Abnormal Psychology: Role Play
Role Play Paper
Liberty University
Abstract
The client, a 29-year old male, seek for clinical evaluation and counselling due to having persistent thoughts about having a bad body odor despite confirmation from family members that he does not smell bad. These thoughts have been present for more than 6 months. Due to his problem, the client takes a bath and applies cologne more frequently than the usual. The thoughts have also often made him worry and get anxious of other people’s reaction towards his smell. The client remained cooperative all throughout the interview. He smelled good, has no unusual behaviors and showed no signs of extreme depression or anxiety. More importantly, no hallucinations …show more content…
of any kind were detected. Initial diagnosis was made pertaining to delusional disorder, somatic type, multiple episode, currently in acute episode. Obsessive compulsive disorder, body dysmorphic disorder and illness anxiety disorder were ruled out. A cognitive approach was used to explain the client’s condition, emphasizing on cognitive biases and maladaptive cognitive distortions. The treatment plan includes the objective of correcting the irrational thought through Cognitive-Behavioral Therapy. The frequent anxiety and worrying were also aimed to be reduced through counselling and family support.
Intake Report
**CONFIDENTIAL**
Identifying Information and Reason for Referral
Client name: Daniel Walters
Age: 29
Sex: Male
Marital Status: Married
Referral source (and telephone number, when possible): Client’s wife
Reason for referral: Consultation and counselling
Interviewer: Pam Thibeaux
Date of report: July 7, 2014
Presenting complaint:
Present complaint involves persistent thoughts about having a bad body odor. He said that he believes that he has foul body odor even if “my friends, family and wife tell me that I do not have a foul body odor.”
Current Situation and Functioning Daniel is able to fulfill his daily tasks and responsibilities. He reported that during weekdays, he wakes up at around eight in the morning, takes a shower, applies deodorant and cologne to be sure that he smells good, and then goes to work. He is currently employed as a web developer in an IT company. He stated that his condition has not interfered significantly with his job and with his relationships with other people at work. He considers himself as a good and responsible employee. However, he is often anxious that his coworkers may be smelling his body odor and worries that they may get offended by the smell and avoid him. He also frequently imagines that his coworkers are being repelled his body odor.
At home, Daniel is also able to fulfill his responsibilities as a father and a husband. His condition has not also significantly interfered his relationship with his wife and child.
Overall, the client is capable of performing daily activities at work and at home. He thinks of himself as a family man who likes to spend time with his family. He considers himself uncomplicated except for his problem regarding his body odor. Currently, he is coping with this problem by trying to ignore thoughts related to it.
Behavioral Observations (including Mental Status) At the time of the interview, Daniel appeared neat and healthy. He smelled good, like the scent of cologne which is not too strong or too dominant. He had a good posture. He maintained eye contact and his facial expressions were appropriate. He articulated himself clearly. He answered questions spontaneously with normal rate and speed. He was cooperative throughout the interview and reported information adequately. His memory is intact and he did not show signs of emotional disturbance or depression. He also has no suicide or homicide ideation. He described his current mood as “normal except for having these thoughts of smelling.” Minimal signs of anxiety can be detected while answering.
