Case Study Assessment Paper Instructions

 Note: The case studies involve issues that may bring up unwanted feelings or are emotional triggers for you.  If this is true for you, please let me know in an email or text right away so we can discuss it privately.

Choose one of the case studies provided, and read it carefully before you begin writing. This assignment is not just writing a research paper. Using the provided template and information gleaned from reading the chosen case study, you will thoroughly assess the subject’s clinical needs. Case Study Assessment.

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The assessment must address the spiritual, genetic, and psychosocial aspects of the individual’s behavior; ascertain if he or she is in use, abuse, or addictive cycle; and determine whether there are any co-occurring diagnoses. Think through your readings from the textbook, the definitions of use/abuse/addiction, and treatment needs associated with the level of use. Read the case study several times, paying close attention to the information that has clinical significance (e.g., what substance he/she is using, how often, how long he/she has used, longest periods of time without use, consequences of use, etc.). Also pay close attention to any family history provided and what is reported about the family. Are there genetic indications and environmental influences? How might the client’s spiritual condition affect recovery? Finally, you will be expected to make a referral or recommendations for treatmen based on your determination of the subject’s current needs. Case Study Assessment.

Refer to the chapters on treatment in the May and Doweiko textbooks, focusing on what you know about the client’s current use and the treatment indications of his/her use. Incorporate the Reading & Study materials from the course into this assessment paper, using strong literature support for your assessment of the client’s current issues and your referral suggestions. Strong literature support means using the course textbooks and presentations as well as any outside academic sources needed. You must have a well-established argument for treatment; this is where you need to draw from sources to explain why you are making your recommendations. Case Study Assessment.

The body assessment paper must be 6–8 full pages (in addition to the title page and the reference page). Your paper must be written in current APA format (font, margins, citations, references, etc.) and have a title page and a reference page. (An abstract is not required for this assignment.) Case Study Assessment.

Introduction

Accurate and effective assessment of patients guides a person in the best direction and treatment to offer. Assessment is a learned skill and it is essential when handling patients with porn addiction and masturbation issues (de Alarcón, de la Iglesia, Casado & Montejo, 2019). A lot of people are addicted to masturbation and hate themselves but they don’t have a clue on how to stop this habit. It is the aim of this paper to assess Alan who has porn and masturbation problems. His background, legal, spiritual, genetic and psychosocial information will be gathered to help in coming up with the best recommendation that can help him quit from the compulsive sexual behavior. Case Study Assessment.

Reason for Assessment

The patient in question has a compulsive sexual behavior and thus an assessment would help in understanding the reason behind his inclination towards pornography and masturbation. Generally, the hallmark of these behaviors is recurrent and intense sexual urges that result in individual distress in daily functioning. An assessment would reveal if the patient has anxiety, depression, and alcohol or drug use dependency, signs of abuse, somatic complaints and relationship problems which are classical signs of compulsive behaviors (Armour, Műllerová & Elhai, 2016). It would also help to determine if the client uses the behavior to escape emotional or physical pain or it is his way of dealing with life stressors. Generally, sexual behavior is a primary way of handling problems but it creates a cycle of problems and increases preoccupation, shame and desperation. The physical and psychological signs of these behaviors are subtle and thus an assessment would help in coming up with recommendations that will assist Alan to cope with pornography and masturbation.Case Study Assessment.

Sources of Information

The primary source of information for this assessment is the client, Alan.  He presented himself to the clinic and explained that he has problems with pornography and masturbation and requires help. He is ready to explain how the problem started, its magnitude and his expectations which is all the information required to develop a treatment program that suits his needs. His wife fear of him being unfaithful again also acts as a source of information. Case Study Assessment.

Background Information

Alan is a 42 years white male who works as an IT professional. He is recently married and he has been viewing pornography since he was 14 years. He works alone which offers him solitude to view pornography materials. His parents divorced when he was young although he has a good relationship with both parents. He does not have a child with the current spouse but the wife Becky has a teenage daughter whom they live with and he has a son who lives away from them. He is a late-bloomer and did not have a girlfriend or experience with women until his early twenties. He started watching pornography after he saw his stepfather magazines which gave him a feeling that has never been fulfilled by other pornography materials viewed later in life. He is likable and of good nature.Case Study Assessment.

Current Status

Currently, Alan wants to stop viewing pornography alone and masturbating compulsively but he is having difficulty stopping. He wants to be faithful to his wife Becky and he says he loves her more than anyone. He wants his marriage to last. His desire for change arises from the fact that Becky forgave him when he placed an ad on Craig’s list and met with someone to fulfill his sexual fantasies. The two at times view pornography together as part of their relationship. Alan thus does not want to stop watching pornography but he realizes he needs to stop viewing it alone. Case Study Assessment.

