Contemporary Psychodynamic Treatment Content: Using contemporary...

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Contemporary Psychodynamic Treatment

Content: Using contemporary psychodynamic theory (self psychology, attachment theory, intersubjectivity, and relational theory) to inform your clinical social work treatment, write an assessment of the attached case by answering the five questions below. Please write your assessment in complete sentences, and give clear examples and rationale for your answers. You must include a minimum of four references from your readings, and you each are responsible for finding a minimum of one new reference (Berzoff et al. can count as only one of your four). You should use first-person when talking about yourselves.

Paper format: Follow APA guidelines for title page, text, headings, and references. Put your name(s) on the cover sheet. The text should be typed, double-spaced, with Times New Roman 12-point font, no less than 6 pages, and no more than 7 pages max (this does not include title page or reference page). Use APA headings to divide your paper in response to the five questions below. You may co-create your paper with a classmate if you so choose - you will both receive the same grade. Be prepared to discuss your paper during the last class. I will grade your paper and return feedback by e-mail. Late papers will receive a 5-point per day penalty.
1. Based on this vignette, how would you describe the presenting problem for clinical social work intervention and/or psychotherapy?
2. What larger socio-cultural issues might be affecting this individual, and what cross-cultural issues might be present in YOUR work with this individual?
3. Using object relations theories (i.e., Klein, Winnicott, and Bowlby), how would you assess the “internal representations of self and other” of the individual under discussion? What evidence do you see of Winnicott’s True or False Self? What evidence do you see of psychological splitting? How would you describe the individual’s functioning from an attachment perspective? How would you speculate the client’s relational patterns developed, and how would YOU work with this?
4. Using self psychology and intersubjectivity, what “selfobject transferences” and “selfobject countertransferences” do you anticipate might develop with YOU and this client and why? How would you work with this?
5. Using contemporary relational theory, what ongoing enactments would potentially develop with YOU and this client and why? How would you work with this?

Donna
Donna, age 17, is an African-American senior in a DC high school, who was referred to the school social worker by her teacher because of ongoing symptoms resulting from the trauma of a rape. She arrived alone for the social work assessment, but concurred with her mother, who joined the meeting later, that she “has always wanted to come to therapy.”
During the initial evaluation, which consisted of an interview about the trauma, Donna portrayed a “nonchalant” attitude and affect that was inappropriate to the situation while she summarized the rape experience. Oddly, her description of the rape was fragmented and almost unbelievable. “They set me up” (Frankie and his “girl”), she asserted. “He started messing with me, so I told him I had gonorrhea and chlamydia and he wanted to check. I let him. Then he did it.”   
According to the detective involved in Donna’s case, the rape investigation was closed due to insufficient evidence. Nevertheless, Donna reported she has had symptoms of flashbacks, restricted affect, sleeplessness, problems concentrating in school, persistent fear, and ongoing panic attacks for the past 6 weeks. She also described unexpected panic attacks characterized by increased heart-rate, shortness of breath, dizziness, feeling “crazy,” trembling, and sweating especially when she feels angry at a loved one. These symptoms have occurred monthly since aged 15 and increased to weekly following the rape. In particular, she said these feelings surface when her mother disappoints her.

