Respond to at least two( Gabriel and Pearl) of your colleagues by providing

Respond to at least two( Gabriel and Pearl) of your colleagues by providing

· one alternative therapeutic approach.

· Explain why you suggest this alternative and

· support your suggestion with evidence-based literature and/or your own experiences with clients.

Gabriel (2 citations and matching references for Gabriel)

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Obsessive-compulsive personality disorder

Obsessive-compulsive personality disorder (F60.5) is a personality disorder characterized by obsessions (i.e., intrusive and unwanted thoughts, as well as doubts about actions), compulsions (i.e., specific behavioral actions which includes covert mental rituals to suppress or neutralize the obsession), and the extensive avoidance to by individuals with this disorder to prevent the provocation of the obsessions and compulsions (American Psychiatric Association, 2013). According to the DSM-V diagnostic criteria, these symptoms must be present beginning by early adulthood, preoccupied with details to the extent that the major point is lost, perfectionism that interferes with task completion, excessive devotion to work and productivity to the exclusion of leisure activities and friendship, over conscientiousness and inflexibility to matters of morality, ethics or values which has nothing to do with religious identification, showing rigidity and stubbornness (American psychiatric association, 2013).

One of the effective approaches to obsessive-compulsive personality disorder is cognitive therapy, which incorporates response prevention exposure (McKay et al., 2015). Cognitive therapy stems from the position that dysfunctional beliefs promote problematic behaviors. Cognitive therapy is a therapeutic approach for individuals with obsessive-compulsive behavior because it will encourage the identification and modification of dysfunctional appraisals of intrusions and symptom-related beliefs in order to impact problematic behaviors (McKay et al., 2015). In terms of psychopharmacology, selective serotonin reuptake inhibitors such as Prozac and Zoloft have been FDA approved as first-line treatment of obsessive-compulsive personality disorder (Hirschtritt, Bloch, & Mathews, 2017).

In order not to damage any therapeutic relationship, and to promote a therapeutic bond between therapists and clients, the ingredients of empathy, alliance, and positive regard must cement the communication between the involved parties (Muntigl & Horvath, 2014). Clients respond well when they are approached from the point of understanding free of judgment and positive regard than when such elements are missing during communication. Displaying a sense of understanding builds trust and encourages the client to open up in ways in which the therapist can better assist with therapeutic care (Muntigl & Horvath, 2014).

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Hirschtritt, M. E., Bloch, M. H., & Mathews, C. A. (2017). Obsessive-compulsive disorder: advances in diagnosis and treatment. Jama317(13), 1358-1367. doi:10.1001/jama.2017.2200

McKay, D., Sookman, D., Neziroglu, F., Wilhelm, S., Stein, D. J., Kyrios, M., … & Veale, D. (2015). Efficacy of cognitive-behavioral therapy for obsessive–compulsive disorder. Psychiatry research225(3), 236-246. https://doi.org/10.1016/j.psychres.2014.11.058

Muntigl, P., & Horvath, A. O. (2014). The therapeutic relationship in action: How therapists and clients co-manage relational disaffiliation. Psychotherapy Research, 24(3), 327-345. https://doi.org/10.1080/10503307.2013.807525

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PEARL  (Two citations and matching references for Pearl)

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                                          Paranoid Personality Disorder Therapy

Paranoid personality disorder (PPD) entails unwarranted tendencies among individuals to interpret the behaviors or actions of others as deliberately demeaning or threatening (Vyas & Khan, 2016). This disorder clearly manifests itself during the adulthood and includes the omnipresent development of a sense of distrust as well as unjustified suspicion that results into persistent misinterpretation of the intentions of other people as being malicious. Persons with the disorder commonly fail to recognize their negative feelings towards others and generally do not lose touch with reality. They may ultimately fail to confide in individuals even after they prove to be trustworthy, as they fear getting betrayed or exploited. In most of the times, they tend to misinterpret harmless behaviors and comments from people and may build up and harbor unfounded resentment for an extended length of time (Lee, 2017).

                                                       Causes and Symptoms

The primary cause of PPD remains unknown. However, the disorder commonly manifests itself in families that have a history of psychotic disorders like delusional disorder and schizophrenia. This suggests that genetic factors may be involved. It can also result from adverse childhood experiences emanating from threatening domestic atmospheres (Vyas & Khan, 2016). The common symptoms of the disorder include expectations to get exploited by others, increased suspicion, doubting the loyalty of others, social isolation, detachment, hostility as well as the inability to cooperate/collaborate with others. Individuals with PPD may often act sarcastic, which leads into the elicitation of hostile responses from other individuals and thus acting as a confirmation of the suspicion (Lee, 2017). They also have difficulties in admitting their problems.

Treatments

The treatment approaches of PPD have proven to be very useful in managing the paranoia, but they may sometimes be challenging to maintain as the patient remains suspicious of the doctor. Therefore, it is always crucial for the doctor or therapist to establish a strong therapeutic relationship while sharing the diagnosis report and engaging the client (Vyas & Khan, 2016). First, I should seek to create rapport with the client as well as to understand his or her strengths and weaknesses. Further, I would listen to him/her and avoid asking too many questions. I would also avoid making comments but rather reformulate what the client says from time to time to capture the diagnostic information. I would further avoid looking surprised or getting offended whenever they say something. This way, the client will develop a feeling of trust as he/she would feel accepted by me. As a result, he/she would also adhere/follow the treatment plan.

Medications

In most of the cases, medications are never recommended for PPD patients as they lead to the development of extreme suspicion and make the patient withdraw from therapy. However, they are essential in managing specific conditions of the disorder such as delusions or anxiety. For severe anxiety, anti-anxiety agents like diazepam get recommended. Also, antipsychotic medications such as haloperidol or thioridazine can be appropriate when the client decompensates into delusional thinking that may lead to harming others or self-harm (Völlm et al., 2011). Markedly, medications should get utilized for the shortest interval possible.

Psychotherapy

Psychotherapy remains the most beneficial approach in managing PPD. Clients may contain deep-rooted problems with their interpersonal functioning and the necessitating intense therapy (Dixon-Gordon, Turner, & Chapman, 2011). As mentioned earlier, a strong therapeutic relationship provides the most promising outcomes. Notably, individuals with PPD hardly initiate treatment and commonly terminate it prematurely. Also, the establishment of the therapist-client relationship needs care and remains complicated to maintain (Dixon-Gordon et al., 2011). The therapist may be required to administer unending therapy since most of the PPD symptoms get experienced over a lifetime.

                                                             Conclusion

Paranoid personality disorder substantially affects the normal functioning of a person. Patients should always try to accept and maintain treatment. If they do, they find it less challenging to keep jobs and healthy relationships. Consequently, therapists should strive to establish a robust therapeutic relationship to guarantee that the patients benefit and maintain the treatment plan.

                                                           References

Dixon-Gordon, K.L., Turner, B. J., & Chapman, A. L. (2011). Psychotherapy for

          personality disorders. International review of psychiatry, 23(3), 282-302.

Lee, R. J. (2017). Mistrustful and Misunderstood: A Review of Paranoid Personality Disorder.  

          Current Behavioral Neuroscience Reports, 4(2), 151-165.

Völlm, B. A., Farooq, S., Jones, H., Ferriter, M., Gibbon, S., Stoffers, J., & Lieb, K. (2011).

          Pharmacological interventions for paranoid personality disorder. The Cochrane Database 

          of Systematic Reviews, 11(5), 19-32.

Vyas, A., & Khan, M. (2016). Paranoid Personality Disorder. American Journal of Psychiatry

          Residents Journal, 11(1), 9-11.

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