Jack: A formulation

I have used a cognitive-behavioural approach

Using one of the examples provided, clearly summarise the service user’s experience of distress 

The case study describes that unresolved issues in Jack’s life contribute to his distressful experience. His mood was unstable and fluctuated wildly. He might talk non-stop when in high mood. At other times, he would lapse into tears and felt that his life was a hopeless mess. As the only son in the family, he also experienced great pressure because he was expected to carry on the family business. He experienced violence at home and sexual abuse at work. His parents’ divorce and financial troubles only made matter worse. He also imagined Robbie Williams has stolen his royalty and raped his sister. Finally, he was particularly frightened when he looked in the mirror and saw his father’s face. All these have caused his difficulties.

Provide a plausible explanation of the development and maintenance of the  service user’s difficulties, and how they may relate to one another; drawing on psychological  theory and principles and details provided in example       

As he has witnessed and experienced violence and sexual abuse over long periods, it is easy to develop psychotic symptoms. Other contributing factors are poverty, relocation and lack of social support. As a migrant group, he might not get a sense of belonging in Swindon. His negative patterns of thinking might cause emotional disorders and unusual beliefs. These include hallucinations, alert for threat, distrust, avoidance. Fear of parents or caregivers during childhood might lead to a heightened sense of insecurity and suspicion of being harmed. One example from the case study is that he imagined Robbie Williams has stolen his royalty and raped his sister.

Effectively outline the benefits and limitations of diagnosis- for explaining the service user’s difficulties and devising an intervention

Jack’s symptoms might be diagnosed as schizophrenia or depression. There are benefits of a diagnosis for him. He might think that he was not to blame for his present difficulties because it was his illness that caused them. Besides, he would feel better because he was not alone with such difficulties. It was easier to get referrals and access treatment as well. On the other hand, since his present conditions are the result of traumatic life experience, a diagnosis of psychosis tells little about the underlying causes. Such diagnosis is usually associated with social stigma, making it difficult to get a job. It will also make him feel powerless and discouraged.

Briefly outline an intervention plan clearly related to the service user’s experience of distress and your explanation of the development and maintenance of the service user’s difficulties

It has been established that there is a significant link between childhood trauma and development of psychotic symptoms. As such, a good therapeutic relationship will be an effective intervention to let him talk openly about his life history. Through such collaborative sessions, the therapist can get a better understanding of the thought processes that causes his distress and thus offer a suitable cure for him. Moreover, it is important to give him hope and encouragement as well. One way is to recognise his strength and talent. The case study mentioned that he was sociable and friendly, did well at school, with a talent for music. These merits should be emphasised to help him move forward.