History of the Presenting Problem(s)
Daniel was prompted by his wife to seek for clinical evaluation and counselling. The client’s present complaint concerns his persistent thoughts about having a bad body odor. His friends, family and wife always tell him that he does not have a foul body odor. However, the thoughts concerning his body odor persists causing him to shower and apply cologne or deodorant more frequently. Despite taking baths more often, the thoughts concerning his body odor continue to persist for years. Daniel recalled that his problem began when he was in college. He overslept for a class one morning so he ran all the way from home to school. When he got to class, he was perspiring heavily and thus, smelled bad. The smell continued for the rest of the day. He was embarrassed because he knew his classmates could smell him. A month later, he began having thoughts of smelling bad. Even after having taken a shower and applying deodorant or cologne, he believes that the smell would not go away. He could not remember when, but eventually, he came to realize that his thoughts on having a bad odor is not true as confirmed by his friends and family. Still, the thoughts of smelling bad persisted for three years. After those three years, the thoughts suddenly stopped. The persistent thoughts did not occur for years, however, after being in remission for five consecutive years, the thoughts returned and have continued since. Although Daniel’s condition did not significantly debilitate his day-to-day functioning, it caused him to experience worries and anxiety. He felt that people around would avoid close physical contact with him once they smell his foul body odor. He became anxious about how other people will react towards his smell. He frequently worries about his body odor which causes him to become overly conscious about smelling good. The thoughts also contribute to his distorted self-perception. These worries and anxiety added up to the mental stress that he is currently experiencing. It is important to note, however, that no olfactory, visual, or auditory hallucinations were detected and reported. Signs and symptoms of depression were also not exhibited by the client.
Treatment (Psychiatric) History and Family Treatment (Psychiatric) History Daniel has not received any mental health treatment in the previous years.
He has not consulted any psychiatrist or psychologist regarding his problem. This is the first time that the client underwent psychological evaluation and interview. He has no history of any psychological disorder nor did any of his family members suffered from any major psychological problem.
Relevant Medical History The client is not under any current medication. He has not consulted a medical doctor for the last five years. He also has not encountered any major injury or surgery in the past. The client also denied having acquired major physical illnesses. He described his physical condition as healthy and requiring no special attention.
Developmental History Daniel’s developmental history is normal. He reached developmental milestones in appropriate ages. His schooling was neither delayed nor advanced. He reported a normal developmental history, and stated that he grew up as “an average kid.” His basic needs were adequately satisfied and his education was financially supported. When he was in high school, he was not too engaged in extra-curricular and sports activities, but received satisfactory grades and performed fairly well academically. Upon graduation from high school, he went to a technical school for a two year degree. While studying, he was able to develop good relationships with few classmates and friends. He related well with his peers and had a peer group to belong to. His grades during …show more content…
college were also satisfactory.
After years of working in the IT industry, the client decided to get married.
He and his wife eventually had a child who became their source of happiness and inspiration. The client did not report having a major family problem. He described his family, wife, and friends as people who constantly provide a good support system.
Social and Family History Daniel is the middle child of three children. He was born and raised in Georgia. His significant early memories involve playing with his two brothers. He reported his family as an “average” family. He mentioned that his parents worked hard and took care of him and his brothers. He considered them as very hardworking who did their best to provide for the whole family and support their needs.
The client initially worked as technical support representative before he transferred to another company as a web developer. He enjoys his work as he is fond of doing computer-related tasks. He considers these tasks as recreational activities.
He also reported that he had several girlfriends before marriage and had sexual intercourse also before marriage with two or three women besides his wife. The client denied being involved in any violent situation. He does not drink alcohol and has not consumed any illegal drug. There were also no legal problems encountered. Daniel said that he “used to be” a Christian but not anymore as of the
present. Case Formulation The client’s cognitive process constitutes several maladaptive cognitive distortions and biases which lead him to have irrational thoughts regarding his body odor. Being maladaptive, these distortions persuade the client to believe in something that is not true despite being provided with reality-based evidences and despite urging from family members to abandon the irrational thought. One of these cognitive distortions detected in the client is catastrophizing or magnification. He magnified that one event when he had a bad body odor by thinking that he will always have that odor despite taking a shower or putting on cologne. That one event never left his mind and was even magnified to the point that the negative event was always thought to happen again. He maintained the belief that if he has a bad body odor, then people will think bad of him and avoid him, leading to more negative events. The client was able to catastrophize a mild negativity into an everyday worry. Another cognitive distortion exhibited by the client is mental filtering. The client’s thought became fixed only on the idea of having a bad body odor that other positive events were neglected. Also, the possibility that he may not have the odor anymore was not considered. The client believed only on his irrational thoughts and other alternative beliefs were rejected. From these observations, it is clear that the client adapts maladaptive cognitive distortions and biases which brought about his false belief regarding his body odor.
