Psy650 Week Four Treatment Plan: Behaviorally Defined Sympto

Psy650 Week Four Treatment Planbehaviorally Defined Symptoms Karen Di

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 distress. 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.

Paper For Above instruction

The treatment planning process for individuals diagnosed with Borderline Personality Disorder (BPD) necessitates a nuanced understanding of the disorder’s core symptoms, behavioral manifestations, and effective therapeutic interventions. The case of Karen, as presented, exemplifies the typical challenges faced by clinicians working with BPD and underscores the importance of a structured, evidence-based approach to treatment. This paper delineates an in-depth treatment plan centered on behavioral symptoms, with a focus on setting realistic goals, selecting appropriate interventions, and considering the theoretical underpinnings of these interventions, particularly Dialectical Behavioral Therapy (DBT).

The primary behavioral symptoms exhibited by Karen include intense emotional reactions triggered by perceived abandonment, impulsivity, unstable interpersonal relationships, recurrent suicidal gestures, and self-injurious behaviors such as cutting. These symptoms are characteristic of BPD and significantly impair her functioning and quality of life. According to the diagnostic criteria outlined in the DSM-5, BPD is marked by pervasive instability in affect regulation, self-image, and relational stability (American Psychiatric Association, 2013). The diagnostic impression, therefore, aligns with the major classification inherent in Karen's symptomatology.

The overarching goal of treatment is the eventual cessation of self-harm behaviors and the stabilization of emotional and behavioral responses. Long-term, the treatment aims to help Karen achieve emotional regulation, build healthier interpersonal relationships, and develop a more stable sense of self. The long-term goal of terminating self-harming behaviors such as substance abuse, cutting, and suicidal gestures is crucial because these behaviors pose immediate threats to her safety and well-being (Linehan, 1993). Additionally, reducing maladaptive thoughts and feelings is vital in fostering adaptive functioning.

Short-term goals serve as stepping stones towards the overarching aim. Initially, it is essential to focus on reducing the frequency of maladaptive behaviors, thoughts, and feelings. By criterion, defining measurable objectives such as a decrease in instances of self-harm or impulsive acts provides tangible benchmarks for progress. This incremental approach helps to engender a sense of achievement and motivation, essential components in therapeutic change.

The choice of interventions is rooted in evidence-based practices tailored to BPD. Dialectical Behavioral Therapy (DBT), developed by Marsha Linehan, is a gold-standard treatment for BPD, emphasizing skills training in mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness (Linehan, 1993). In this case, Dr. Banks will outline the process of DBT, providing Karen with an understanding of the therapy’s rationale and structure. This psychoeducational component aims to foster engagement and compliance.

Furthermore, Karen will participate in group behavioral skills training and individual psychotherapy sessions. Group therapy offers a supportive environment where Karen can learn and practice skills, receive feedback, and normalize her experiences. Individual therapy provides a tailored space to explore her unique challenges, develop insight, and apply skills learned in group settings. Consistent participation in both modalities enhances the likelihood of behavioral change and emotional stabilization.

Imaginal exposure to trauma is also integrated into Karen’s treatment plan, particularly because trauma-related symptoms often exacerbate BPD manifestations. The goal of imaginal exposure is to help Karen process traumatic memories, thereby reducing their power to induce distress. This approach is grounded in exposure-based therapies like Prolonged Exposure (PE), which have evidence supporting their efficacy in reducing trauma symptoms (Foa et al., 2007). Administering exposure until the traumatic memories no longer cause marked distress aligns with principle-based exposure intervention strategies, facilitating desensitization and cognitive restructuring.

Implementing these interventions necessitates careful assessment and ongoing monitoring. Evaluating progress through behavioral checklists, self-report measures, and clinical impressions ensures that treatment remains goal-oriented. Adjustments to interventions may be warranted based on Karen’s response, emphasizing the importance of a flexible, patient-centered approach.

In conclusion, managing BPD symptoms requires a constellation of targeted, evidence-based interventions aimed at reducing self-harm, improving emotional regulation, and fostering healthier interpersonal functioning. Karen’s case exemplifies the application of a comprehensive treatment plan incorporating psychoeducation, skills training, trauma processing, and continual assessment. The integration of these elements, grounded in empirical research and clinical best practices, offers the best prospects for her recovery and improved quality of life. Future directions may include adjunctive treatments such as pharmacotherapy for comorbid conditions and continued support to sustain gains achieved during therapy.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  • Foa, E. B., McNally, R. J., & Nadorff, M. (2007). Exposure therapy for posttraumatic stress disorder. The Journal of Clinical Psychology, 63(11), 1375–1389.
  • Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
  • Stuart, S., & Hilsenroth, M. J. (2007). The efficacy of dialectical behavior therapy: A review. Clinical Psychology Review, 27(5), 541–561.
  • Ball, S. A., & Links, P. S. (2007). Clinical implications of borderline personality disorder. Canadian Journal of Psychiatry, 52(7), 447–456.
  • Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004). Borderline personality disorder. The Lancet, 364(9432), 453–461.
  • Swartz, H. A., et al. (2010). Effects of dialectical behavior therapy on impulsivity and aggression among women with borderline personality disorder. Journal of Consulting and Clinical Psychology, 78(6), 919–929.
  • Levy, K. N., et al. (2006). Addressing the needs of patients with borderline personality disorder in primary care. Journal of Clinical Psychiatry, 67(Suppl 22), 23–28.
  • Gunderson, J. G., & Lyons-Ruth, K. (2008). BPD and the development of attachment. Development and Psychopathology, 20(2), 491–517.
  • Clarkin, J. F., et al. (2015). Psychotherapy for borderline personality disorder. Psychiatric Clinics, 38(2), 191–209.

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