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For this assignment you will select 2-3 human service theories that relates to the attached. The theories selected should help explain the scenario created in the case study. The paper should provide an analysis of the selected theories and how they support the case study.

-apa format

-12 pt time new roman -double space

-4 academic sources

– 3-4 pages (Not including cover page and reference page)

Attach you will find a copy of the case study.

 

 

Case Study:Melissa Herbert

Karina Bard

Capella University

HMSV5002

Dr. Betsy McDougall

 

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ABSTRACT

This case study is about a 27- year-old Caucasian female who suffers from Borderline Personality Disorder. Melissa has been going through trauma since the age of 5 and continued over the years. Now as an adult Melissa past continue to affect her tremendously. Family and friends believes Melissa condition is getting out of hand and they’re ready to get intensive help but Melissa is not open to it at the time. Due to Melissa condition there may be some ethical dilemmas that may occur throughout this process.

Keywords: DBT therapy, Borderline personality disorder, Substance abuse, physical abuse, sexual abuse.

 

Background History

Melissa Herbert is a 27-year-old, Caucasian female. Over the last 18 months, Melissa has been seeing a psychiatrist due to her suicidal ideation. Melissa has been hospitalized at least 4 times for treatment of suicidal ideation, one suicidal attempt. Melissa also had numerous of suicidal gestures such as drinking bleach, anti-freeze and self-inflicting cuts. One of Melissa’s hospitalization lasted for a duration of 4 months. Melissa’s family thinks she is too dangerous to seek long-term care out of the hospital, butMelissa disagrees with the family.

As a child, Melissa was raised by both parents and was the only child. Both of Melissa’s parents had a history of substance abuse and depression.  At age 5, Melissa’s father sexually abused her. Not only was Melissa being sexually abuse by her father, both of Melissa’s parents physically abused her throughout her childhood. The abuse continued until Melissa was 15 years old. During the beginning of age 14, Melissa begin abusing alcohol and binging and food restriction. While in college, Melissa attended a Drug and Alcohol treatment program where she met a guy who she later married. Despite her problems, Melissa was able to finish college and complete 2 years of law school. While in her second year of law school, one of Melissa’s acquaintances committed suicide. This traumatic event caused Melissa to fall into depression and decideshe wanted to kill herself. Within weeks, Melissa dropped out of law school and officially became actively suicidal and hopeless.

Melissa’s suicidal behavior patterns became precipitating. Melissa’s encounters began with feelings criticized, threaten or unloved by her husband and family. Depending on how angry she was at the time, Melissa’s feelings were followed by urges of self-mutilate or suicidal ideation. Other times, Melissa expressed emptiness and hopelessness desiring to end her emotional pain, during this stateMelissa was erratic and unstable. Melissawould also be verbally aggressive towards her friends and then will do things to try to win them back because she was afraid they would abandon her. When friends and family would distance themselves from Melissa because of aggressiveness, she would make suicidal commits by either to keep them from leaving her or attempt to beat them in ending the relationship. Nevertheless, Melissa could not accept her strengths and weaknesses or identify her place in the world. Melissa expected her needs to be met but was too unstable to verbalize them effectively.

Problems and Needs

Melissa has been diagnosis with F60.3 Borderline Personality disorder. Based on the behavior being displayed, Melissa is demonstrating the criteria for Borderline Personality Disorder.Melissa has showed signs of her frantic effort to avoid abandonment from her parents and fear of abandonment from her friends (Criterion 1), demonstrate patterns of unstable and intense relationships such as verbally berating her friends and then doing something kind to win them back in fear of the leaving her (Criterion 2). Melissa also showed a lack in identifying her place in the world or accepting her strengths or weakness as acceptable (Criterion 3) (DSM-5, 2013).

In addition, Melissa performed impulsive behaviors such as binging, food restriction and abusing alcohol (Criterion 4), recurrent suicidal behaviors, gestures, threats and self-mutilating behaviors such as burning her leg and injecting it with dirt (Criterion 5), Instability due to a marked reactivity of mood such as her acquaintance committing suicide (Criterion 6) and chronic feelings of emptiness (Criterion 7). Nevertheless, Melissa had difficulty controlling her anger such as having thoughts of “I’ll show you” when feeling threatened or criticized by her husband or close persons (Criterion 8) (DSM-5, 2013).