Diagnostic Impressions
Daniel has Delusional Disorder, Somatic Type, Multiple episode, currently in acute episode. He has been delusional about having body odor for more than 6 months.
Rule out 300.3 Obsessive Compulsive Disorder. The client’s behavior of taking showers and applying cologne or deodorant are not done in a repetitive manner, only with more than the common frequency. The client’s thoughts and behaviors did not significantly interfered with his daily functioning.
Rule out 300.7 Body Dysmorphic Disorder. The client’s preoccupation does not concern his physical appearance, but his odor.
Rule out 300.7 Illness Anxiety Disorder. The client’s delusion does not concern having a serious illness.
Theoretical Perspective The cognitive theory states that people’s thoughts greatly influence their behaviors. It supports the saying that we are what we think. For cognitive theorists, normal people exhibit adaptive assumptions and thoughts while people suffering from psychological disorders have maladaptive cognitive distortions (Meichenbaum, 1977). Considering this argument, delusions are viewed more as a form of cognitive dysfunction and bias rather than as an effect of certain psychodynamic or biological factors. According to the cognitive approach, delusions may be caused by specific cognitive dysfunctions. One of these dysfunctions is probabilistic reasoning. Delusional patients have a tendency to make assumptions and generalizations from little or less evidences (Garety & Hemsley, 1994). Another dysfunction lies on their metacognitive performance. People with delusions have an impaired ability to differentiate internally generated experiences from external ones (Moritz, et al., 2005). Another factor which is attributional style may also lead to personalizing and externalizing biases. All in all, these dysfunctional cognitive processes interact with one another to produce the delusion or irrational thought and failure to correct these biases may lead to continuous persistence of the delusion.
Treatment Plan Since the major problem of the client is the delusion of having bad body odor, he is recommended to undergo cognitive-behavioral therapy. This form of therapy aims to replace the client’s irrational thoughts and transform them into rational ones by gradually providing reality-based evidences that will challenge the patient’s delusion and allow him to re-examine his thoughts and views. This form of therapy also aims to enable the client to recognize the irrationality behind his thoughts so that he can independently distinguish between delusion and reality. With the help of psychological education, the client will be able to fully understand his condition. The second major problem found in the client is his persistent worrying and feelings of anxiety brought about by the delusion. To combat this, the client will be assisted in forming and exploring more socially adaptive coping mechanisms. These adaptive coping skills, including rational thinking, shall be strengthened and reinforced through the use of rewards. This is to empower the client to become independent in dealing with his own problems and reduce his need for affection. To reduce the amount of mental stress that the client is experiencing due to persistent worrying, sufficient social and emotional support will be provided and sought. For this, the client is encouraged to undergo counselling. His family and friends will also be encouraged to offer support and will be taught the proper way to deal with this kind of problem.
________________________________ ______________________ Signature Date
(Print name and title under line in place of “signature”)
References
Garety, P.A. & Hemsley, D.R. (1994) Delusions: Investigations into the Psychology of Delusional Reasoning. Psychology Press.
Meichenbaum, D.H. (1977). Cognitive-behavior modification. New York: Plenum.
Moritz, S. et al. (2005). Confidence in errors as a possible basis for delusions inschizophrenia.
Journal of Nervous and Mental Disease, 193, 9–16.
Appendix A: Treatment Plan Worksheet
Counselor Name: Pam Thibeaux
Client Name: Daniel Walter
Case #:
Problem 1: Client is having delusions of somatic type.
Goal 1: Eliminate distorted/irrational thoughts.
Objective 1: Correct irrational thoughts with rational and reality-based views of self.
Intervention1: Assist the client in restructuring his irrational beliefs by presenting reality-based evidences through Cognitive-Behavioral Therapy.
Intervention 2: Probe client’s underlying needs and feelings that trigger irrational thought and allow him to discover more adaptive ways to satisfy those needs.
