Building a Therapeutic Relationship – Depression Example

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"Building a Therapeutic Relationship" is a wonderful example of a paper on depression. Sondra is certainly suffering from low self-esteem that is increasingly causing a mental breakdown. The case reflects one of the many instances of patients suffering from bipolar borderline personality disorder coupled with self-harm tendencies. Her story reflects anger, hopelessness, and a feeling of disconnect from the world. Some of the significant issues that form the basis of therapy include detailed mental history with a particular focus on family, friendship, intimate relationships, and workplace. More importantly, understanding behavioral dynamics throughout life helps to create a possible desired environment.

However, man beliefs have been put on mental illness, a therapist should seek to understand the background of clients.                         The first step in addressing Sondra's psychological problems s to establish rapport and build trust. Her story reflects a disintegrated personality, her view about people, and life is contrary. She is discouraged and see nothing good in anyone and anybody around her. These are emotional baseline issues facing this client. As a therapist, the approach is to get her attention first, be honest, and assure uttermost confidentiality (Watkins 2009).

Issues around personality require a therapeutic relationship built on trust and confidentiality. To establish a relationship with an emotionally unstable person is quite challenging, and a therapist should be patient with the client. This is because building a therapeutic relationship is a process that requires careful planning and patience.                       Additionally, it is clear that the client suffers from solitude after the parents migrated. The loss of contact and family bond perhaps makes her not to trust people. Besides, her broken relationships are significant contributors to the current mental problem.

To address this, a therapist should be ready to listen actively (Fonagy & Bateman, 2006). Meaningful therapy is achieved when a client can freely express feelings and emotions without withholding information (Leichsengring et al. , 2011). Of course, this is only possible after trust has been built and a helping relationship established. While establishing contact, it is important to avoid a judgmental approach in looking at issues. A good therapist must suppress his or her views and look at issues from the patient perspective. This is the only way of achieving trust and meaningful persuasion in the early phase of therapy.                       Furthermore, Sondra has now embarked on a self-destruction phase as a way of relieving her disintegrating mental wellbeing.

The long-term focus of this treatment is to free her from discouragement, restore a positive self-image, and more importantly, reverse the self-destructive route she has opted. Her mental history depicts the possibility of self-harm and even suicide. Self-harm behavior at 17 and her ideal way of assessing men before relationships show he long struggle with mental illness (Female Psychopaths | Intimate Relationships, Family & Society).

Being on antidepressants is a significant factor in evaluating the best way of addressing her problems.                                                                                                                     Recovery Model                       Therapy goals will vary and more importantly, the timing of various stages is crucial (Royal College of Psychiatrist 2010). The outcome is an entire rehabilitation and emotionally stable client whose achievement should be patient-driven; this is according to the recovery model. Therapy goals, shared decision making, and teaching coping skills reflect the application of this model. These objectives are achievable only if a therapist can win her attention and trust.

They often have mixed emotions that keep fluctuating from time to time, knowing this will help the therapist to understand all the phases of the cycle, gain patience, and ultimately win trust and confidence from the patience.                       Department of Health (1999) illustrates that this group of people has a hypersensitive reaction to other feelings, views, and attitudes towards them. This principle is relevant to Sondra's case; a therapist should measure words, e enthusiastic and accommodate overreaction from the client. Self- harm behavior should not be seen as recklessness, but rather the focus should be built on making the client's mind to recognize its existence.

Also, people with self-harm history and low self-esteem have "self-esteem attacks" characterized by their holding regrets of acting silly, rude, or off-target actions (Gould2012).   Together, they form a complex web of self-blame and loss of value. They often consider themselves a burden to others and totally wrong in everything they do.                       Navigating through demands caused by such feelings is demanding. However, a therapist should focus on ensuring the patient understands this complex mental process.

The hallmark is to teach them to suppress the ad emotions and view the positive side of their stories (Hawkes & Hingley 2011). Based on these demands, the therapist should stay quiet, observe the client's reaction, and refrain from interrupting during an engagement with the client (Blackburn 1998). Getting their views on issues and people help in not only achieving desirable psychotherapy outcome but also a rekindling sense of self-worth.                       More importantly, the therapist should build a therapeutic relationship rely on the recognition of the client's role in personal wellbeing as an essential element of the recovery model.

