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Role Play

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Role Play

Mrs. KL is a patient who has come in on a follow-up session after being referred to the clinic for a psychiatric evaluation. She is a female patient aged thirty-two who has had several clinical manifestations that indicate affectation with a psychiatric disorder. Below is an outline of what took place during the second session with a therapist.

Therapist: Hello, Mrs. KL. Thank you for coming in. So, how have you been since our last meeting?

KL: Thank you for seeing me. Well… I am still feeling depressed. No matter how hard I try, this sense of sadness keeps engulfing me. I feel that I am a bad mother to my children because I can no longer care for them as well as I should.

Therapist: Tell me more, Mrs. KL. What about the headaches? Do you still have them? And, have you ever felt the need to hurt yourself?

KL: (Whispers). Sometimes I still have headaches, although the medications you gave me have been helpful. However, I do not wish to harm myself. My children need me because I am all that they have. I wish to get better.

Therapist: Has any member of your family experienced a similar problem in the past?

KL: No, not that I know of.

Therapist: What about work? Have you been going to the office lately?

KL: Yes, though I can barely get any work done. I often feel weak. I can no longer perform my tasks as well or as competently as I used to. Also, I easily get angry at my colleagues and sometimes feel like crying because I cannot control my emotions. Maybe it is because I have not been eating well. I no longer eat well. I have lost my appetite completely. I cannot take this anymore. I feel completely worthless.

Therapist: Mrs. KL, I understand that all this must be frustrating. That is why I am here. We need to work on a plan of the approaches we will use to ensure that you get better. But first of all, please confirm that these are the symptoms you have been experiencing.

KL: Okay

Therapist: From what I have gathered from our conversation, ever since you learned about your husband’s infidelity and got separated from him, you have been feeling constantly sad and empty and have not been sleeping well. You have also lost interest in going out with your friends and prefer to stay alone at home. You also indicated that you no longer work as effectively as you used to and have lost your appetite. You also feel worthless and have been experiencing headaches from time to time. Is this correct?

KL: Yes. That is about all.

Therapist: These symptoms indicate that you may have a major depressive disorder based on a criterion known as DSM-5, which is to make confirmatory diagnoses of psychological conditions. It is a condition precipitated by several factors, including genetic composition, hormonal changes, or changes in the brain composition (Barsky, 2015). However, do not worry because several interventions are available that can effectively eliminate the symptoms you have been experiencing and make you feel better again.

KL: Okay, tell me more. I wish to be well to take care of my children. They need me.

Therapist: There are two types of treatment approaches that can help treat the condition. Firstly, you can use medications such as antidepressants or SSRI. Secondly, you can use a psychotherapeutic model known as CBT. This therapeutic model helps overcome depressive symptoms by changing your thinking patterns and how you view the problems you are currently experiencing (Bingham & Banner, 2014). It will also help you develop essential skills in coping with challenging situations. Which treatment approach is more preferable to you?

KL: I have a question. Are the two methods equally effective?

Therapist: Yes. Both methods are effective. However, CBT has long-term benefits because it addresses significant issues such as the root cause of psychological problems and helps individuals develop skills for coping with challenging situations (Bingham & Banner, 2014). Therefore, the coping skills acquired during the process will be useful in handling challenging situations that arise in the future.

KL: This model sounds good to me. I wish to overcome this heaviness that clouds my heart and impedes me from living my life productively. I should do this for myself and my children because they deserve better.

Therapist: Exactly. For now, I will prescribe some NSAIDs for your headaches. Afterward, we will have our first psychotherapy sessions in the next visit, which will be next week.

References

Barsky, A. (2015). DSM-5 and the ethics of diagnosis. The New Social Worker.

Bingham, R., & Banner, N. (2014). The definition of mental disorder: Evolving but dysfunctional? Journal of Medical Ethics, 40(8), 537-42. https://bit.ly/32Lqcce 

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