Objective 2: Persuade the client to accept the fact that his delusions are symptoms of a mental disorder.
Intervention 1: Educate and provide client with literature on Delusional Disorder.
Intervention 2: Engage the client into an informative discussion regarding the disorder.
Goal 2: Enable the client to think rationally/realistically.
Objective 1: Enable the client to recognize his own irrational thoughts and distinguish them from rational ones.
Intervention 1: Assist the client to point out situations, emotions or thoughts that trigger delusion.
Intervention 2: Gradually and gently confront and challenge the client’s illogical thoughts to refocus disordered thinking to a more realistic and more rational frame.
Objective 2: Stop the delusion and irrational thoughts from dominating the client’s cognitive processes.
Intervention 1: Teach client thought stopping techniques.
Intervention 2.: Reinforce the client’s clarity and rationality of thought through the use of rewards and repetition.
Problem 2: Daniel persistently experiences worries and anxieties brought about by the delusion.
Goal 1: Reduce anxiety symptoms.
Objective 1: Encourage client to see a psychiatrist for him to be evaluated for psychotropic medication.
Intervention 1.: Enumerate to the client the benefits of psychopharmacotherapy.
Intervention 2.: Resolve clients’ issues regarding taking psychoactive drugs.
Objective 2: Assure that medication is followed as directed by psychiatrist.
Intervention 1.: Advice client as to why medication compliance is necessary.
Intervention 2.: Monitor client for medication compliance. Goal 2: Provide adequate emotional and social support.
Objective 1: Enhance client’s adaptive coping skills.
Intervention 1: Create a conducive environment where the client can verbalize his underlying needs, conflicts, and emotions.
Intervention 2: Provide counselling that will strengthen client’s coping mechanisms in order to help him cope independently and adaptively with these needs, conflicts and emotions.
Objective 2: Encourage support from the significant persons in the client’s life.
Intervention 1: Educate client’s family and peers regarding the nature of the disorder.
Intervention 2: Teach family members on how to properly deal with the client and his problem.
Liberty University
Abstract
The client, a 29-year old male, seek for clinical evaluation and counselling due to having persistent thoughts about having a bad body odor despite confirmation from family members that he does not smell bad. These thoughts have been present for more than 6 months. Due to his problem, the client takes a bath and applies cologne more frequently than the usual. The thoughts have also often made him worry and get anxious of other people’s reaction towards his smell. The client remained cooperative all throughout the interview. He smelled good, has no unusual behaviors and showed no signs of extreme depression or anxiety. More importantly, no hallucinations …show more content…
of any kind were detected. Initial diagnosis was made pertaining to delusional disorder, somatic type, multiple episode, currently in acute episode. Obsessive compulsive disorder, body dysmorphic disorder and illness anxiety disorder were ruled out. A cognitive approach was used to explain the client’s condition, emphasizing on cognitive biases and maladaptive cognitive distortions. The treatment plan includes the objective of correcting the irrational thought through Cognitive-Behavioral Therapy. The frequent anxiety and worrying were also aimed to be reduced through counselling and family support.
Intake Report
**CONFIDENTIAL**
Identifying Information and Reason for Referral
Client name: Daniel Walters
Age: 29
Sex: Male
Marital Status: Married
Referral source (and telephone number, when possible): Client’s wife
Reason for referral: Consultation and counselling
Interviewer: Pam Thibeaux
Date of report: July 7, 2014
Presenting complaint:
Present complaint involves persistent thoughts about having a bad body odor. He said that he believes that he has foul body odor even if “my friends, family and wife tell me that I do not have a foul body odor.”
Current Situation and Functioning Daniel is able to fulfill his daily tasks and responsibilities. He reported that during weekdays, he wakes up at around eight in the morning, takes a shower, applies deodorant and cologne to be sure that he smells good, and then goes to work. He is currently employed as a web developer in an IT company. He stated that his condition has not interfered significantly with his job and with his relationships with other people at work. He considers himself as a good and responsible employee. However, he is often anxious that his coworkers may be smelling his body odor and worries that they may get offended by the smell and avoid him. He also frequently imagines that his coworkers are being repelled his body odor.
