Field Journal

Client B - DSM Provisional Diagnosis: Genealized Anxiety Disorder​

Client B is a teenaged student experiencing tightness in her chest and difficulty breathing- two symptoms associated with Generalized Anxiety Disorder. Because she is involved in high school classes and cross-country sports, biomedical (drug) therapy may not be the best route for treatment. Her physical symptoms from Client B's Generalized Anxiety Disorder are expected to lessen with psychotherapy. Client B may benefit from humanistic therapy using the practice of unconditional positive regard- exclusively positive feedback- and active listening, a practice where the therapist restates the client's words so she can hear herself. Humanistic therapy often results in the client determining a plan of action to live a meaningful and productive life. This approach also enables the client to discuss her feelings, thoughts, desires, and dreams without fear of negative judgment. This aspect is particularly important given Client B's anxiety- negative stress may lead anxiety symptoms, perhaps inhibiting psychological growth. Client B may also benefit from Ellis's cognitive-behavioral therapy, a practice focused on changing emotions and actions by challenging the client's irrational thoughts. Client B is "awfulizing" many situations, such as the times when she skipped school due to the irrational belief that "something bad was going to happen". Cognitive-behavioral therapy can help Client B to reassess her emotions regarding daily life, possibly leading to a dramatic improvement in her anxiety.

 

Client B would most benefit from a combination of individual and family therapy. Client B reported acute depression, mostly associated with the death of her grandmother. Client B feared "everyone she loved would die." A discussion of these fears may best take place during individual therapy since the client may not feel comfortable enough to discuss these ideas with immediate family whom she considers herself close to. In individual therapy, the client and therapist work together to address the client's concerns. The approach reinforces the idea that the therapist has the client's best interests in mind, and the client's information is confidential. Client B expressed concern that she "got" her anxiety from her father (diagnosed) and that, although he is supportive of her cross-country, he is "always worried" and "never sleeps." Family therapy focuses on rebuilding a sense of connection between members of the family. This practice also improves communication and problem-solving abilities. Both of these improvements would be significant to Client B, as the family could work together to improve their situation. As opposed to the family sorting out problems in private, family therapy gives them a chance to address difficult issues in safety and with the guidance of a therapist. Research shows that psychotherapy alone can be enough to overcome some psychological disorders, such as Generalized Anxiety Disorder. The effects of drug therapy may not last as long as the effects of psychotherapy, but sometimes a combination of the two is necessary to treat chronic disorders. Client B should start individual therapy within two weeks, leading up to family therapy when the therapist determines Client B has begun to improve. Sessions should continue until the client's Generalized Anxiety Disorder is under control or has healed completely. Progress should be accounted for weekly, and after two months, the therapist may explore the option of drug therapy if advised by a medical professional.