Question

Dr. Ann works in a solo private practice. She has been working

with Mr. Gray for several months for signs and symptoms of
depression. Mr. Gray comes to some sessions as emotionally intense,
and high-s

Answer 1

Dr. Ann should consider addressing Mr. Gray's emotional intensity and potential risk factors for high stress in therapy sessions, possibly implementing coping strategies or recommending additional support.

Step-by-step explanation:

When a client exhibits emotional intensity and high stress during therapy sessions, it's essential for the therapist, in this case, Dr. Ann, to explore the underlying causes. Mr. Gray's emotional intensity might stem from various sources, such as unresolved trauma, overwhelming life circumstances, or the nature of his depression. It's crucial for Dr. Ann to create a safe space for Mr. Gray to express these emotions while also assessing their impact on his well-being.

Understanding the triggers and patterns of Mr. Gray's emotional intensity can guide Dr. Ann in tailoring therapeutic interventions. This might involve teaching coping skills, such as mindfulness techniques, stress management strategies, or emotion regulation exercises. Additionally, exploring the context of Mr. Gray's stress and emotions outside the therapy room could provide valuable insights into managing his mental health more effectively.

Collaborating with Mr. Gray to identify potential stressors and developing a plan to address them outside of therapy sessions can empower him in managing his emotions and stress levels. Dr. Ann may also consider recommending additional support resources, such as support groups, workshops, or even psychiatric consultation if necessary, to complement the therapy and assist Mr. Gray in coping with his emotional intensity more effectively. Regular communication and a therapeutic alliance built on trust and understanding are pivotal in supporting Mr. Gray through his emotional challenges during therapy.

Answer 2

1. The ethical issues involved in this case include concerns about the duty to protect, confidentiality, and potential harm to the patient or others.

2. Pertinent clinical issues in this case involve assessing the risk of harm to Mrs. Gray, exploring the potential presence of a cyclic mood disorder in Mr. Gray, and addressing Dr. Ann's personal history of abuse, which may impact her ability to maintain objectivity.

3. To help Dr. Ann deal with her emotions, it's crucial to provide a supportive and non-judgmental space for her to explore her feelings, seek supervision, and consider personal therapy to manage any countertransference.

4. I would recommend that Dr. Ann return the call, as it is essential to gather more information and assess the situation. Possible options include scheduling a joint session with Mr. and Mrs. Gray, consulting with other professionals, or involving authorities if there is an immediate risk.

5. Transparency with Mr. Gray should be carefully managed. Dr. Ann can share concerns about the reported behavior, emphasizing a commitment to ensuring everyone's safety, while maintaining confidentiality within ethical bounds.

Step-by-step explanation:

In this complex case, the ethical issues revolve around the duty to protect Mrs. Gray from potential harm, balancing confidentiality with the need to intervene. The duty to protect raises questions about whether Dr. Ann should inform authorities or take other actions to ensure Mrs. Gray's safety. Confidentiality is also a concern, especially considering the sensitive nature of domestic violence issues.

Clinically, the focus should be on assessing the risk of harm to Mrs. Gray and exploring Mr. Gray's mental health, particularly the possibility of a cyclic mood disorder. Dr. Ann's personal history adds another layer, requiring careful management of her emotions to ensure objectivity in her professional role.

To help Dr. Ann, a supportive and non-judgmental environment is crucial. Seeking supervision and considering personal therapy can assist in managing any countertransference that may arise due to her own history of abuse.

Returning Mrs. Gray's call is recommended to gather more information and assess the situation. Options include scheduling a joint session, consulting with colleagues, or involving authorities if immediate risk is identified. Transparency with Mr. Gray should be approached cautiously, balancing the need for disclosure with ethical considerations and maintaining the therapeutic alliance.

Here is Complete Question:

Dr. Ann works in a solo private practice. She has been working with Mr. Gray for several months for signs and symptoms of depression. Mr. Gray comes to some sessions as emotionally intense, and high-strung. Dr. Ann has considered the possibility that Mr. Gray suffers with some type of cyclic mood disorder. As part of treatment, Mr. Gray admitted to experiencing anger management problems, to the point where he described physically intimidating his wife and pushing her down. They worked on anger management skills. Mr. Gray reported progress in this area. Dr. Ann receives a phone message from Mr. Gray’s wife. In the voicemail, Mrs. Gray reports that Mr. Gray has become more physically intimidating and has started to push her around. The voicemail indicated he has not caused her any significant harm. She requested a session to see Dr. Ann to explain what is happening between them. She only met Mrs. Gray informally while she sat in the waiting room before and after several sessions. Dr. Ann wants to be helpful, but she is struggling with whether she should even return Mrs. Gray’s phone call. Dr. Ann has a personal history of being involved in a physically abusive relationship herself and is concerned about both the clinical and ethical issues involved regarding calling Mrs. Gray back. Feeling uncomfortable about what is happening with this patient and his wife, Dr. Ann calls you for a professional consultation. She wants to make an appointment to talk with you candidly about her history as well as the dynamics of the current case.PLEASE ANSWER THE FF: 1. What are the ethical issues involved in this case? 2. What are the pertinent clinical issues in this case? 3. How would you help Dr. Marie Besh deal with her emotions related to this situation, given how her history relates to this patient and his wife? 4. Would you recommend Dr. Marie Ann's return the call or not? What are some possible options should Dr. Besh return the phone call? 5. How much transparency would you suggest to Dr. Besh with Mr. Gray about the phone message?