At home, Daniel is also able to fulfill his responsibilities as a father and a husband. His condition has not also significantly interfered his relationship with his wife and child.
Overall, the client is capable of performing daily activities at work and at home. He thinks of himself as a family man who likes to spend time with his family. He considers himself uncomplicated except for his problem regarding his body odor. Currently, he is coping with this problem by trying to ignore thoughts related to it.
Behavioral Observations (including Mental Status) At the time of the interview, Daniel appeared neat and healthy. He smelled good, like the scent of cologne which is not too strong or too dominant. He had a good posture. He maintained eye contact and his facial expressions were appropriate. He articulated himself clearly. He answered questions spontaneously with normal rate and speed. He was cooperative throughout the interview and reported information adequately. His memory is intact and he did not show signs of emotional disturbance or depression. He also has no suicide or homicide ideation. He described his current mood as “normal except for having these thoughts of smelling.” Minimal signs of anxiety can be detected while answering.
History of the Presenting Problem(s)
Daniel was prompted by his wife to seek for clinical evaluation and counselling. The client’s present complaint concerns his persistent thoughts about having a bad body odor. His friends, family and wife always tell him that he does not have a foul body odor. However, the thoughts concerning his body odor persists causing him to shower and apply cologne or deodorant more frequently. Despite taking baths more often, the thoughts concerning his body odor continue to persist for years. Daniel recalled that his problem began when he was in college. He overslept for a class one morning so he ran all the way from home to school. When he got to class, he was perspiring heavily and thus, smelled bad. The smell continued for the rest of the day. He was embarrassed because he knew his classmates could smell him. A month later, he began having thoughts of smelling bad. Even after having taken a shower and applying deodorant or cologne, he believes that the smell would not go away. He could not remember when, but eventually, he came to realize that his thoughts on having a bad odor is not true as confirmed by his friends and family. Still, the thoughts of smelling bad persisted for three years. After those three years, the thoughts suddenly stopped. The persistent thoughts did not occur for years, however, after being in remission for five consecutive years, the thoughts returned and have continued since. Although Daniel’s condition did not significantly debilitate his day-to-day functioning, it caused him to experience worries and anxiety. He felt that people around would avoid close physical contact with him once they smell his foul body odor. He became anxious about how other people will react towards his smell. He frequently worries about his body odor which causes him to become overly conscious about smelling good. The thoughts also contribute to his distorted self-perception. These worries and anxiety added up to the mental stress that he is currently experiencing. It is important to note, however, that no olfactory, visual, or auditory hallucinations were detected and reported. Signs and symptoms of depression were also not exhibited by the client.
Treatment (Psychiatric) History and Family Treatment (Psychiatric) History Daniel has not received any mental health treatment in the previous years.
He has not consulted any psychiatrist or psychologist regarding his problem. This is the first time that the client underwent psychological evaluation and interview. He has no history of any psychological disorder nor did any of his family members suffered from any major psychological problem.
Relevant Medical History The client is not under any current medication. He has not consulted a medical doctor for the last five years. He also has not encountered any major injury or surgery in the past. The client also denied having acquired major physical illnesses. He described his physical condition as healthy and requiring no special attention.
Developmental History Daniel’s developmental history is normal. He reached developmental milestones in appropriate ages. His schooling was neither delayed nor advanced. He reported a normal developmental history, and stated that he grew up as “an average kid.” His basic needs were adequately satisfied and his education was financially supported. When he was in high school, he was not too engaged in extra-curricular and sports activities, but received satisfactory grades and performed fairly well academically. Upon graduation from high school, he went to a technical school for a two year degree. While studying, he was able to develop good relationships with few classmates and friends. He related well with his peers and had a peer group to belong to. His grades during …show more content…
college were also satisfactory.
