Kris is a 35-year old female who was born in Winnipeg and moved to Vancouver at the age of 3. Her mother (aged 55) is a school teacher and her father (aged 65) is an accountant. Her parents

Given below is a case study of Kris. Formulate a treatment plan for this fictional patient, “Kris”. The plan must include and consider information about the patient’s background. Prioritize treatment goals, and determine a course of action for the mock patient to help the patient attempt to make changes. The answer should include-
– Goals for therapy and which primary goal that will be focused upon.
– Name and explain a few interventions that can be used in this case.
– Based on preliminary reading, what intervention makes the most sense out of the ones selected and why?
Kris is a 35-year old female who was born in Winnipeg and moved to Vancouver at the age of 3. Her mother (aged 55) is a school teacher and her father (aged 65) is an accountant. Her parents divorced when she was 5 and she was raised mostly by her mother. She reported that she never felt close to her mother, who she described as “rigid” and “strict.” Her mother would not let her leave the house and kept her under “lock and key”. In fact, Kris vividly remembers a time when she was 7 years old where she accidentally broke one of her mom’s specialized vases, this resulted in Kris being locked in a closet all night without any food. Kris remembers that her mom would have violent outbursts whenever Kris did “something wrong” in the mom’s eyes and this caused Kris to walk on eggshells around the home. In terms of siblings, she has one sister (aged 36), who has been living in Japan for the past 5 years teaching English. She reported that, although they were close in age, she and her sister were never really friends. She attributes this to “big personality differences.” Kris graduated high school in 2000. She received very good grades throughout her schooling, and she went to college in Alberta in order to get away from her mom, but dropped out after a year due to several reasons including difficulty adjusting to living alone. She ended up moving back to Vancouver and getting a job as a full-time receptionist. She met her partner, Henry, when they were 15, and had an on-off again relationship until they got married at age 20. Kris lost contact with most of her high school friends once she and Henry started dating. Kris had a miscarriage at the age of 16, and another miscarriage at age of 19. Ultimately, out of fear of another miscarriage, Kris and Henry adopted a baby girl together (Emma, currently aged 10) and Kris quit her job and stayed home full-time with her daughter. Henry was laid-off from his job in January (10 months ago), and has not been employed since. She has recently been trying to find a job and has been going to several interviews per week. They are currently supported by Henry’s Employment Insurance benefits and are struggling financially. For instance, they keep their lights off in the evenings to save on their electricity bill. They are considering having a renter come into their house for extra income. Kris was referred to you for therapy by her previous counselor due to limited progress.
HISTORY OF PRESENTING PROBLEM
Kris reported that she and Henry have always had a turbulent relationship. Kris thinks that Henry is bitter about the fact they do not have a biological child because this is very important in Henry’s culture. Henry and Kris often have explosive arguments (e.g., yelling, throwing things, breaking dishes). However, there has been no physical violence between them. Kris tries to control her emotions when Emma is around but is worried, she has witnessed several “really bad” arguments. After an argument, Kris gets extremely concerned that Henry is going to leave him and she ends up having a severe panic attack where she isolates in the washroom and cries intensely. Kris acknowledged that sometimes Henry gets so frustrated that he leaves the house for hours on end. When Henry leaves, Kris experiences panic attacks and Kris sometimes sends Henry multiple text messages that include thoughts of killing herself. She also will text mutual friends telling them she is struggling and scared and does not know what to do. Her friends have come to the house to take care of Emma and make sure that Kris does not do anything to hurt herself. This causes more conflict between Kris and Henry. Kris described that she had similar “love/hate” relationships with previous partners, but it has never been as intense as it is now with Henry. Kris disclosed a history of suicide attempts. She has tried to end her own life on three occasions, including by taking an overdose of medication and by cutting her wrists. During each of these attempts she ended up feeling very afraid of what she had done and called 911 or a crisis line for help. She thinks about suicide often, usually several times per week, but said she would not make another attempt because she does not want Emma to grow up without her. Kris acknowledged that she sometimes feels hopeless about her life. She described herself as being emotionally sensitive and intense and said she finds her emotional suffering incredibly difficult to bear. She often feels empty and purposeless in life. Kris also reported that she has been struggling with anxiety around leaving the house to run errands, including going to the grocery store, retail shopping and driving her daughter to school and medical appointments. She is totally petrified to do these things because of a few incidents, such as the time when she had a random panic attack at the swimming pool where she had taken Emma to go swimming six months ago. During this attack, her heart had started racing and she felt like she couldn’t breathe. The lifeguard had started performing the Heimlich maneuver on her on the pool deck in front of everyone because she thought Kris was choking. Kris also feels a lot of shame when going shopping for clothes or groceries as she feels that people are judging her for her weight, even though she is of average bodyweight, she starts shaking and becomes flush when in those situations. For instance, when she goes to buy a dress, she gets very worried that the staff are looking at her and thinking that she will not fit into her selected dress and this causes her a lot of anxiety. Since these incidents, Kris has avoided errands and appointments, which has resulted in her daughter missing several appointments with the specialists she usually sees. Further, Kris has not bought herself any new clothes and her current set of clothes have begun to appear well worn. In fact, Kris avoids taking her daughter shopping as well for fears of how others will perceive her parenting given the old clothes they wear. Further, Kris tends to order groceries online so as to avoid going out in fear of being judged and shamed. Finally, Kris reported that she has been feeling resentful toward Henry for being able to get his degree in finance and work full-time – things that Kris had always wanted to do – while Kris stayed home raising Emma. She reported that over the past several months she has been feeling “lost” and “down”. She has also noticed decreased interest in activities she used to enjoy, low energy, and difficulties with concentration and sleep. Kris reported that she doesn’t socialize PSYC 371 – Intervention much with others, though she used to enjoy having dinners with Henry’s co-workers. After Henry was laid-off, Kris stopped calling the co-workers.

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