Application: Case Study – Sexual Dysfunction and Gender DysphoriaFor many beginning psychologists, one of the most difficult topics to
broach with a client is the topic of sex: sexual behavior, sexual
identity, or sexual problems. By using professional sensitivity and
consideration of other personal factors such as cultural awareness and
client privacy, psychologists may produce a comfortable environment in
which to lead the client into discussion.For the first part of this Application, you review the client in the
case study in the Learning Resources. Give a DSM diagnosis for the
presenting problem. Include an assessment of the client’s ability to
function in daily life. Be sure to pay particular attention to symptoms
of the disorder and the influence of the disorder on the client as well
as the client’s significant other. For the second part, imagine a 13-year-old female client is brought
by her parents to see you. Her parents are concerned because they report
their daughter is very unhappy with being a girl. She is increasingly
being teased at school because she looks, dresses, and tries to act like
a boy. She is an active athlete, but will only play contact sports with
boys. The client states she does not like her breasts and wishes she
could have them removed. She reports that she has always wanted to be a
boy for as long as she can remember. Give a DSM diagnosis for the
presenting problem. Include an assessment of the client’s ability to
function in daily life. Be sure to pay particular attention to the
symptoms of the disorder and the influence it has on the client, as well
as the client’s family. The Assignment (3–4 pages)A DSM diagnosis of each client An explanation of your rationale for assigning these diagnoses on the basis of the DSM An explanation of what other information you might need about each client to make an accurate diagnosisA brief description of additional individuals you might include in your assessment and explain whyDiscuss how you would produce a comfortable environment to lead your clients to discuss their issuesReadingsAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Schizophrenia Spectrum and Other Psychotic DisordersGender DysphoriaSexual Dysfunctions
Paris, J. (2015). The intelligent clinician’s guide to the DSM-5 (2nd ed.). New York, NY: Oxford University Press.
Chapter 8, Schizophrenia Spectrum and Other PsychosesChapter 12, Substance Use, Eating, and Sexual Disorders
Boskey, E. (2013). Sexuality in the DSM 5. (Cover story). Contemporary Sexuality, 47(7), 1–5. Retrieved from the Walden Library databases.Drescher, J., & Byne, W. (2012). Introduction: The treatment of gender dysphoric/gender variant children and adolescents. Journal of Homosexuality, 59(3), 295–300. Retrieved from the Walden Library databases.Drescher, J., & Byne, W. (2012). Gender Dysphoric/Gender
Variant (GD/GV) children and adolescents: Summarizing what we know and
what we have yet to learn. Journal of Homosexuality, 59(3), 501–510. Retrieved from the Walden Library databases. Fujii, D. (2002). Neuropsychiatry of Psychosis Secondary to Traumatic Brain Injury. Psychiatric Times, 19(8), 33.
Retrieved from the Walden Library databases.
McCarthy, B. W., & Fucito, L. M. (2005). Integrating
medication, realistic expectations, and therapeutic interventions in
the treatment of male sexual dysfunction. Journal of Sex & Marital Therapy, 31(4), 319–328.
Retrieved from the Walden Library databases.Stein, E. (2012). Commentary on the treatment of gender variant
and gender dysphoric children and adolescents: Common themes and
ethical reflections. Journal Of Homosexuality, 59(3), 480–500. Retrieved from the Walden Library databases.Zucker, K. J., Wood, H., Singh, D., & Bradley, S. J.
(2012). A developmental, biopsychosocial model for the treatment of
children with gender identity disorder. Journal Of Homosexuality, 59(3), 369–397. Retrieved from the Walden Library databases.
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Sexual Dysfunction, Schizophrenia Spectrum, and Other Psychotic Disorders
Sexual Dysfunction, Schizophrenia Spectrum, and Other
Psychotic Disorders
Program Transcript
[MUSIC PLAYING]
MALE SPEAKER: It’s pretty frustrating. Not just for me, but for the both of us. I
mean I feel like I’m letting her down. I mean we do other things. But I just can’t
seem to get an erection. It’s no fun.
FEMALE SPEAKER: We’re hanging in there though.