After years of working in the IT industry, the client decided to get married.
He and his wife eventually had a child who became their source of happiness and inspiration. The client did not report having a major family problem. He described his family, wife, and friends as people who constantly provide a good support system.
Social and Family History Daniel is the middle child of three children. He was born and raised in Georgia. His significant early memories involve playing with his two brothers. He reported his family as an “average” family. He mentioned that his parents worked hard and took care of him and his brothers. He considered them as very hardworking who did their best to provide for the whole family and support their needs.
The client initially worked as technical support representative before he transferred to another company as a web developer. He enjoys his work as he is fond of doing computer-related tasks. He considers these tasks as recreational activities.
He also reported that he had several girlfriends before marriage and had sexual intercourse also before marriage with two or three women besides his wife. The client denied being involved in any violent situation. He does not drink alcohol and has not consumed any illegal drug. There were also no legal problems encountered. Daniel said that he “used to be” a Christian but not anymore as of the
present. Case Formulation The client’s cognitive process constitutes several maladaptive cognitive distortions and biases which lead him to have irrational thoughts regarding his body odor. Being maladaptive, these distortions persuade the client to believe in something that is not true despite being provided with reality-based evidences and despite urging from family members to abandon the irrational thought. One of these cognitive distortions detected in the client is catastrophizing or magnification. He magnified that one event when he had a bad body odor by thinking that he will always have that odor despite taking a shower or putting on cologne. That one event never left his mind and was even magnified to the point that the negative event was always thought to happen again. He maintained the belief that if he has a bad body odor, then people will think bad of him and avoid him, leading to more negative events. The client was able to catastrophize a mild negativity into an everyday worry. Another cognitive distortion exhibited by the client is mental filtering. The client’s thought became fixed only on the idea of having a bad body odor that other positive events were neglected. Also, the possibility that he may not have the odor anymore was not considered. The client believed only on his irrational thoughts and other alternative beliefs were rejected. From these observations, it is clear that the client adapts maladaptive cognitive distortions and biases which brought about his false belief regarding his body odor.
Diagnostic Impressions
Daniel has Delusional Disorder, Somatic Type, Multiple episode, currently in acute episode. He has been delusional about having body odor for more than 6 months.
Rule out 300.3 Obsessive Compulsive Disorder. The client’s behavior of taking showers and applying cologne or deodorant are not done in a repetitive manner, only with more than the common frequency. The client’s thoughts and behaviors did not significantly interfered with his daily functioning.
Rule out 300.7 Body Dysmorphic Disorder. The client’s preoccupation does not concern his physical appearance, but his odor.
Rule out 300.7 Illness Anxiety Disorder. The client’s delusion does not concern having a serious illness.
Theoretical Perspective The cognitive theory states that people’s thoughts greatly influence their behaviors. It supports the saying that we are what we think. For cognitive theorists, normal people exhibit adaptive assumptions and thoughts while people suffering from psychological disorders have maladaptive cognitive distortions (Meichenbaum, 1977). Considering this argument, delusions are viewed more as a form of cognitive dysfunction and bias rather than as an effect of certain psychodynamic or biological factors. According to the cognitive approach, delusions may be caused by specific cognitive dysfunctions. One of these dysfunctions is probabilistic reasoning. Delusional patients have a tendency to make assumptions and generalizations from little or less evidences (Garety & Hemsley, 1994). Another dysfunction lies on their metacognitive performance. People with delusions have an impaired ability to differentiate internally generated experiences from external ones (Moritz, et al., 2005). Another factor which is attributional style may also lead to personalizing and externalizing biases. All in all, these dysfunctional cognitive processes interact with one another to produce the delusion or irrational thought and failure to correct these biases may lead to continuous persistence of the delusion.
