Assignment: Conceptualization and Treatment Plan

Object Relations Case Study of Richard:

A Conceptualization and Treatment Plan

Bea A. Goodstudent

Liberty University

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AAbstract

B egin a new page. Your abstract page should already include the page header as shown above.

Keywords: APA style, good paper style, headings, title page

Chapter 2, 2.04, p. 25-27) (Figure 2.1, p. 41).

“The example below focuses more on the details of the case and does not explain the process using outside sources. The portions in yellow-highlight are meant to give you guidance as to how to incorporate outside sources in a manner that would support the material you are presenting, therefore making a case study more of an assignment that is appropriate in an academic environment.”

Object Relations Case Study of Richard:

A Conceptualization and Treatment Plan

Case Conceptualization of Object Relations

You would want to write a good introduction to your paper here that would be one paragraph and would include your thesis statement. This should be different than your abstract which is a summary of your paper.

This is where you will also answer the following questions (each in a separate paragraph without the “bullets”):

· Who is (are) the developer(s) of the theory?

· What did they believe about human nature and the counseling process?

· Explain any research that has been done showing the efficacy of this theory.

· What diagnoses has this theory been shown to be effective with (depression, anxiety, etc.)?

· What makes this theory appropriate for your client and their presenting problems you noted in the first paper?

· What are any potential ethical issues that may arise using this theory with your client?

· What are any potential multicultural issues that may arise using this theory with your client?

· How can this theory be used in crisis situations?

Treatment Plan and Interventions

Presenting Problems:

Richard presents himself as depressed following his recent divorce. He feels lonely and unworthy. He also reports feeling great anger towards his former wife and unable to move on with his life after the divorce. He considers that the divorce was caused mostly by lack of communication between him and his wife. Richard recognizes that he has had great difficulty in communicating with others throughout his life and that only recently he has become aware of this. He reports that previous to this marriage at the age of 44, relationships with women had been short and non-committal. Throughout the interview Richard revealed that both parents were alcoholic and that he was very isolated and angry as a child. He grew up moving frequently from the homes of relatives, including one of his grandmothers.

Goals for Counseling

Write a short paragraph giving a synopsis about the 3 goals you wrote about on the Case Summary paper. Again, detail is not needed, just a quick summary of the goals that will be directing your interventions/techniques. However, make sure they are specific to your client’s problems!

From a psychodynamic and object relations perspective, the goal of therapy is to help Richard connect with his emotional self, feel the pain and rage associated with his early negative experiences to achieve emotional catharsis and gain insight regarding how these early experiences are related to the relationship problems he has experienced in his life. In the process it is also expected that by forming a close bond with the therapist, Richard may learn how to experience closeness in relationship at the same time maintaining appropriate boundaries. You would briefly tie these goals to the theory, again utilizing outside sources.

Interventions

You would want to offer a definition of each of the interventions you are using, explain why you choose to use this intervention, and what you hoped to accomplish with this intervention.

Establishing the relationship. Given Richard’s lack of significant nurturing relationships in his life, issues of trust were particularly difficult with him. This was addressed, in an empathic way, early on in the relationship – I told him that I recognized and understood that it would likely be difficult for him to trust me, the therapist, but that as he felt comfortable it was important for him to gain some trust so that the therapy may work. I also encouraged him to communicate to me how he felt regarding being or not being able to trust me, even if it felt uncomfortable for him to talk about trust issues. Initially Richard was very guarded, tended to make jokes or become hostile with me when the counseling came close to painful issues for him. In some of these instances I pointed out his behavior and asked him what he might have been feeling about himself and about me (immediacy of the relationship) just before he said the remark. Sometimes, instead of asking, I reflected to him feelings of discomfort or anger that I picked up in relation to the issues we were discussing. Sometimes, I shared with him (immediacy of the relationship) how his jokes and/or angry remarks made me feel in the relationship with him (e.g. “when you respond in that way – make a joke about something serious we are talking about or respond angrily at me – makes me feel like you are pushing me away”). And, using parallel process, other times I wondered out loud to what extent others in his life may feel like me when he behaves that way.

Analysis of transference. I helped Richard recognize and process when he was pushing me away. In these instances I asked him to stay with and explore the feelings that he was experiencing – which often included fear, anxiety, pain, disbelief that the therapist cares. As he was able to recognize and label these feelings I encouraged him to make connections with other times in his life when he had felt in similar ways. As I described above, these intervention entailed confronting Richard with what was happening in the here and now of the counseling relationship.

Insight. As part of the therapy process Richard came to understand how his early deprivation, which was not his fault, led him to not trust himself or others and feel bad about himself, and how these feelings have made it very difficult for him to enter in close relationships with others.

In summary this process involved both emotional and intellectual insight. With the support of the therapist, he allowed himself to get in touch – feel – the pain generated by his early deprivation, which lies beneath the strong anger that he feels today.

During this process my role as a therapist included providing emotional support, helping Richard “hold” and “contain” the strong pain and anger that had been pent up in him for so long, and feel accepted as he was. I often assure him that his feelings were reasonable given the experiences he had had, and communicated to him (verbally and non-verbally) that it was ok to express them and that I was not overwhelmed by his pain, anger, and fear. In some ways, he was able to re-live his painful childhood experiences in the context of a relationship where he felt accepted, and psychologically taken care of. These experiences constituted a “corrective emotional” experience.

With this new insight and corrective emotional experiences, Richard started to be less defensive and more open in relationships with women. He realized that his search of perfection in others was in part an effort to cover his strong sense of inadequacy (insight) that also served to keep others away. This realization helped him to work towards accepting himself and others (shedding away the mechanism of defense) as they are, with good and not so good things.

Spiritual Applications

Here, you want to make sure you show three ways the theory you chose is compatible and three ways it is not compatible with a Christian worldview (from your standpoint). Don’t forget to show your resources and referrals here.

Compatibilities:

Object Relations therapy is compatible with Christian principles in some ways. First, in

OR therapy, clients are seen as having the potential to change and grow, which aligns with

Scripture (Jones & Butman, 2011). Second, . . .

Incompatibilites:

Object Relations therapy is also incompatible with a Christian worldview in several ways. First, in OR therapy, clients . . .

Conclusions

With time it is hoped that Richard would become better at recognizing his anger and confronting the feelings associated with it. It is thought that Richard will experience the connection between his early experiences of abandonment and his current difficulties as he allows himself to experience and accept the pain of his lost childhood, and the anger he felt toward his parents for the constant fighting in the house and for not loving and caring for him. During these times it would be important for the therapist to assured Richard that regardless of the parents’ problems, their behavior had been wrong and that as a child he deserved better. This would serve as a corrective emotional experience. It is believed that Richard would eventually be able to understand that his anger was justified and that another person, the therapist, was able to accept him with his anger whereas in the past he interpreted his feelings of anger as further proof of his badness and feared that if the parents knew of this anger they would further reject him.

NOTE: This case study is adapted from a case study retrieved from: http://www.coe.uh.edu/arbona/courses/epsy6325/readings/Outline%20Case%20Conceptualization.doc

References

Good, W. A . (2004). Always be sure to use the best sources that you can find: It will help your paper to be better. Peer Reviewed Articles Are Best, 1 (2), 22-26 .

Books, T. N., & Notes, F. G. (2010). Use your textbooks whenever possible. (2nd ed.). New York, NY: Plenty Publishing.

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