Family History
Donna lives in a lower middle-class, educated family in an urban area. Her unmarried parents have remained in contact for 27 years, but have never lived in the same house. Donna was raised by her grandmother and cared for her by her Aunt Bea until age 5. Currently, she lives with her mother, but she has a closer relationship with her father and grandfather who live in a nearby apartment building. She has two older brothers who are in college.
She says she experiences her mother as distant and bizarre. She states, “She’s not a mother. She’s just a lady.” She describes her mother as “lunchin’,” which is a saying used by urban teens derived from the expression “out to lunch.” She describes her father as dually affectionate and aggressive, stating that he has a “cursing problem.” She has experienced caregiving relationships that have provided her with the support unavailable from her mother and father. She was nurtured by her babysitter, Aunt Bea, during her first 5 years of life and cared for by her Grandma Bessie. Yet both relationships have resulted in loss as well. Aunt Bea died when Donna was 5-years old, and her Grandma Bessie is dying of Alzheimer’s disease.
Donna’s early childhood memories reflect the primary feeling that she was afraid and alone. She cannot recall joyful moments. She received messages from her mother that she was “hungry and eating like crazy all of the time.” Her first memory at 2-years old was when she was sitting on the beach and fearfully watching a wave come up over her head, while her father was nearby and her mother was absent. Interestingly, a favorite family story depicts Donna’s angry feelings and subsequent relationship with her mother: she recalls that shortly after Aunt Bea’s death, she cut her sleeping mother’s hair off and then glued it back on, fearing her mother’s angry response.
These feelings are counterbalanced by Donna’s description of feeling calm and loved, while sitting on Aunt Bea’s lap, even in the midst of a reprimand for “being bad.” During her mother’s depression, Donna turned to her “other” mother, Aunt Bea, for comfort and discipline. At age 5, Aunt Bea died, leaving Donna lost and alone. Donna proudly recounts that she did not cry at the funeral. In the presence of Grandma Bessie, Donna beamed. While growing up, she identified most with her grandmother.
At the age of 8, Donna began wishing that she would die. After sharing that wish with her mother, Donna received a slap in the face in response to her childhood grief. These feelings further turned inward, and she acted in response when she tried to hang herself at age 10.

School and Social Life
Currently, Donna attends 12th grade at an urban public high school for the arts with a specialty in vocal theatrics. She has excelled in school all of her life and has been on the honor roll. Since the rape, she says she has been unable to concentrate in school or to sustain her after-school job. Until the rape, school had provided her a haven and an arena to demonstrate her competence.
Socially, Donna has felt isolated due to the push-pull within her self about her developing “crushes” on girls. Isolated from her family, overlooked by adults, and conflicted in “liking girls,” Donna “did her own thing” through her teen years. She states that she has always been a “tomboy.” She recalls at age 13 cutting her waist-length hair “boy-cut short” in an effort to test people’s reactions. At 15, she fell in love with Damond; this relationship ceased when her mom discovered that they were sexually active and her aunt reacted to that discovery by punching Donna in the stomach. Donna then explored her romantic interest in girls and began an 8-month relationship with Angela. Donna says her mother “acted jealous” when she discovered that Angela was gay. The relationship was severed when her mother called Angela’s mother and “outed her.” Donna reacted by cutting her hair even shorter and by delving into academics; she succeeded by making honor roll and developing her singing talent.
Although living in a large extended family and having many social relationships, Donna feels like the “odd one out”; she says she feels left out and alone.She feels confused about “all the pieces of the puzzle” within her life, and she says she has feelings that there is a “lost” part of herself that her family is keeping hidden in some way.

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These solutions may offer step-by-step problem-solving explanations or good writing examples that include modern styles of formatting and construction of bibliographies out of text citations and references. Students may use these solutions for personal skill-building and practice. Unethical use is strictly forbidden.

The presenting problem for clinical social work intervention and/or psychotherapy
According to Woolford, Patterson, Macleod, Hobbs, and Hayne2015), a presenting problem refers to the initial symptoms for which an individual seeks assistance from a health care provider. Having understood this definition, one can point out to the presenting problem for clinical social work intervention based on Donna’s case. As such, the chief presenting problem is anxiety. From what has been related in the case study, Donna is experiencing extreme fear and worry, panic attacks, separation anxiety, social anxiety disorder, selective mutism, and specific phobias. All these issues apparently present anxiety.
The larger socio-cultural issues that might be affecting Donna and the cross-cultural issues that might be presenting my work with the patient
According to Pandit, Chen-Feng, Kang, Knudson-Martin, and Huenergardt (2014), a socio-cultural issue is primarily the challenge posed by lifestyle, customs, and values that a given group or society has adopted. From the case study, there is a host of socio-cultural factors that might be contributing to the situation that Donna is in. One of these is a spirit of lesbianism. It is well defined in the case study that at some point in her life, Donna developed a liking for girls. As a matter of fact, she had a love relationship with Angela, a fellow girl, until they were found out by their parents. Another socio-cultural factor is a work-life balance. The case study puts it forward that Donna has been inept to concentrate in school and to maintain her after-school job. What this means is that, despite being a minor, Donna is involved in...

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