Atherapeutic approach for Borderline Personality Disorder is Dialectical Behavior Therapy (DBT). According to Bedics, Korslund, Sayrs, & McFarr (2013), Dialectical Behavior Therapy is a comprehensive and principle-based cognitive–behavioral intervention initially developed for the treatment of suicidal behavior and has expanded to treatment of borderline personality disorder. Dialectical Behavior Therapy consistsof multiple modalities of intervention including individual therapy, skills training, telephone consultation, team consultation, and the structuring of ancillary treatments. Majority of a Dialectical Behavior Therapy sessions is spent in the application of standard behavioral principles such as a clear problem assessment and solution generation. During Dialectical Behavior Therapy, therapists drag out new behavior and seek to optimize generalization to all relevant contexts in clients’ lives. During this therapy sessions therapists act with speed and flow and combine a reciprocal interpersonal style with acceptance, change, confrontation and irreverence (Bedics, et al., 2013)

Community Problem Analysis

Due to this case being so severe, I recommend Melissa to a licensed mental health professional or a psychiatrist for assistance with this case study. A mental health professional such as a psychiatrist will be more experienced in this situation and have the specific treatment and medication if necessary. In addition,Melissa can also seek help at the National Institution for Mental Health (NIMH) which is the lead agency for research on mental health. The National Institution for Mental Health mission is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure (NIMH, 2017). Speaking to a professional may help Melissa understand and may get her to look at her mental health diagnosis from a different perspective. A human service professional knows the roots of his or her profession and can work in a consultative and mature manner (Neukrug, 2015).

 

Ethical Considerations

In this case study there may be several ethical challenges we may face as a Human Service Professional. As stated in Chapter 3, “Human service professionals hold a commitment to lifelong learning and continually advance their knowledge and skills to serve clients more effectively” (Neukrug, 2015). The ethical challenges we may face as a Human Service Professional are; informing clients of the purpose of the helping relationship, keeping information confidential, respecting client self-determination, breaking confidentiality if the client is threatening harm to self, and also sharing confidential client information with your supervisor. These ethical challenges are many that we may face every day while interacting with clients and interacting with Melissa is no different.

As Human Service Professionals, confidentiality is major when it comes to client’s rights and responsibilities. Some of our clients does not want to disclose their personal information when it comes to their medical condition or mental health diagnosis and they have that right, but sometimes at some point, that need to be broke especially interacting with a client who may have suicidal ideation. When a client is threatening to him their self or others, you may have to step in and disclose that information to a family member and your supervisor in order to take the next step. Even though you want to respect your clients wishes, sometimes you have to do what’s best for the client in order to keep them safe and out of harm’s way.

 

Summary

Melissa Herbert an is a 27-year-old, middle-class Caucasian woman who experiencing symptoms and signs of Borderline Personality Disorder. Melissa has recently been hospitalized and is currently experiencing suicidal ideation, suicidal attempts, and suicidal gestures. In addition, Melissa has demonstrated feelings of abandonment, emptiness, and hopelessness that is affecting her relationship with family and friends. Nevertheless, Melissa is struggling with remaining interpersonally stable and identifying her place in the world. I think Dialectical Behavior Therapy would be effective for Melissa’s diagnosis along with appropriate prescribed medication from a psychiatrist. These approaches will have a significant impact and demonstrate a positive outcome on Melissa’s mental, emotional and social skills.

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental

disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Bedics, J. D., Korslund, K. E., Sayrs, J. H., & McFarr, L. M. (2013). The observation of essential

clinical strategies during an individual session of dialectical behavior therapy.

Psychotherapy. 50(3). 454-457.

National Institution of Mental Health (NIMH). Retrieved (April 15 2017) from

https://www.nimh.nih.gov/index.shtml

Neukrug, E. (2017). Theory, practice, and trends in human services: An introduction(6th ed.). New york: Cengage learning

Verheul, R., Van Den Bosch, L. M., Koeter, M. W., De Ridder, M. A., Stijnen, T., & Van Den

Brink, W. (2003). Dialectical behavior therapy for women with borderline personality disorder: 12-month, randomized clinical trial in the Netherlands. British Journal of Psychiatry. 183, 135-140.

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