Citation

Mian MN, Lin B, Hormes JM, Earleywine M. Clin. Case Stud. 2020; 19(6): 473-490.

Copyright

(Copyright © 2020, SAGE Publishing)

DOI

10.1177/1534650120952883

PMID

unavailable

Abstract

Despite the vast array of empirically validated treatments for psychopathological problems, interventions still require considerable client resources for engagement and success. For clients lacking safety and stability outside of therapy, numerous barriers to treatment can prevent improvement and lead to disengagement. In such cases, therapists can seek to understand clients' difficulties with safety and stability. Developing both rapport and the client's problem-solving abilities can instill a sense of agency, keeping clients in treatment for better outcomes overall. This case study describes the modified application of the Unified Protocol following safety planning and crisis management. "Mary," a 23-year old female, presented to a training clinic with fluctuating mood episodes, trauma symptoms, and problem substance use; pre, post, and routinely collected session data with clinical report indicate symptom improvement and increased treatment engagement following client gains in safety, employment, and housing. This case illustrates the importance of the therapeutic alliance in establishing client safety to effectively deliver a transdiagnostic treatment to address core mechanisms underlying emotion dysregulation. © The Author(s) 2020.

Language: en

Keywords

adult; human; sexual abuse; female; bipolar disorder; psychotherapy; suicidal ideation; depression; schizophrenia; social support; motivational interviewing; anxiety; psychosis; substance use; suicide attempt; mood disorders; health behavior; mood disorder; emotional disorder; psychoeducation; personality disorder; interpersonal communication; clinical article; automutilation; hallucination; diazepam; olanzapine; risperidone; social phobia; lorazepam; lamotrigine; DSM-IV; emotionality; Article; Clinical Global Impression scale; semi structured interview; young adult; internet addiction; sexual violence; cognitive behavioral therapy; cannabis use; Positive and Negative Affect Schedule; sleep latency; therapeutic alliance; exposure therapy; transdiagnostic; Unified Protocol