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Vignette Five

Kelly is a 22 year old woman from a strong Irish-Catholic background. She comes into therapy upon the ultimatum of her new husband because of her impulsivity, spending money and obsession with the home shopping channel, which she watches all night. Kelly says, “since we got married he is such a pinch penny. He used to be my ‘partner in crime’. Life was exciting and spontaneous. Now he wants to settle down and have a family. How boring is that! I’m a free spirit and love living on the edge. Who has time to sleep! I love to party, I love to run on a whim and I love to shop! Oh, and let me tell you about the awesome deal I just got. I have this special ability to be in the right place at the right time. Did you know that tomorrow there are half-off sales at the mall and by the way, I just love the thrill of being the first one at the door when the store opens.” During the interview, Kelly appears relaxed but keeps shifting her position in her chair. When you ask her if she has ever been depressed, she tells you, “sometimes the world seems dark and heavy and did you know that your picture frames are crooked?” She denies suicidal ideation, but admits to not wanting to get out of bed some mornings, until an idea strikes her and she’s “off and running again”.

Considering both traditional and mindfulness perspectives of bi-polar disorders, formulate an assessment and treatment plan for Kelly, using theoretical concepts from both of the course texts.

Your response must include the information covered in the text(s) reading assignments throughout the course, choosing CBT and Mindfulness concepts that you find pertinent to working with Kelly

(refer to chapters 11, 12 & 13 in Strategic Decision Making for case examples)
Vignette Six

Lorena is a 35 year old Salvadoran female who came to the United States 15 years ago. Lorena comes for treatment to, “fix my relationship”. She tells you that her live-in boyfriend has threatened to leave her if, “I don’t grow up and get a job”. She says that she doesn’t feel that she should have to work, that, “If he truly loved me, he’d let me hang out all day while I figure out what I want to do. People should like what they do and not just work to collect a paycheck. As a kid in El Salvador, I watched my mom break her back while my dad sat home and drank all day. Mom would come home after working 12 hours and he’d push her around because dinner wasn’t on the table. I swore I’d never be like my mother!” Although Lorena denies suicidal ideation, you notice some superficial scarring on her wrist, which she insists was an “adolescent thing that helped me cope with life back then.” You also notice bruises on her upper arms. “Oh, that is from my old man. He got me so ticked off I swung at him and he had the nerve to grab me and toss me against the wall.” Lorena insists that it is never her fault when they fight and that he always starts it. She claims to love him no matter what he says or does and that she can’t stand the thought of being alone.
Considering both traditional and mindfulness perspectives of personality disorders, formulate an assessment and treatment plan for Lorena, using theoretical concepts from both of the course texts.

Your response must include the information covered in the text(s) reading assignments throughout the course, choosing CBT and Mindfulness concepts that you find pertinent to working with Lorena
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