Interesting Case

The following case is from the textbook, Introduction to group therapy: A practical guide for future group therapists. Take this case, analyze it, and create a treatment plan using the cbt - psychodramatic modality. To complete the assignment, place yourself in the role of a group therapist. Use clinical textbooks to build your case and come up with a diagnosis as well. Use the DSM IV for this. Create a thought record for this case, conceputalize the case, apply CBT & Action techniques that you determine as needed to problem solve this case. Take it through the three phazes of group therapy.

Case

You are treating a young woman in group psychotherapy. She had been referred to you by another client whom you treated in group psychotherapy in the past. Her presenting problem is that she is uncomfortable with other people and is having very intense moments of anxiety in social situations.

You had seen her three times in individual psychotherapy before she entered group. In those previous three session she related that she is 26 years old, unmarried and has recently graduated from a prestigious Law School. This individual also discloses that she has spent most of her adolescence and early adulthood studying and preparing for her career which she knows is approved of by her parents. In fact, she relates that she thinks that she has been living her life only for parental approval.

The client’s parents are both professionals. Her father is a doctor and her mother a marine biologist. She feels that she has a good relationship with her parents as she has always been the supposedly "good child" never causing them any worry or concern. The client is the youngest with two older sisters; one, 30 years old, a doctor and married, and the other, 32 years old, an accountant and married. As reported by the client, her relationship with her sisters has been good although she feels there was a lot of academic competition in the family.

In relationship to her dating history, the client has been on approximately five dates in her entire life. She is attractive, bright and verbal with fine introspective abilities in relationship to her personality. Although she has never been in any form of previous therapy, her analysis of herself, although limited in certain areas, is quite good.

The client feels that maybe the group will help her with her social problem and at the same time give her some insight into her personality. Her first three sessions of group were relatively surprising in the sense that her disclosures were not typical of someone who is experiences extreme anxiety with strangers. She related that she felt quite comfortable with the group right from the beginning and believes it to be due to the accepting attitude of the group members.

During her fourth group session, the client disclosed that she felt an attraction to another woman in group. She stated that she felt this attraction during the session but did not have the courage to even think about it. As a result the feelings have intensified over the last four weeks. This is causing her severe distress and anxiety. She had wondered over the past few years whether she was gay, but has been successful in putting it out of her mind allowing her to focus on her career. Also being gay is ego-dystonic to her basic belief system and she is very aware that this will create enormous stress, tension and upheaval in her family. In addition, the dreaded fear of parental disapproval is paramount.

Diagnosis
Axis I

Axis II

Axis III

Axis IV

Axis V