Jack’s Formulation, Psychodynamic approach

Clearly summarize the service user’s experience of distress

Jack has experienced abuse (physical and sexual), exhibits extreme mood swings, has witnessed his family going through hardship, was torn away from his old life and maybe felt isolated (would’ve lost friendship community when they moved and lost the Italian community in Swindon), felt abandoned/rejected by parents (father left the family and was later kicked out by mother) and harassment and bullying once they moved.

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 

  • All of Jack’s distressing experiences (domestic and sexual abuse, failing GCSE’s, losing community) happened mid-adolescence when Jack’s identity, gender and achievements are being developed – this is a crucial time which was subsequently interrupted which means Jack doesn’t have a clear sense of self and identity
  • Started with promising capabilities (sociable, popular, musically talented, opportunity to continue father’s business) and never capitalising on any of these possibly led to him feeling like he’s lost all his leads – got nothing good going for him anymore, gives up
  • Father was highly successful but also inflicted violence on the rest of the family means Jack wanted to and didn’t want to be like his father at the same time, led to a possible identity crisis (explains seeing his father’s face in the mirror)
  • Confusion about father combined with sexual abuse would’ve confused Jack’s perception of masculinity and instilled fear concerning trust, violence and betrayal as he’s been abused by the two main male authority figures in his life
  • Substance abuse is an attempt to dull the pain from the inner conflict he feels
  • All negative experiences could lead to Jack feeling a lack of motivation and drive which has led to his inability to hold down a job – being the only male figure and failing to take care of his family could also feel like disappointment
  • Delusions Jack talks of are his last attempt to manage and have some control over his personal experiences, delusions also seem to reveal underlying anxieties (Robbie stole his music = never addressed his musical ability, feels like he lost it at some point, Robbie’s friends are out to beat him up = the uncertainty and anxiety of being harassed by the community, Robbie’s friends raped his sister = the disparity he feels from being sexually abused)

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

Pros:

  • being diagnosed with something may help him understand what’s going on in his life – why he struggles with substance abuse, why he feels so fragile and upset
  • makes mental health services more readily available

Cons:

  • may feel dismissive – he could get the feeling people aren’t listening to him and therefore enforce feelings of powerlesness and discourage / frustrate him further
  • diagnosis comes with social stigma which could possibly endanger his work possibilities and exclude future emplyers (which would be counteractive to my suggestions for intervention)
  • combination of these two things may push Jack further into his avoidant coping strategies (substance abuse, delusions)

The cons outweigh the benefits so might be more strategic / efficient to enforce intervention without informing Jack of the diagnosis

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

CBT to talk about his feelings of domestic and sexual abuse and other issues like the pressure of carrying on the family business but not being able to do so or losing his attributions like popularity and musical abilities

Family therapy to repair relationship with mother and sisters – will help him retrieve a place of belonging as well as emotional support

Some sort of programme that focuses on his habits (aims to weaken his relationship with drugs and alcohol), maybe replaces them with things like exercise, having a routine, things to do in free time to pass the time

Some sort of programme that targets building skills and work opportunities, helps him to figure out where he might want to work, create a CV and apply, end goal is a stable job and a stable income that he enjoys, feels rewarding and can hold down

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One thought on “Jack’s Formulation, Psychodynamic approach

  1. This is a great start, well done! These comments may help:
    In section one differentiate Jack’s current distress from the reasons for his distress. The latter should go in section two.
    In section two, name which theoretical approach you’re taking and make sure all your points reflect this approach. In the final assignment you’ll be adding in citations too.
    You make some good points in section three. In the final assignment don’t put these in bullet points and do add citations.
    In section four, you want your treatment plan to follow directly from your section two theory. At present you’re advocating treatment that doesn’t match your approach.

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