Some people argue that antidepressants serve to curb productive behavior, destroy individuality, and blunt people’s emotions and quality of life. Are such concerns justified? What are your thoughts on appropriate uses of medication, and when therapy alone is sufficient?
If fear is such an unpleasant experience, why do so many people enjoy and seek out feelings of fear brought on by roller coasters, scary movies, haunted houses and other such experiences? 2 – Most individuals at some point in their lives have pretended to be sick in order to avoid school, work or some unpleasant activity in their lives. How do we determine what is a “normal” frequency of this behavior? If you were an employer, what strategies would you incorporate to address this issue in the workplace? 3 – Some people argue that antidepressants serve to curb productive behavior, destroy individuality, and blunt people’s emotions and quality of life. Are such concerns justified? What are your thoughts on appropriate uses of medication, and when therapy alone is sufficient?
Part 2 Instructions: Read the case study on Emma and answer the questions. You may put the 5 correct letters in section 2 (submission) by high lighting the correct multiple-choice answer.
With a brittle smile, blonde hair pulled back in a pony-tail, plaid button shirt, and ripped jeans, Emma entered the therapist’s office. She was a 25-year-old Caucasian woman. After graduating college, she got a job as a full-time receptionist for a physician’s office. She was happy to work at a place that contributed to promoting health. She had difficulties in social interactions for most of her life and had been in and out of therapists’ offices, but things seemed to be getting much worse at work over the past year. Emma’s desire to go to work has decreased. She thought that her past was behind her and that she had moved forward but she found herself remembering childhood events of abuse. She would zone out when talking to patients at her job and they would seem to get frustrated with her. Her other friends at work would comment to her, telling her “you are losing your focus” and “you can’t keep zoning out with patients.” Sometimes Emma would feel her heart racing so much that she would leave the office to go outside, get some fresh air, and get a drink of water. Emma found herself feeling anxious when some male clients would raise their voice or move their hands suddenly around her. She stopped enjoying being at work and would sometimes call in reporting she was sick to avoid going to work. When she was at work she would spend more time watching the patients in the waiting room and continuously looking at the entrance door to the office, waiting to see if someone was coming into the office. She became less interested in talking with her fellow co-workers.
The most recent episode that was disturbing for Emma was when a male patient had brought his son with him to an appointment. The patient was in the waiting room with his son when Emma heard the patient raising his voice at his son. The patient called his son names and told his son “Stop being stupid. You are worthless. You need to do what I told you to do.” In that moment Emma remembered when her father would say similar things to her followed by hitting her across her face with any object within his reach. Emma began to feel her heart pound in her chest and she had a brief thought of wanting to help the boy. Her thought was immediately circumvented with thoughts of “it doesn’t matter what I do” and “I am helpless.” Emma retreated to the office bathroom and locked herself inside. Her co-workers were worried about her and told the physician. The doctor talked with Emma and suggested that she may want to take some time to find a physician or psychologist to assist her with her concerns.
Emma noticed that as things were worse at work that she also was experiencing challenges at home. She was having nightmares again which would often lead to her waking up and staying awake for an hour or so afterwards. She would be very worked up and worried about her safety after waking up from a nightmare. She would check the house doors to see if they were locked and then cuddle on the couch with her tablet to watch a light-hearted comedy movie or show, in attempts to calm and distract her. When Emma woke from a nightmare in which she was really worked up, sweaty, and scared she would drink some wine with her movie to help her get back to sleep. She found herself drinking more alcohol at nights than she had before. Early
one morning, Emma decided to drink a bottle of wine and relax in the bath. She drank so much that she passed out in the bath and almost drowned.
