Sample Case Conceptualization

Case Conceptualization Due to the client losing both her parents during infancy in a tragic car accident, the client’s disorder can be viewed as one of detachment. The client’s history shows deficits in three of the five Pathogenic Care Realms: settings where there is persistent disregard for the child’s emotional needs, settings in which there are repeated changes in primary caregivers, and settings in which child is raised with limited opportunities for stable attachments (American Psychiatric Association, 2013). The client experienced a detachment from her family, not just losing her parents to death, but also being separated from her twin brother. According to Bowlby, the client’s difficulties in maintaining boundaries, periods of

A key component to the client’s treatment will be to educate the client to the systems approach and to empower the client that though her predominant, original identity may feel weak and overwhelmed, she is ultimately interrelated to all her identities. Individual therapy will focus on the structure and function of this interconnectedness and whether any alignments, alliances, and/or coalitions exist amongst the alter

61). Due to the client’s current distress and present suicidal ideation, a partial hospitalization group is the level of care most suitable for the client at this time, having recently been discharged from a residential level of care. This phase of the client’s treatment focuses on safety, stabilization, and symptom reduction. In the partial hospitalization group, the goals include maintaining personal safety, controlling symptoms, modulating affect, building stress tolerance, enhancing basic life functioning, and building or improving relational capacities (International Association for the Treatment of Trauma and Disassociation, 2011). Though the client’s prominent identity is introverted, a group setting with members at a similar level of care will offer more support while the client is still able to establish some independence at a group home provided by this agency. The program will initially require the client to come to the agency each weekday for group therapy, psychoeducational groups, skills building, individual therapy and pharmacological assessments and check-ins. Depending on the client’s progress, this may be shortened to three days a week.

Individual therapy will focus on the development of the therapeutic alliance and internal cooperation and co-consciousness between