When a therapist has imposed therapy schedules, they create more harm than good. The fundamental foundation of a meaningful treatment is patient-based and powered by an acknowledgment of existing needs that requires attention (Stickley & Wright 2011).                       In essence, therapy is a process of intelligently guided steps whose ultimate goals focus on respect, responsibility, and understanding. Some patients will at times gain meaningful self-worth that is marked by the reduction of self-harm and placing importance on treatment.

However, there are many times when they will slide backward. An attribute of therapists should be that of patience and understanding (Department of Health 2012).                       Despite the existence of a clear outline on the management of such mental illness, building a positive environment should involve shared responsibility in the decision and more importantly flexible schedule (Beck & Freeman 1990). The essence is to therapy sensible and allow the patient time to reflect on personal life. Internalizing issues require honesty and willingness to help where possible. Advancing some incentives to clients to address their problems is unethical and quite deleterious.

However, the nature of therapy should be friendly but professional.                                                                                                             Health Promotion            A dysfunctional past seems to be driving Sondra's current mental breakdown. To address the past, the therapist needs to allow the client to give her account (Benjamin 1998). Health promotion allows therapists to teach clients stress avoidance strategies. In this case, it involves involvement in sports or exercise, sharing issues with a trusted few including religious leaders. More importantly, drug adherence and establishing social groups will help the client recover (Mental Health Foundation 1994).                                                                                                                 Conclusion                      To meet the demanding needs of Sondra, there should be multiple and blended virtues.

Helping a mentally unstable person requires a deeper understanding of their situation and showing respect. Moreover, a favorable environment characterized by active listening, avoiding judgmental environment, and patience are fundamental in reversing the deleterious effects of low self-esteem and volatile borderline personality disorder.  

References

Beck,A. & Freeman,A. 1990. Cognitive Therapy of Personality Disorders. Guilford: New York.

Benjamin, L.S. 1998. Personality Disorders: Models for treatment and strategies for treatment development. Journal of Personality Disorders.

Blackburn, R. 1998. Treatability of personality disorders. Paper submitted to the Committee of Inquiry into the Personality Disorder Unit,Ashworth Special Hospital.

Department of Health / Home Office (1999) Managing Dangerous People with Severe Personality Disorder: Proposals for Policy Development.The Stationery Office: London.

Department Of Health 2012. Preventing Suicide in England National Institute for Clinical Excellence (2004) Self-Harm. Guideline 16

Fonagy, P., & Bateman, A. (2006). Progress in the treatment of borderline personality disorder. The British Journal of Psychiatry : The Journal of Mental Science, 188, 1–3. http://doi.org/10.1192/bjp.bp.105.012088

Gould, D. 2012. Service User Experiences of Recovery Under the 2008 Care Programme Approach (executive summary). Available at: http://www.mentalhealth.org.uk/content/assets/PDF/publications/CPA_exec_summary.pd f (last accessed 21.05.2015)

Hawkes, D & Hingley, D 2011. ‘Asking Questions to Aid Recovery’ Mental Health Practice, 15 (1) p14 – 20

http://www.youtube.com/watch?v=y_oAGv_tXHc (Female Psychopaths | Intimate Relationships, Family & Society)

Leichsengring, F., Liebing, E., Kruse, J., New, A. S., Leweke, F., & Leichsening, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74–84. http://doi.org/10.1016/S0140-6736(10)61422-5

Mental Health Foundation: Recovery available at: http://www.mentalhealth.org.uk/help- information/mental-health-a-z/R/recovery/ (last accessed 19.01.2015)

Stickley, T & Wright N 2011. The British research evidence for recovery, papers published between 2006 and 2009 (inclusive). Part One: A review of the peer-reviewed literature using a systematic approach Journal of Psychiatric and Mental Health Nursing 18, 247- 256

Stickley, T & Wright N 2011. The British research evidence for recovery, papers published between 2006 and 2009 (inclusive). Part Two: a review of the grey literature including book chapter and policy documents Journal of Psychiatric and Mental Health Nursing 18, 297-3-7

Royal College of Psychiatrists 2010. Self-Harm, Suicide and Risk: Helping People Who Self- Harm

Watkins, P. 2009. Mental Health Practice: A guide to compassionate care. 2nd edition. Elsevier: London

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