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Formulating Diagnoses

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-What is the best approach to take in formulating diagnoses when working with couples and families? Why?
- What factors are important to assess or diagnose in families or couples in order to make effective choices about therapy goals and interventions?
- What specific diagnostic processes would you use during your assessment of a couple or family? How are these similar to and different from the processes you would use with an individual?

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? What is the best approach to take in formulating diagnoses when working with couples and families? Why?

Research indicates that the most empirically validated approach to marital therapy is Emotionally-Focused Therapy ([EFT] (Johnson, & Talitman, 1997). The EFT approach is focused upon emotional responses and interactional patterns that characterize marital distress. The therapeutic approach is focused upon re-processing emotions to bring about a change in partners' emotional responses. The role of the therapist within the approach is to observe the pattern of the couples' interaction. For example, Lum (1973) suggested an approach focused on the communication theory. The theoretical base of this theory is formulated based on three dimensions: (1) He, (2) She, and (3)We. Focused on these dimensions, therapeutic process consists of having the husband (He) disclose, while the wife empathizes with him. Following the wife (She) discloses, and the husband empathizes with her. Finally, in the "we" dimension the husband and wife encounter each other, examine the patterns of interaction and enter ...

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This solution discusses means of formulating diagnoses for couples and families

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Analysis

Jenni is a 38 year old woman of Middle Eastern heritage. She is meticulously dressed, color coordinated and carefully groomed. She has lived in this country most of her life. Jenni is married with 3 children, ages 17, 14 and 10. Jenni is open and disclosive during your initial session. She hands you a neat and orderly list of those areas she wants you to help her with. She tells you, â??lately I find myself having great difficulty leaving the house. I get so anxious when I am around people. I am so afraid that I will say or do something wrong and that people won't like me and that would devastate me. I can't stand it when people don't approve of me. I feel so ashamed when I make a mistake. I try to run my life by the book. I clean my house twice a day so that my husband won't get mad. I make no decisions without asking his permission first. I've dedicated my life to my family and yet I am so miserable and feel like a worthless failure.â? Jenni denies suicidal thoughts and has never sought mental health treatment in the past.

1. In considering the Cluster C Personality Disorders, formulate a Differential Diagnosis for Jenni. What are your diagnostic considerations and why? Support your ideas by discussing what you see in the vignette utilizing all course readings thus far. What information would you need to look for to confirm your diagnostic impression and why?

2. Construct a tentative treatment plan for Jenni. In consideration of the discussion by Comer (2007), integrate the etiological theories and recommended treatment modalities. Discuss the role of pharmacological interventions and if you believe it would be helpful for Jenni and why.

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