Emma was never too interested in romantic relationships. Throughout college she distanced herself from others who were romantically interested in her. However, at an office party a co-worker introduced her to a man named Zach, with whom she felt a connection. She liked Zach because he displayed genuine care, he was very relaxed, and seem to be the most gentle and friendly man she had met. After many months of talking and some occasional dates, she began to exclusively see Zach and refer to him as her boyfriend. When Emma began to struggle at work she clung to Zach and would text him anytime she felt anxious and unsafe. Zach had a calming manner and his words always seemed to comfort Emma. Recently, Emma has become distant from Zach as well. She stopped sending him text messages, would ignore his messages, and would often refuse dates by telling Zach that she just felt like staying home. Emma deeply cared for Zach but found herself to be more comfortable with staying alone at home. Emma’s distance began to concern Zach as well. After Emma was told that she should see a physician or psychologist, Zach encouraged her to see someone. Knowing her abuse history, Zach thought Emma might need someone to help her.
Emma was hesitant to seek therapy due to previously having negative experiences with therapists. One therapist that Emma saw, while in college, had fallen asleep during a session, which contributed to Emma’s negative view of therapy. It was these past experiences coupled with having no interest in talking about her past abuse that demotivated Emma to seek counseling. However, she decided that she would attend in order to appease her boyfriend, boss, and co-workers. She thought that she could see the therapist and get some tips about how to better handle stress at work or maybe find some strategies to improve her relationship.
Emma grew up in a very large family with many siblings and cousins around. Emma was the fourth born of five children. Emma had two brothers, the eldest, and two sisters. She reported that at times she remembers four of her cousins, on her mother’s side, would live with her family. She remembers growing up without many toys or material possessions. She stated that she and her siblings would often play outside when they were not in school. Emma had a very close relationship with her sisters throughout childhood. She and her sisters would often play together and find comfort together after being physically abused by their older brothers or their father. Emma’s mother and father argued very frequently about finances, relationship concerns, chores, work, and the children. Emma’s father would often drink alcohol after getting home from work and would often begin to complain or yell at her mother.
Emma’s most salient memory of her parents is a fight that occurred, when she was 7
years old, one weekend after her father had been drinking all day and working outside. In the evening, Emma heard her father and mother yelling about chores and the children not doing enough, which was followed by the loud sounds of objects being thrown around. When Emma and her siblings ran out of their rooms to go see, Emma was unintentionally hit by a lamp that
her father had thrown. After getting up from falling down, Emma was yelled at by her father and called numerous names indicate her lack of worth.
Emma’s father continued to be aggressive with her and her siblings. Her father would hit
her across her face with sticks and tell her to not speak because he owned her. There were many other events wherein Emma experienced physical and verbal assaults from her father throughout her life until she turned 18 and left her house.
At the age of 18, Emma moved out of her house with her friend, to attend college. Emma
enjoyed the freedom of being out of her abusive house but had a difficult time adjusting. Emma only trusted her close friend and roommate. She would usually go to classes, go to work, and stay at her apartment. Emma did not trust many people.
In college Emma sought various therapists. She attended the university counseling center
off and on for a couple of years, seeing different therapists. Emma was prescribed antidepressants from her primary care provider in her junior year of college and took them off and on for about a year. She sought a psychologist in a private practice but due to her fears of wanting to talk about her past and her father, she stopped attending.
Place the letter of the correct answer in the space to the left of the question number. _____1. Emma’s case displays symptoms that meet diagnostic criteria for Posttraumatic Stress Disorder. Emma’s continuously looking at the entrance door to the office would be best described as: A) perseverating B) hypervigilance C) detachment D) avoidance _____2. One of the most effective treatments that is an empirically supported treatment (EST) for Emma would be: A) Psychological Debriefing B) Posttraumatic Stress Safety Management Program C) Stress Inoculation Therapy D) Prolonged Exposure/Exposure Therapy _____3. If a therapist were to explore and help Emma challenge her thoughts of “worthlessness” and “helplessness” along with gradual and systematic desensitization to the trauma, then this therapist would be best described as: A) Jungian Therapy B) Psychoanalysis C) Cognitive Behavioral Therapy D) Acceptance and Commitment Therapy _____4. If Emma were to have medication prescribed as an adjunctive treatment, primarily for her anxiety symptoms, which medication might she be taking? A) Benzodiazepine B) Clonidine C) Lithium Salts D) Haloperidol _____5. The recent changes for Emma that are affecting her work are best representative of which of the four Fs? A) Frequency B) Feeling Pain C) Function D) Fatality