Please view the PowerPoint and here are the instructor comments.Hey the power point looks Great…I do have questions about Gestalt Theory (Bullet #4Key Principles (Bullet #3Slide #9 (Bullet #4Make these bullet more clear in how it ties into the Ruth Case StudyAnd how does Behavioral Theory tie in. She did ask me Monday why I had that in there. And I did not see the psychological portion? Please add psychological portion
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Mental Health Case Study For Ruth
Counseling Theories and Process
November 18, 2018
CLINICAL SUMMARY OF RUTH
❑ Ruth complains of fear every time she encounters new people
❑ Ruth has a characteristically trembling and shaking movements
❑ She complains of shortness of breath when disturbed by a strange happening
❑ She is unable to live a balanced life with total fear control
❑ Ruth has a psychological disturbance which hinders her from normal peace
❑ The psychological disturbance of Ruth is not related to another mental disorder
PSYCHOSOCIAL ISSUES OF RUTH
She has altered perception of people
❑ Xenophobia; the fear of strangers and sweats at the incidence of strangers
❑ She has a negative attitude to the social settings
❑ She has a negative perception of the things which causes noise
❑ She cannot take her exams peacefully and sweats in anticipation
❑ She is anxious about medical procedures and has altered perception of medical
MEDICAL AND PSYCHOSOCIAL HISTORY
She has been on antipsychotics for the last six months
❑ No history of mental illness in the family
❑ No history of admission or chronic illnesses
❑ She has no history of blood transfusion or surgical procedures
❑ She has a history of disturbed psychosocial perception
❑ No history of admissions to psychiatric units for management
PROBLEM IDENTIFICATION (DIAGNOSIS)
Ruth has Panic disorder based on the following DSM-5 diagnosis criteria:
A. Recurrent unexpected panic attacks with somatic symptoms such as: Palpitations,
trembling, fear of dying, sweating, derealisation and fear of losing control (Dias &
B. At least one of the attacks has been followed by 1 month (or more) of one or both of
the following: Persistent concern and worry about self and a significant maladaptive
change of behaviours (American Psychiatric Association, 2013).
C. The disturbance is not better explained by another mental illness
❑ Ruth has panic disorder based on the DSM-5 diagnostic criteria since she exhibits the
somatic signs expressed in the above criteria (Dias & Thuret, 2016).
BEHAVIORAL THEORY IN THERAPEUTIC COUNSELLING OF RUTH
Behavioral theory is based on the principle that behaviors are learned (Trauer et al.,
❑ For Ruth, it is essential to counsel her on behavior change.
❑ Panic disorder is developed from advanced fear and phobias (Trauer et al., 2015).
❑ Environmental exposure and stimulants are supposed to be made into practice.
Interventions and recommendations
❑ Ruth should be exposed to the stimuli which causes the panic.
❑ Constant exposure will bring a general regress of the panic behavior (Trauer et al.,
❑ Emotional support is key in helping Ruth.
G ESTALT THEORY IN THERAPEUTIC COUNSELLING OF RUTH
The Gestalt theory makes considerations of totality in handling humans.
It views the human being as a whole instead of specific aspects and views of
the person like Ruth in this case.
It therefore introduces a holistic approach towards mental health.
One must get to understand how Ruth’s mind processes the relationships of
the different sets of reality in order to establish solution for her and the is
what gestalt theory brings to the this process.
According to DSM-V Ruth suffers from a panic disorder.
KEY PRINCIPLES AND TECHNIQUES OF GESTALT THEORY
Holistic consideration – Ruth’s mind should be considered holistically and
not in isolation of different schools of thoughts as well as elements of reality.
Her condition is a result of the connection of different elements of reality and
the solution is based in understanding them.
Active understanding of reality – Human beings have differences in how each
perceives reality based n previous knowledge and experience and that is what
sets Ruth aside (Guberman, 2015). Her disorder arises from perceived
information and experience and hinders her from adapting to new situations.
Perception – perception is how knowledge is acquired, processed and
understood then applied accordingly.
APPLICATION: INTERVENTIONS AND RECOMMENDATIONS
Gestalt theory according to DSM-V should be a solution to panic disorder.
It entails creating an environment of comfort for Ruth to share her realities.
Understanding reality is the first step into the solution.
It is based on the Kantian ideal of not knowing how things are in reality until
they are experienced hence complexity of individual knowledge and
experience (Delisle, 2018).
The therapy establishes a sense of identity restoring confidence and
awareness hence loosing the disorder gradually (Rhyne, 2016).
Practice and experience should be key over time.
Dias, G. P., & Thuret, S. (2016). The Hippocampus and Panic Disorder: Evidence
from Animal and Human Studies. In Panic Disorder (pp. 79-91). Springer, Cham.
Trauer, J. M., Qian, M. Y., Doyle, J. S., Rajaratnam, S. M., & Cunnington, D. (2015).
Cognitive behavioural therapy for chronic insomnia: a systematic review and metaanalysis. Annals of internal medicine, 163(3), 191-204.
American Psychiatric Association. (2013). Diagnostic and statistical
manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric
Guberman, S. (2015). On Gestalt theory principles. Gestalt Theory, 37(1),
Delisle, G. (2018). Fifty years of Gestalt therapy. In Object Relations in
Gestalt Therapy (pp. 3-9). Routledge.
Rhyne, J. (2016). Gestalt art therapy. In Approaches to art therapy (pp.
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