The Psychodynamic Therapy - Assignment Example

Week 3 22 Assignment Abby is not yet ready in my opinion to use a psychodynamic theory of counseling. Her greatest challenge that she is presenting right now is her sadness and depression. Before she can get started, it would seem that an ASE assessment for possible risk of suicide would be most appropriate. Also, she seems to need some type of pharmacological intervention for the depression and the anxiety. According to Nemade, Reiss, and Dombeck (2007), this action would help her get into a position where her depression could be addressed. Strengths Once she is stabilized she would be a good candidate for psychodynamic therapy because she would be more able to listen to the counselor and allow them to help guide her to understand how she is feeling. I agree with R. Ford and that reparenting may be necessary for Abby. To me this is one of her strengths because she would be able to handle this situation. She would need to accept where she is and gain strength in the "soothing and repair efforts" for herself. Abby seems to be pretty stable individual in one sense, because she has come to therapy and because she has a generally strong history. Weaknesses She does not have a strong support system other than her mother according to the case study which could leave room for transference in a positive or negative way. She seems very stressed which could be part of the cause for depression. She seems very fragile and prone to anxiety so there are some other types of therapy that would not work well for her. She feels helpless so she may feel resistant to some types of psychodynamic therapy. Wk 3 (22) Assignment 2 The first aspect of using Adlerian Therapy with Abby is to have an objective interview. This will help the therapist get an idea of who she is on many different levels. The MSE is a very good start for this because of her presenting problems with anxiety and depression. I would also like to see how The Life Situation Assessment (Corey, 2001, p. 55). It is essential in this type of therapy to get a lifestyle assessment so we know where we are headed as therapists. This would help me see the bigger picture and may present information that can be used later. Some of that interview has already been given in the case study but what concerns me is that she seems to be so out of control with anxiety that she probably will not be able to deal with her issues. The question, "If you didnt have these issues, concerns, or problems, what would be different?" Is a very good question for Abby because it would bring her out of the pain of her presenting problems. In this situation, I would start by talking to her about her depression and what she thought the cause of it may be. I would also suggest medication and refer her to her family physician for a diagnosis. I would want to get her stabilized for the depression and the anxiety before we would proceed. My overall goal with Abby would be to help her become a fully functioning human being who loved live and who was not afraid of so many things. I would want to help her look at her family issues (possibly abandonment, lack of a foundation for assistance and her general relationship issues) to get closer to looking at her relationship with her husband. Other goals of therapy for her would be: 1. To establish a good working relationship between Abby and myself so that she would feel safe in the environment. 2. Provide a positive and safe environment where she would be able to bring her issues and to understand her feelings about herself and the world around her. 3. To discovery that some of her beliefs may be faulty and help her understand how they came to be faulty. 4. To assist her in developing alternative ways of thinking by looking at her situation, having insights that are important and translating her insights into some type of action. The fact that Abby is the third of six children may lend a clue as to what is going on with her. Birth order was very important to Adler because he felt that the order in which a child was born gave a strong indication of their personality (Boree, 2006, "Theory"). It appears that Abby may be considered a "middle" child since she was the halfway between the first and last three children. As an example, Abby may be exhibiting traits of the second child. She has already seen two children ahead of her and this may be the reason why she presents as someone who is running all the time and not really taking a breath for herself. He also felt that early lifestyle had something to do with how the adult presented later in life. All of this information would add to what the therapist needed to know about Abby. Abby does not have a support system it seems other than her mother. This could be an indication of how she sees and perceives relationships. It seems to me that Abby must make some changes in her life in order to become emotionally stronger within herself. By helping her disclose her goals and purpose, she can discover her own goals and motivations. This will be very helpful to her challenges with relationships. It would also be important to help Abby find a sense of empowerment. This would help her find more social-emotional competence as she moved forward in therapy and in her life. I think the major strengths for Abby would be her willingness to learn and to move forward with her life. Adlerian Therapy puts an emphasis on moving the client forward into a more rewarding life. I think that once she was stabilized with her medications, she would begin to realize what she really wanted in life. Gender issues that may come about might have something to do with her age. Since she is 56, there may be some issues that have come because of her age group and the treatment from her family. This information may give a clue to the therapist about how she perceives herself within the family which would be important to this theory. Legal issues would be that there should be full disclosure of the counseling process and the counselors limitation. There may be a tendency for her to experience transference or counter-transference and the counselor would have to be mindful of the process as Abby gets better. The challenge may be that she would want to cling to the therapist and have them tell her what to do; the counselor would have to be careful to make sure she was leading her progress. Termination should also be talked about with the client because there could come a time when the therapist finds that a different referral may be necessary because they are getting into territory that is beyond their comfort zone or area of expertise. References Boeree, G. (2006). Alfred Adler 1870-1937. Personality Theories. Retrieved September 24, 2009 from http://webspace.ship.edu/cgboer/adler.html. Corey, G. (2001). Case approach to counseling and psychotherapy. Fifth Edition. CA: Wadsworth/Thompson. Nemade, R., Reiss, N.S., and Dombeck, M. (2007). Other forms of psychotherapy for major depression - Psychodynamic therapy. MentalHealth.net. Retrieved September 24, 2009 from http://www.mentalhelp.net/poc/view_doc.php?type= doc&id=13028&cn=5. Read More