Different Approaches to Psychotherapy

Different Approaches to Psychotherapy



2 Assessing Clients with Addictive Disorders

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2 Assessing Clients with Addictive Disorders

Episode 1

1 Description of what is Mr Levy’s perception of the problem?

Mr Levy perceives the problem that he is sick and that his wife is not living to their marriage vows because she is not happy with drinking alcohol and the outcomes. Mr Levy does not understand that he has post-traumatic stress disorder, and he is also avoiding the problem of alcohol dependency. He has depression, and when his wife tells him that she wants them to go back to their old life, he replies that their marital relationship died when he went to Iraq.

2 What is Mrs Levy’s perception of the problem?

Mrs Levy is worried about his husband’s alcohol consumption rate and the effects on their living standards. She perceives that her husband is depressed and not sick but makes matters worse by drinking too much alcohol. She also noted how their marriage life changed after her husband went on the Iraq mission trip.

2 What can be some of the implications of the problem on the family as a whole?

Various aspects of the family, including emotional, economic, social, and intimate relationships, can be affected by this problem. The family’s unity is also at risk because the couple no longer shares their best moments. Mr Levy is frequently depressed, moody, and angry, and according to Mrs Levy, the situation is tearing them up (Laureate Education (Producer) [2013c]). Mr Levy may lose his job if he continues to miss his work, which may cause financial issues to the family (Laureate Education (Producer) 2013a).

Episode 2

1 Description of what did you think of Mr Levy’s social worker’s ideas?

The social worker’s ideas aim to address PTSD in Mr Levy, and she needs to meet him to define the treatment plan. Some of her ideas include meditation, art therapy, and yoga. According to Wheeler (2014), a therapist’s role is to help clients develop coping skills, improve their decision-making ability, and deepen their self-understanding. The social worker should incorporate evidence-based research to support the practice.

1 What were your thoughts on her supervisor’s questions about her suggested therapies and his advice to Mr Levy’s supervisor?

The supervisor’s questions were very crucial, and they served as an eye-opener towards a patient-centered treatment. He validated the social worker’s ideas and reminded her to meet with the patient to facilitate therapeutic decision-making. The relevancy of a treatment option depends on the client’s problem, and thus, a therapist should talk with a client before making decisions.

Episode 3

2 What were your thoughts about the way Mr Levy’s therapist responded to what Mr Levy had to say?

In this episode, Mr Levy shared his memory about the experience in the combat zone (Laureate Education (Producer) [2013c]). The therapist responded to Mr Levy in an empathetic way and showed him compassion in her response. She proposed exposure therapy to help the client deal with PTSD, bad thoughts, and anxiety.

2 What were your impressions of how the therapist worked with Mr Levy? What did you think about the therapy session as a whole?

The therapist worked well with Mr Levy, and her strategy was impressive. She helped the client to manage anxiety and provided assurance to him. She explained to Mr Levy the root cause of his behavioral change and how they can address them. This allowed the client to be comfortable and accept treatment.

2 Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.

1 When an individual has anxiety, it makes it difficult due to chest muscle tension. The chest muscles become tighter as the anxiety rises; thus, increasing the work of breathing. Therefore, anxiety is managed by changing the breathing patterns. Deep breathing improves blood oxygenation; thus, increasing the supply of oxygen to the brain, which promotes better thinking. 1 It also relaxes the blood vessels, lowers blood pressure, and enables a client to breathe normally and relax.

2 Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?

The therapist chose exposure therapy to help in addressing the issues affecting the client. This therapeutic approach reduces anxiety and fear associated with bad experiences by making a client less sensitive (American Psychological Association, 2020). 1 I would use exposure therapy for this client because Mr Levy has experiences of traumatic events. According to Foa and McLean (2016), the use of trauma reminder approaches helps clients recover from a traumatic event because they develop avoidance behavior to the stimuli related to the trauma event.

Episode 4

3 Mr Levy tells a very difficult story about Kurt, his platoon officer. 2 Discuss how you would have responded to this revelation

I would respond to Mr Levy’s difficult story by encouraging him to take a deep breath, giving him time to express his emotions, being nonjudgmental, and showing compassion. I would also prolong the exposure therapy to help the client reduce fears of the experience. 1 According to Schnurr and Lunney (2019), the use of prolonged exposure is effective in reducing the severity of PTSD.

2 Describe how this information would inform your therapeutic approach. What would you say/do next?

Mr Levy’s information reveals his alcohol drinking behavior and explains his anger and anxiety, which has affected his work and family relations. The therapist should encourage the client to discuss his trauma more and utilize exposure therapy to manage his painful memories.

Episode 5

4 Mr Levy’s therapist is having issues with his story. 2 Imagine that you were providing supervision to this therapist; how would you respond to her concerns?

The concerns of the therapist are valid because the combat trauma correlates with domestic violence. The therapists should maintain her professionalism, show compassion, and validate the feelings of the client. 1 The client should try to understand Mr Levy’s thoughts concerning the baby in the next episode.


5 American Psychiatric Association. (2013). 5 Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. 1 https://doi.org/10.1176/appi.books.9780890425596

American Psychological Association (2020). Different Approaches to Psychotherapy. Retrieved

from: 1 https://www.apa.org/topics/therapy/psychotherapy-approaches

Foa, E. 4 B., & McLean, C. P. (2016). 4 The Efficacy of Exposure Therapy for Anxiety-Related Disorders and Its Underlying Mechanisms: The Case of OCD and PTSD. 1 Annual Review of Clinical Psychology, 12, 1–28. https://doi-org.ezp.waldenulibrary.org/10.1146/annurev-clinpsy-021815-093533

5 Laureate Education (Producer). (2013c). Levy family: 5 Episodes 2 [Video file]. Baltimore, MD:


5 Laureate Education (Producer). (2013c). Levy family: 5 Episodes 3 [Video file]. Baltimore, MD:


5 Laureate Education (Producer). (2013c). Levy family: 5 Episodes 4 [Video file]. Baltimore, MD:


Schnurr, P. 1 P., & Lunney, C. A. (2019). 1 Residual symptoms following prolonged exposure and present-centered therapy for PTSD in female veterans and soldiers. Depression and Anxiety, 36(2), 162–169. https://doi-org.ezp.waldenulibrary.org/10.1002/da.22871

Wheeler, K. (Ed.). (2014). 5 Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

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