The Case of Lynn
Lynn is a 21 year old single, Native American college student with no prior history of mental problems. She was involuntarily admitted to a short-term psychiatric ward from a hospital emergency room because she described a series of strange experiences. These included increased anxiety, weakness, loss of appetite, feelings of danger to herself, auditory and visual hallucinations, and grandiose delusions. During the week prior to admission, the symptoms gradually worsened, and she reported becoming increasingly preoccupied with death and dead people. While in the hospital, she became very weak and dizzy, and fainted.
A number of stressful events preceded the onset of these symptoms. A maternal aunt, a strong and central figure in her family, had died four months previously. As a college senior, Lynn was struggling with decisions about her career choices following graduation. She was considering applying to graduate programs but was unable to decide which course of study she preferred. She was very much involved with her boyfriend, also a college senior. He too, was struggling with anxiety about graduation, and it was not clear that their relationship would continue. The patient also reported feeling pressured and overextended.
Assume you are Lynn's therapist, what type of therapy would you use with Lynn (be specific)? Why?
Full Answer Section
- Application to Lynn's Case: CBT can help Lynn:
- Challenge negative thoughts: Explore the link between her stressful life events, negative thoughts about death, and her current symptoms.
- Develop coping mechanisms: Learn relaxation techniques and coping skills to manage anxiety and improve sleep.
- Reality Testing: Challenge the validity of her hallucinations and delusions through discussion and reality checks.
2. Culturally Sensitive Therapy:
This approach integrates traditional healing practices and spiritual beliefs of Native American cultures with evidence-based therapy techniques like CBT.
- Rationale: Considering Lynn's Native American background, incorporating cultural aspects can enhance rapport, trust, and engagement in therapy.
- Application to Lynn's Case: A culturally sensitive therapist can:
- Explore the role of grief: Discuss the loss of her aunt and its potential impact on her mental health from a cultural perspective.
- Incorporate cultural practices: If appropriate, explore the possibility of integrating traditional healing practices alongside CBT to address her emotional and spiritual well-being.
Additionally:
- Family Therapy: Including Lynn's family, if appropriate, could provide support and address any family dynamics contributing to her stress.
- Medication: A psychiatrist might consider medication to manage her symptoms, especially if they are severe or significantly impacting her daily life.
Choosing the Right Therapy:
The most suitable therapy for Lynn will likely involve a combination of approaches. A culturally sensitive therapist can assess her specific needs and preferences, and collaboratively develop a treatment plan that incorporates CBT techniques along with culturally relevant practices. This comprehensive approach can provide the best opportunity for Lynn's recovery and well-being.