Treatment Plan Since the major problem of the client is the delusion of having bad body odor, he is recommended to undergo cognitive-behavioral therapy. This form of therapy aims to replace the client’s irrational thoughts and transform them into rational ones by gradually providing reality-based evidences that will challenge the patient’s delusion and allow him to re-examine his thoughts and views. This form of therapy also aims to enable the client to recognize the irrationality behind his thoughts so that he can independently distinguish between delusion and reality. With the help of psychological education, the client will be able to fully understand his condition. The second major problem found in the client is his persistent worrying and feelings of anxiety brought about by the delusion. To combat this, the client will be assisted in forming and exploring more socially adaptive coping mechanisms. These adaptive coping skills, including rational thinking, shall be strengthened and reinforced through the use of rewards. This is to empower the client to become independent in dealing with his own problems and reduce his need for affection. To reduce the amount of mental stress that the client is experiencing due to persistent worrying, sufficient social and emotional support will be provided and sought. For this, the client is encouraged to undergo counselling. His family and friends will also be encouraged to offer support and will be taught the proper way to deal with this kind of problem.
________________________________ ______________________ Signature Date
(Print name and title under line in place of “signature”)
References
Garety, P.A. & Hemsley, D.R. (1994) Delusions: Investigations into the Psychology of Delusional Reasoning. Psychology Press.
Meichenbaum, D.H. (1977). Cognitive-behavior modification. New York: Plenum.
Moritz, S. et al. (2005). Confidence in errors as a possible basis for delusions inschizophrenia.
Journal of Nervous and Mental Disease, 193, 9–16.
Appendix A: Treatment Plan Worksheet
Counselor Name: Pam Thibeaux
Client Name: Daniel Walter
Case #:
Problem 1: Client is having delusions of somatic type.
Goal 1: Eliminate distorted/irrational thoughts.
Objective 1: Correct irrational thoughts with rational and reality-based views of self.
Intervention1: Assist the client in restructuring his irrational beliefs by presenting reality-based evidences through Cognitive-Behavioral Therapy.
Intervention 2: Probe client’s underlying needs and feelings that trigger irrational thought and allow him to discover more adaptive ways to satisfy those needs.
Objective 2: Persuade the client to accept the fact that his delusions are symptoms of a mental disorder.
Intervention 1: Educate and provide client with literature on Delusional Disorder.
Intervention 2: Engage the client into an informative discussion regarding the disorder.
Goal 2: Enable the client to think rationally/realistically.
Objective 1: Enable the client to recognize his own irrational thoughts and distinguish them from rational ones.
Intervention 1: Assist the client to point out situations, emotions or thoughts that trigger delusion.
Intervention 2: Gradually and gently confront and challenge the client’s illogical thoughts to refocus disordered thinking to a more realistic and more rational frame.
Objective 2: Stop the delusion and irrational thoughts from dominating the client’s cognitive processes.
Intervention 1: Teach client thought stopping techniques.
Intervention 2.: Reinforce the client’s clarity and rationality of thought through the use of rewards and repetition.
Problem 2: Daniel persistently experiences worries and anxieties brought about by the delusion.
Goal 1: Reduce anxiety symptoms.
Objective 1: Encourage client to see a psychiatrist for him to be evaluated for psychotropic medication.
Intervention 1.: Enumerate to the client the benefits of psychopharmacotherapy.
Intervention 2.: Resolve clients’ issues regarding taking psychoactive drugs.
Objective 2: Assure that medication is followed as directed by psychiatrist.
Intervention 1.: Advice client as to why medication compliance is necessary.
Intervention 2.: Monitor client for medication compliance. Goal 2: Provide adequate emotional and social support.
Objective 1: Enhance client’s adaptive coping skills.
Intervention 1: Create a conducive environment where the client can verbalize his underlying needs, conflicts, and emotions.
Intervention 2: Provide counselling that will strengthen client’s coping mechanisms in order to help him cope independently and adaptively with these needs, conflicts and emotions.
Objective 2: Encourage support from the significant persons in the client’s life.
Intervention 1: Educate client’s family and peers regarding the nature of the disorder.
Intervention 2: Teach family members on how to properly deal with the client and his problem.