The First Part Of Your Response Should Include The Follow ✓ Solved

I. The first part of your response should include the follow

I. The first part of your response should include the following:

· A description of how you will develop a therapeutic relationship, given the fact that Alice may not think she needs your services

· An explanation of the steps you will take to ensure the client's physical and emotional well being

· An explanation of the process you will undertake to establish or restore a normal routine for the client

II. The second part of your response should include completion of the Treatment Plan:

Identified Problem #1: Alice is at risk for physical and emotional abuse.

Behavioral Definition:

Long-term Goals:

1.

2.

Short-term Objectives:

1.

2.

3.

4.

Therapeutic Interventions:

1.

2.

3.

4.

Vignette — Alice:

Alice is a 32-year-old African-American woman who is employed as a family physician in a large family practice in a medium-sized city in New Jersey. She was raised Protestant and still attends church on Sundays with one of her sisters. Mike is a 27-year-old African-American man who is employed as a pharmaceutical representative. Alice and Mike met at a medical conference where Mike’s employer was a major sponsor. They sat next to each other at a dinner and started dating soon after that.

Alice does not have children and Mike has two children from a previous relationship. 'Mike and I had been dating for about four months. He was the greatest thing that had come into my life. I hadn’t been with a man for so many years, I had forgotten what it was like, how much fun it was to be in love, how happy it was to have someone make you smile, and someone you could smile with. I guess I was so busy being in love that I didn’t see some of the little incidents that were happening.

I guess maybe if I would have opened my eyes, what happened the other night wouldn’t have happened. I just don’t know. I just don’t understand it all. Mike had come over at about four in the afternoon, and we were going out to dinner and then to a game. I was excited.

I had never been to a basketball game. Mike was going to explain everything that happened for me, so that I would understand what was going on. We were supposed to go with a couple of his friends. I had a patient, and I didn’t get home until close to 4:30. Mike was pacing up and down the floor when I walked in.

I apologized for being late and told him that I was sorry but I could not leave this patient. We had had little incidents before, but this was the first time I really began to be fearful. Mike’s face started to get red, and I looked in his eyes and I became frightened. His eyes just looked like they belonged to someone else. His whole body began to change.

It became more rigid, and he started to yell at me. At first, his abusiveness was really only putting me down for only caring about my patients and not caring about him. When I protested and tried to calm him down, he only seemed to get angrier. Before I knew it, he was shaking me and slapping me, as well as screaming at me. I screamed back at him to stop, but he wouldn’t listen.

In fact, he reminded me of patients I have had who have gone into psychomotor seizures. At that point, I started pushing away from him and attempted to flee, but he caught me and started swinging me around in the kitchen. All of a sudden, he took me and flung me across the room, and I felt myself crashing into the stove. That was the last thing I knew. I fell on the floor, and I could feel somebody stomping and kicking me as I lay there.

I sort of felt like I was drifting in and out of consciousness. 'I don’t know how long I lay there on the floor, but when I woke up, Mike was gone. The house was dark. The pain was so bad I could barely move. I knew that I had to have been seriously injured.

From the pain, I thought maybe I had some internal bruises. Thank God there’s a phone in the kitchen. I crawled and barely made it to the phone. I pulled on the cord so that I could knock it down to the floor, because I could not stand. I called my partner and just told him that I was physically injured.

I didn’t tell him what happened to me but just told him to send an ambulance. The next thing I knew, I was there in this hospital bed. I don’t know what happened. I don’t know how I got here. All I know is what they had told me the next morning.

'Apparently, when Mike pushed me into the stove and maybe when he was stomping on me with his feet, my kidneys were damaged. As soon as they got me to the hospital, they could barely find my pulse, and they knew there was internal bleeding. They rushed me into the emergency surgery and had to remove one kidney. My second kidney was badly damaged, but they think they can save it. I don’t know what happened.

I don’t know how it got so bad. It just seems like it’s all one great big nightmare. I just don’t know what I’ll do. How can anyone so kind and gentle like Mike, that I could love so much and who could love me so much, do this to me? I just don’t understand.'

(Two days after the surgery, she was asked how she felt about being in the hospital. Afterward, she said that she and Mike were going off on this wonderful cruise as soon as she got out of the hospital.) 'I’m really not sure how the whole incident happened. Perhaps it was my fault. Mike says he really didn’t throw me against the stove. He just pushed me and I fell and hit the stove. I really believe him. He couldn’t have wanted to hurt me as badly as I was hurt. It really must have been an accident.'

Paper For Above Instructions

Summary and clinical approach

Alice presents as a recently assaulted professional who minimizes the severity and responsibility of her partner’s actions. The clinical plan must prioritize safety and stabilization, build a trusting therapeutic alliance in the face of minimization/denial, address physical and emotional needs, and restore a predictable routine while documenting and planning to reduce future risk (WHO, 2013; Campbell, 2002).

Developing the therapeutic relationship

Initial engagement will follow trauma-informed and empowerment-based principles: express empathy, validate her experience, and avoid confrontation about her beliefs (SAMHSA, 2014). Use motivational interviewing techniques to explore ambivalence and gently elicit her goals rather than imposing judgments (Miller & Rollnick, 2013). Because Alice may not see herself as a victim, I will: (1) reflect her stated feelings and values (e.g., love, professional identity), (2) normalize common responses to trauma and abuse (shame, minimization), and (3) invite collaboration on safety and recovery planning. Culturally sensitive language and respect for her faith and profession will be integrated into sessions to reduce stigma and increase trust (Johnson, 2008).

