Mallory is a 25-year-old woman seeking therapy from Dr. Santos, a clinical psychologist.  When Mallory initially called Dr. Santos, she described mild depressive symptoms.  At the first interview, Dr. Santos began with some open-ended questions intended to allow Mallory to explain the issues for which she sought treatment.  Mallory began by describing her dissatisfaction with numerous aspects of her life.  She had hoped to be married or seriously involved with a romantic partner, but she was not.  Although her job paid her bills, she found it boring and unfulfilling, and she regrets not completing a university degree and pursuing her dream job of becoming a lawyer.

Mallory also described having an intense phobia of dogs. She was attacked by her neighbour’s dog at the age of 7 and was badly injured, resulting in her being hospitalized. She continues to experience panic attacks whenever she sees a dog, which has negatively impacted her life in many ways, for example, she cannot go to public parks where dogs might be walked.

About 10 minutes into the interview, Mallory interrupted herself and said to Dr. Santos, “I’m sorry, I know I’m boring you.  You’re probably thinking, ‘I have more important things to do, and other clients who need my help more than her—this is a waste of my time.’  I feel bad that I’m making you spend time listening to my stupid complaints.  I’m just gonna leave.”  Mallory stood up to go, but Dr. Santos urged her to stay and assured her that she was indeed very interested in what Mallory was saying.  Mallory stayed and continued, but again after about more 10 minutes, she interrupted herself and insisted that Dr. Santos must be bored and frustrated with her.  In all, the interview included four such self-interruptions by Mallory.

Dr. Santos was paying an appropriate amount of attention to Mallory, she was careful not to display any behavior (verbal or nonverbal) that would communicate that she was disinterested at all.  She listened to Mallory with as much eye contact and interaction as she did any of her clients.  Dr. Santos had never conducted an interview in which a client interrupted themself “knowing” that Dr. Santos was bored.

1. Consider the psychodynamic approach to therapy.

(a) What is the name of the phenomenon described in psychodynamic therapy that Mallory seems to be displaying in her interaction with Dr. Santos?

(b) What is happening and where might you speculate this response came from?

(c) How should Dr. Santos work with Mallory to deal with the phenomenon?

QUESTION 2 (5 points)

1. Now consider the case for Mallory from a humanistic approach to therapy. Define and explain the humanistic concepts of…

(a) What is the term Roger’s would use for the problem Mallory is experiencing related to her concept of self, and what would be a healthy goal in that regard?

(b) Name and explain the three main elements of humanistic therapy that the therapist should be sure to use with Mallory.

QUESTION 3 (5 points points)

1. Consider the behavioural approach to therapy….

(a) What would be a technique that a behavioural therapist would use to treat Mallory’s phobia of dogs?

(b) Describe the process of how that technique would be done by giving a series of steps.

QUESTION 4 (3 points points)

1. Consider the cognitive approach to therapy.

(a) How would Beck’s cognitive theory explain Mallory’s depression?

(b) Based on the case description, what kind of thinking style might Mallory have?

ANSWER

Exploring Therapeutic Approaches for Mallory’s Challenges: A Comprehensive Analysis

Question 1: Psychodynamic Approach

Phenomenon Displayed: Transference

Transference is the name of the phenomenon that Mallory seems to be displaying during her interaction with Dr. Santos. Transference occurs when a client’s emotions, attitudes, and reactions towards a therapist are influenced by their past experiences and relationships, often unconsciously.

Origin of Response: Unresolved Emotional Conflicts

Mallory’s self-interruptions and beliefs about boring Dr. Santos likely stem from her past experiences and unresolved emotional conflicts. These interactions might echo past relationships where Mallory felt unheard or unimportant. Her perception of Dr. Santos being disinterested could be a projection of her own self-doubt and insecurities onto the therapist.

 Working with Transference: Exploration and Interpretation

To address the phenomenon of transference, Dr. Santos should adopt a psychodynamic approach. This involves empathetic exploration and interpretation. Dr. Santos could gently guide Mallory to explore her feelings of inadequacy and assumptions about the therapist’s thoughts. By making Mallory aware of these projections, they can collaboratively analyze how these patterns impact her current interactions and emotions.

Question 2: Humanistic Approach

 Rogerian Term and Goal: Congruence and Self-Actualization

Mallory’s challenge is related to incongruence, where there’s a discrepancy between her real self and her ideal self. The healthy goal would be to achieve congruence, where her self-concept aligns closely with her actual experiences and aspirations. Self-actualization, the realization of one’s fullest potential, is another vital goal.

 Elements of Humanistic Therapy: Unconditional Positive Regard, Empathy, and Authenticity

Unconditional Positive Regard: The therapist should provide Mallory with genuine acceptance and empathy, fostering a safe space for her to express her thoughts and feelings without judgment.

Empathy: The therapist needs to truly understand Mallory’s emotions and experiences, enabling her to feel valued and heard. Empathy cultivates trust and encourages Mallory to explore her emotions.

Authenticity: Being authentic and genuine in interactions allows the therapist to establish a real and meaningful connection with Mallory. Authenticity encourages her to reveal her true self and experiences.

Question 3: Behavioral Approach

Technique: Systematic Desensitization

Systematic desensitization is a behavioral technique that could help treat Mallory’s phobia of dogs. This technique involves gradually exposing her to dogs in a controlled and safe environment while she learns relaxation techniques to manage her anxiety.

 Steps of Systematic Desensitization:

Assessment: The therapist assesses the intensity of Mallory’s phobia and identifies specific triggers and anxiety levels associated with different situations involving dogs.

Hierarchy Creation: A hierarchy of anxiety-provoking situations related to dogs is developed. The situations range from least anxiety-inducing to most anxiety-inducing.

Relaxation Training: Mallory is taught relaxation techniques like deep breathing, progressive muscle relaxation, or meditation to manage her anxiety.

Exposure and Relaxation: Starting with the least anxiety-inducing situation, Mallory is exposed to images or descriptions of dogs while simultaneously practicing relaxation techniques. She continues this exposure until her anxiety subsides.

Gradual Progression: As Mallory becomes comfortable with each step, she progresses to more anxiety-inducing situations, maintaining relaxation throughout.

Real-Life Exposure: Finally, Mallory is exposed to real-life situations involving dogs while employing relaxation techniques. Over time, her fear response diminishes, and she can cope more effectively.

Question 4: Cognitive Approach

 Beck’s Cognitive Theory Explanation: Negative Cognitive Triad

Beck’s cognitive theory suggests that Mallory’s depression could be attributed to a negative cognitive triad: negative views about herself, the world, and the future. Her self-doubt, regrets, and phobia might contribute to this negative perception.

 Thinking Style: Catastrophic Thinking

Based on the case description, Mallory might have a thinking style characterized by catastrophic thinking. Her assumptions that she is boring Dr. Santos and that she’s wasting the therapist’s time reflect this cognitive distortion. This negative thinking pattern intensifies her emotional distress.

In conclusion, different therapeutic approaches offer unique lenses through which Mallory’s challenges can be understood and addressed. Integrating aspects of psychodynamic, humanistic, behavioral, and cognitive approaches can provide a comprehensive and tailored framework to support Mallory’s growth, healing, and self-discovery.