Introduction to Theories in Psychotherapy

 Running head: PSYCHOTHERAPY
Introduction to Theories in Psychotherapy
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PSYCHOTHERAPY 2
Introduction to Theories in Psychotherapy
A single woman in modern-day society is often faced with many dilemmas leading to
later psychological dysfunction. This is especially true if the young woman is a lesbian and
devoid of a solid inner foundation and plagued with self-esteem issues. Lesbian women are
human beings like everyone else except for the affixed label defining their sexual orientation.
Society’s desire and need for labels can create much psychological havoc in individuals who
could lead otherwise normal lives.
Women who define themselves as lesbians encounter many of the same psychological
issues as everyone else. Depression and anxiety may be more evident within some areas of this
diverse group due to public ridicule, misunderstanding, and scrutiny. When members of a
socially diverse group make the conscious decision to engage in psychotherapy, the therapist
must take into consideration the nature in which the individual fits into the diverse grouping.
Many therapeutic techniques are designed to enhance and bring forth an inner understanding and
confidence which, in turn, provides the client with the ability to accept the self. Psychotherapy
techniques can greatly enrich and change the quality of life experienced by the diversely grouped
client, but a caring and well trained therapist will work diligently to aid the client in reaching the
therapeutic goals.
Background
Personal History
Dana is a thirty-two year old, single, Caucasian, female who defines herself as a lesbian.
Her parents are deceased, by natural causes, and she has one sibling, a brother, who lives in
another state. She indicates having little if any contact with her brother. Dana has been single for
PSYCHOTHERAPY 3
the past eighteen months since breaking up with her long-time partner due to an incident of
infidelity. Dana reveals that her ex-partner had been involved in an affair outside of their
relationship boundary for several months before discovering the infidelity. Dana has no
children, biologically or through any previous relationships. She works as a cashier for a small
retail business, but she is now on a leave of absence due to the recurring panic attacks.
Psychological History
Dana reports being diagnosed with Bipolar Disorder I over a year ago following a brief
hospitalization for unexplained depression and a sudden burst of energy that could not be
explained. She is currently on a medication regimen of 500mg of Depakote twice a day. She
briefly continued with outpatient Cognitive Behavioral Therapy (CBT) and was released with
only intermittent appointments to see the treating psychiatrist for medication.
Methodology
Presenting Symptoms
Dana enters the therapeutic setting with the chief complaint focusing on recurring panic
attacks. She explains that sometimes the panic attacks will start and seem to dye-down before
resurging and setting off another panic attack. She says the panic attacks seem to come in
waves. The symptoms associated with the panic attacks include numbness in her hands, chest
pains, confusion, sweating, and worrying that she is having a heart attack. After several trips to
the local emergency room to confirm that she was not having a heart attack, the attending
physician diagnosed Dana with having had a panic attack. She was then referred to the mental
health agency for follow-up. The referral was made three months ago.
PSYCHOTHERAPY 4
Dana has taken a voluntary leave of absence from work because she is scared of having
another panic attack at work or while driving. She refers to her home as her “safe haven”. It is
revealed that she is reluctant to leave her home even to check the mail or go to the grocery store
because of the insatiable fear of having another panic attack. The panic attacks are now reported
to be occurring at home and include waking her up from sleep. Dana defines the episodes as
feeling out of control. Further questioning uncovers new “habits” that Dana has now engaged in
as well. Dana exposes that she now feels that she can ward off the panic attacks if keeps every
door and window locked while inside her home. She also tells how repeating the word “Amen”
after saying a prayer will also help to ward off the panic attacks.
Physically, Dana appears to be lacking sleep. Her eyes have darkened circles beneath
them, and they appear to be puffy from either crying or from allergies. All the lab work indicates
that her Depakote level is well within the safe range and that she is continuing to take her
medication. While her facial appearance resembles exhaustion, her body language suggests
otherwise. Her right foot is constantly bouncing, and she continually changes positions in her
seat. Her hands are kept clasped together tightly, and it appears as if she is trying to wring out a
washcloth.
Diagnosi