Ensuring physical and emotional well-being

First, confirm ongoing medical needs and coordinate with her treating physicians: wound care follow-up, nephrology for the remaining kidney, and documentation of injuries for safety/legal options (Campbell, 2002). Second, complete a safety assessment and create a personalized safety plan with concrete steps (safe contact numbers, warning signs, escape routes) and review mandatory reporting or legal protections as needed (WHO, 2013; National Domestic Violence Hotline, 2020). Third, address acute emotional needs via stabilization techniques (grounding, breathing, sleep hygiene) and short-term pharmacologic consultation for severe anxiety or sleep disturbance if indicated (CDC, 2021). Facilitate access to community supports (shelter, legal aid, faith-based support) and link with case management to reduce barriers to care (NCADV, 2020).

Restoring routine and functioning

Restoration of routine is gradual and collaborative. Begin with small, achievable goals (self-care, consistent sleep-wake times) and progressive role resumption (part-time return to practice when medically cleared, or temporary administrative duties). Implement behavioral activation to reduce avoidance and depressive symptoms and provide vocational accommodations support as needed (Resick et al., 2016). Coordinate with her employer for safety planning at work (changing schedules, security measures) while respecting confidentiality and her autonomy.

Treatment modalities and timeline

Once medically stable and safety is established, evidence-based trauma therapies should be offered: trauma-focused cognitive behavioral therapy (TF-CBT), cognitive processing therapy (CPT), or prolonged exposure (based on preference and clinical suitability) to address PTSD symptoms and maladaptive beliefs (Resick et al., 2016; Foa et al., 2009). Parallel case management will address legal, financial, and social needs. Frequency: twice-weekly initial stabilization sessions for 2–4 weeks, then weekly trauma-focused therapy for 8–16 sessions, reassessing goals and safety every 2–4 weeks.

Treatment Plan (completed)

Identified Problem #1: Alice is at ongoing risk for physical and emotional abuse by her partner.

Behavioral definition: Recurrent incidents in which Mike uses physical force and verbal degradation leading to injury, fear, and minimization by Alice; current risk characterized by prior severe physical assault resulting in major injury and the partner’s unpredictability and escalation.

Long-term Goals:

1. Alice will achieve and maintain personal safety and be free from further physical and emotional harm within 12 months.

2. Alice will reduce trauma-related symptoms (PTSD, anxiety, depression) to functional levels that allow safe independent work and social engagement within 12 months.

Short-term Objectives:

1. Within 2 weeks, complete a documented safety plan and emergency contacts, including options for shelter and legal resources (National Domestic Violence Hotline, 2020).

2. Within 1 month, coordinate medical follow-up and obtain documentation of injuries; ensure nephrology care and workplace accommodations as needed.

3. Within 4 weeks, initiate stabilization therapy (weekly or twice-weekly) focused on grounding, sleep, and emotion regulation techniques (SAMHSA, 2014).

4. Within 8–12 weeks, engage in trauma-focused psychotherapy (e.g., CPT) and report measurable reductions in PTSD symptom severity on standardized scales.

Therapeutic Interventions:

1. Safety planning and risk reduction counseling, including lethal risk assessment and connection to legal supports (WHO, 2013).

2. Medical coordination and case management to ensure physical recovery, documentation, and access to community resources (Campbell, 2002).

3. Trauma-informed stabilization: grounding, affect regulation, and sleep hygiene; brief pharmacologic consultation if indicated (CDC, 2021).

4. Evidence-based trauma therapy (CPT or TF-CBT) to process trauma, correct self-blame cognitions, and restore functioning (Resick et al., 2016).

Clinical considerations and follow-up

Care will be guided by Alice’s autonomy, cultural background, and readiness for change. Regular risk reassessment and multidisciplinary coordination (medical, legal, occupational) will be maintained. Therapists must document informed consent, safety planning, and referrals. If Alice re-enters relationship dynamics with Mike, contingency safety planning and rapid re-evaluation will be required (WHO, 2013).

References

• World Health Organization. (2013). Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines. World Health Organization.
• Centers for Disease Control and Prevention. (2021). Intimate Partner Violence: Consequences. CDC. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/consequences.html
• Substance Abuse and Mental Health Services Administration. (2014). Trauma-Informed Care in Behavioral Health Services. SAMHSA.
• National Domestic Violence Hotline. (2020). Safety Planning. https://www.thehotline.org/
• Campbell, J. C. (2002). Health consequences of intimate partner violence. The Lancet, 359(9314), 1331–1336.
• Johnson, M. P. (2008). A typology of domestic violence: Intimate terrorism, violent resistance, and situational couple violence. Northeastern University Press.
• Dutton, D. G. (1995). The Domestic Assault of Women: Psychological and Criminal Justice Perspectives. Guilford Press.
• National Institute for Health and Care Excellence. (2014). Domestic violence and abuse: multi-agency working. NICE guideline.
• National Coalition Against Domestic Violence. (2020). Domestic Violence Statistics. https://ncadv.org/
• Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive Processing Therapy for PTSD: A Comprehensive Manual. Guilford Press.