FEMALE SPEAKER: Well, it seems as if you guys support each other. And
you’ve had a complete physical, right?
MALE SPEAKER: Yes. I’ve been checked out by both my GP and a urologist.
Nothing medically showed up. I’m pretty healthy. I mean I barely even drink.
Maybe a couple of beers or a glass of wine now and then, but-The one doctor tried putting me on some of those medicines for erectile
dysfunction. Like the ones advertised on TV. But they didn’t work. I just can’t
seem to get it up.
Which is how we ended up here. This is out of the blue for both of us. I’ve never
had this before. I’ve never even been to see a therapist. We just want to work this
out.
FEMALE SPEAKER: Of course, you do. So what else is going on with you,
maybe at home or at work?
MALE SPEAKER: I think things are pretty good overall. Wouldn’t you say,
honey?
FEMALE SPEAKER: Yeah, no problems. None that I can think of We have two
children. They’re wonderful. Doing just great. And things are fine for me at work.
I’m a nurse. I work part-time.
MALE SPEAKER: And I’m in marketing. I just went through my annual review
and I got flying colors. So no stress there.
FEMALE SPEAKER: Well, that’s good to hear. Well, it sounds like you’re not
seeing any other issues related to this?
FEMALE SPEAKER: Well, maybe. You haven’t been sleeping well.
©2013 Laureate Education, Inc.
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Sexual Dysfunction, Schizophrenia Spectrum, and Other Psychotic Disorders
FEMALE SPEAKER: Oh yeah, that’s right. I toss and turn a lot. Been worried
about this I guess.
Oh, and I’ve been taking some online business courses. I’m going after my MBA.
I work on the computer a lot of nights. And I probably have that on my mind when
I come to bed.
FEMALE SPEAKER: Yeah, a lot of nights.
MALE SPEAKER: Come on. It’s not that bad.
FEMALE SPEAKER: No, actually sometimes it is. I’ve told you, sometimes it’s
like the computer comes first. Not all the time, but-MALE SPEAKER: It’s my MBA, honey.
FEMALE SPEAKER: So you’re saying is that it feels as if he’s a little disengaged
from you and the family.
FEMALE SPEAKER: Yes. Hmm. So since the erectile dysfunction became an
issue for you, have you sought any other sexual outlets? Do you masturbate?
MALE SPEAKER: Yes.
FEMALE SPEAKER: And are you able to ejaculate?
MALE SPEAKER: Yes.
FEMALE SPEAKER: But how? I thought you couldn’t.
FEMALE SPEAKER: By any chance, do you use pornography to help you
masturbate?
MALE SPEAKER: Yes.
FEMALE SPEAKER: What? That’s what you’re doing on the computer at night?
Masturbating to porn?
MALE SPEAKER: I’m sorry.
FEMALE SPEAKER: Look at me. No more lies. What else haven’t you told me?
MALE SPEAKER: It’s not just at night. I look at it during the day. Sometimes
once, sometimes twice, sometimes more. And my job review really wasn’t all
flying colors. I got caught looking at it at work. I got reprimanded. It was bad.
©2013 Laureate Education, Inc.
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Sexual Dysfunction, Schizophrenia Spectrum, and Other Psychotic Disorders
But don’t worry. I’m not going to get fired. I swear. I haven’t used the computer
there like that for months. You have to believe me. Please.
FEMALE SPEAKER: You swear you’re not using your work computer. But what
about that new cell phone they gave you? Using that for your porn now? Oh, my
God.
Sexual Dysfunction, Schizophrenia Spectrum, and Other
Psychotic Disorders
Additional Content Attribution
IMAGES:
Images provided by http://www.istockphoto.com/
MUSIC:
Creative Support Services
Los Angeles, CA
Dimension Sound Effects Library
Newnan, GA
Narrator Tracks Music Library
Stevens Point, WI
Signature Music, Inc
Chesterton, IN
Studio Cutz Music Library
Carrollton, TX
Special Thanks:
Fairland Center/Region One Mental Health
©2013 Laureate Education, Inc.
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