006).

Reflections on Clinical Supervision

I receive clinical supervision weekly from my preceptor, which involves case review, discussion of therapeutic strategies, and ethical dilemmas. Sessions typically involve presenting cases, receiving feedback, and role-playing interventions to enhance clinical skills. My preceptor emphasizes building therapeutic rapport, adherence to ethical standards, and integrating evidence-based techniques. These supervision sessions are instrumental in translating theoretical knowledge into practical skills, helping me navigate complex client dynamics and ethical issues.

Conclusion

Effective diagnosis and intervention require a thorough understanding of client history, the application of DSM-5 criteria, and an ethically grounded therapeutic approach. For this client, an existential-humanistic therapy has the potential to facilitate self-exploration and growth, addressing core issues of identity and meaning. Regular supervision provides critical support and guidance, ensuring that clinical practices remain ethical and effective. As I progress in my clinical training, integrating these elements will enhance my capacity to offer compassionate, evidence-based care.

References

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
2. Frankl, V. E. (2006). Man's search for meaning. Beacon Press.
3. Linehan, M. M. (2015). DBT skills training manual. Guilford Publications.
4. Nagy, T. F. (2011). Ethics in psychotherapy. In Essential ethics for psychologists: A primer for understanding and mastering core issues (pp. 185–198). American Psychological Association.
5. Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Springer Publishing Company.
6. Yalom, I. D. (1980). Existential psychotherapy. Basic Books.
7. Zanarini, M. C., et al. (2012). The burden of borderline personality disorder from the patient’s perspective: A qualitative study. Psychiatric Services, 63(7), 694–701. https://doi.org/10.1176/appi.ps.201100531
8. Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice. Psychotherapy.net.
9. Laureate Education. (2012). Clinical supervision follow-up. Baltimore, MD: Psychotherapy.net.
10. American Psychological Association. (2010). Ethical principles of psychologists and code of conduct. American Psychologist, 66(9), 987–1000. https://doi.org/10.1037/a0020572