Depressive and Conduct Disorders: Bob’s Case

Ethical Conduct Evaluation

Dr. Brewer decided to interview Bob’s friends and mother to better understand the patient’s condition. The client only agreed to sign a release of information for my colleague to talk with the friends but refused to do the same for his mother. However, the psychologist still interviewed the latter without the patient’s permission. From the ethical perspective, such behavior violates the norms described in Section 4 of the APA’s Ethical Principles of Psychologists and Code of Conduct (American Psychological Association, 2017). Dr. Brewer should have obtained Bob’s permission to talk to the client’s mother about the case. Therefore, the psychologist failed to maintain the patient’s confidentiality by disclosing the information without prior consent.

Crucial Symptoms

There are several crucial factors to consider in Bob Smith’s case that can help to conceptualize his problems and formulate an adequate diagnosis. First of all, the patient does not have a relationship with his mother. This can be explained by the fact that Bob thinks that his mother had excessive control over his life and decisions. Secondly, the client’s friends admitted that nearly three years ago, Bob transformed from a companionable and outgoing person to a suspicious and unsociable and lost weight in a short period. Finally, the client is regularly absent from work and avoids talking to his friends.

Humanistic Perspective on Bob’s Case

Based on the humanistic perspective, it is possible to assume that Bob’s symptoms are caused by the lack of self-actualization in his personal relationship with his mother and career sphere. As for the former, it seems that Bob avoids his mother because the latter exhibited excessive control over the client’s life. The patient probably thought that moving to another city to start studying at university would resolve this issue. Thus, when his mother wanted to come to live in the same city, he stopped having any relationship with his parents. However, as a family plays a major role in life, the absence of relationships with his father and mother could affect Bob. On the other hand, the client claims that his work does not satisfy him, which makes the client question the correctness of his career and life direction decisions. All these factors together have led to Bob’s feeling of existential anxiety.

Diagnosis

Considering all the symptoms mentioned above, the diagnosis based on DSM-5 would be a mild persistent depressive disorder (F34.1) and mild form of conduct disorder, adolescent-onset type (F91.2). As for the former, the symptoms of dysthymia include depressed mood, inadequate appetite, and feelings of hopelessness (American Psychiatric Association [APA], 2013). Indeed, Bob avoids connecting with the friends, suggesting that he is in depression. Additionally, he lost weight in a short period of time and experiences anxiety concerning his future. The latter diagnosis encompasses the cases when a person violates the rules, including frequent absence from school or work (APA, 2013). According to Bob’s friends, the patient often did not appear in his work.

Treatment Methods

There are various medication and non-medication-based treatment methods to help Bob overcome his symptoms. For instance, one of the evidence-based methods includes emotion-focused therapy (Greenberg & Goldman, 2019). It aims at enhancing patients’ emotional control, empathy, and communication skills. This can help Bob finally encounter the problems that he has with his mother and resolve them through open discussion. Moreover, there are also alternative treatment methods that the client can adopt, such as yoga, meditation, or massage sessions.

Questions

Although the current paper establishes two diagnoses, they may not be quite accurate due to the scarcity of information. For this reason, during the next session, the patient should be asked the following questions: 1) “What feelings do you have towards your mother?” 2) “Why did you stop talking to your parents?” 3) “Do you feel the absence of a relationship with your mother?” 4) “Do you have insomnia and become exhausted fast?” They would allow obtaining a deeper understanding of the patient’s relations with his mother and discovering any additional symptoms of dysthymia.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5, 5th ed.). American Psychiatric Association.

American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. Web.

Greenberg, L. S., & Goldman, R. N. (Eds.). (2019). Clinical handbook of emotion-focused therapy. American Psychological Association.

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