Indicators of Use/ Abuse / Dependency

When dealing with compulsive sexual behaviors, the indicators of use, abuse and dependency can be analyzed using five factors. The first one is time consumed by sexual fantasies and repetitively interferes with important obligations, activities, and goals. Secondly, it is seen when one engages in sexual behaviors while responding to dysphoric mood states (Derbyshire & Grant, 2015). Third engagement in the behaviors a response to stressful life events is a clear indicator of use, abuse, and dependency. Fourth the repetitive but unfruitful efforts to reduce the behavior and repetitively engaging in the behaviors while disregarding the risk for emotional or physical harm to self or others are the other indicators. According to ICD-10-CM guidelines if there is both use and abuse one should assign the code for abuse. However, if abuse and dependence are documented the code is dependence while if use and dependence are documented the assigned code is dependence (Kraus et al., 2018). In Alan’s case, use and abuse are documented. He views pornography and masturbates in the office. He is an IT professional thus has access to the internet and he works alone offering him a conducive environment to fulfill his urges. His dependence is seen when he lists an ad in the Craig list and he gets a partner to fulfill his fantasies. He ends up hurting his wife but there is fear that he can repeat the same. Case Study Assessment.

Attitude and Behavior

Alan voluntarily comes to the clinic to seek help. He admits that he masturbates and watches pornography and he would like to stop the compulsive masturbation and watch the porn videos with his wife as part of their relations. He can be said to have a positive behavior and attitude since he is ready to salvage his marriage and he answers questions with honesty and integrity (Derbyshire & Grant, 2015). Case Study Assessment.

Social Functioning

Social functioning refers to how a person easily and successfully interacts with other people (Kraus, Voon & Potenza, 2016). The interview with Alan reveals less information pertaining to his social life although he is likable and good-natured. Nevertheless, he works alone in his office which shows his social interactions is only within his family. Additionally, he admits that he is a “late bloomer” and thus did not have a girlfriend or any experience with women until he was in his early 20s. It shows he may be reserved and shy.  Case Study Assessment.

Occupational Functioning

Assessment of an individual occupation function helps in generating a picture of many complex and interrelated factors that influence one’s ability to function (Kraus, Voon & Potenza, 2016). It helps in revealing a person occupational performance and establishing areas that require more depth evaluation. In Alan’s case, he is functioning well since he does not complain of warning or failed projects. As an IT professional, he is able to access pornographic materials all day and thus the urges may make him more productive as he gets the solitude that is required to engage in compulsive sexual behaviors. Case Study Assessment.

Financial Aspects

Financially Alan seems to be stable as he manages to work as an IT professional. He manages to support Becky and her daughter as well as his son although they do not live together.

Familial Relationships

Alan familial relationship is what exposed him to pornographic materials as well as compulsive masturbation. His parents divorced when he was eight years and he lived with his mother and step-father. It was a magazine that belonged to his step-father that introduced him to pornography. His relationship with his parents is good. He has been divorced once and has a son from the marriage but he is currently married to Becky who has a daughter. He, however, runs the risk of losing his family because excessive masturbation results in unrealistic sexual expectations from a spouse and leads to broken marriages and unhappy marriages as well as an aversion to romantic relationships by the stressed partner (de Alarcón, de la Iglesia, Casado & Montejo, 2019). Case Study Assessment.

Legal History

Apart from legal issues dealing with the divorce, Alan does not engage in behaviors that put him at risk or contravenes the law.

Health History

From the interview, Alan has no underlying health issues and he does not report any injuries on his private part which would be the effects of excessive masturbation. However, the behavior has induced psychological problems of shame and guilt. It has also resulted in low self-esteem as well as anti-social behavior that makes Alan feel morally selfish and sexually depraved. He also runs the risk of developing more depraved sexual tendencies as a way of finding a new exciting way to fulfill his sexual pleasure (Kraus, Voon & Potenza, 2016). He may start watching child pornography, molesting his own children and peeping through holes to catch a glimpse of a naked body. Case Study Assessment.

Spiritual History

From the interview, Alan reveals that he does not consider himself a spiritual person although when he was growing up, he used to go to church and Sunday school with his grandparents. Case Study Assessment.

Diagnostic impression

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not officially list pornography addiction just like sexual addiction is not listed (Armour, Műllerová, & Elhai, 2016). However, there are three main criteria taken when one is diagnosing porn addiction. The first one is preoccupation to a point that one is obsessed with sexual imagery. Per week a Porn addict spends least 11 hours searching for and looking at pornography and at times can triple that amount of time (Kraus & Sweeney, 2019). The second criterion is the loss of control over pornography use. The criterion is characterized by the desire to quit or limit porn but without success. The third criterion is the negative consequences directly linked to compulsive use of pornography. Some of the adverse consequences experienced by porn addicts are similar to those experienced by compulsive spenders, gamblers, drug addicts and alcoholics. Pornography addiction is also followed by compulsive masturbation which makes one engage in other forms of sexually addictive behaviors like serial affairs, anonymous sex, prostitution and webcam mutual masturbation sessions (Kraus & Sweeney, 2019). Case Study Assessment.

Alan qualifies as a porn addict and a compulsive masturbater. In the first criteria, it preoccupies him and has created an obsession in him. He spends more than 11 hours per week watching porn and his circumstances are favored by the solitude he gets from his office and his professional affiliation as an IT personnel. The second criterion is the desire to quit without success. He admits that he wants to stop viewing pornography alone and masturbating compulsively but he finds it difficult. The third criterion is negative consequences, he risks losing his marriage as the addiction makes him engage in risky affairs to fulfill his fantasies. He masturbates compulsively and he admits that he placed an ad on Craig list where he connected with an anonymous person and fulfilled his fantasies. Case Study Assessment.

Recommendations

To help Alan cope with his compulsive sexual behavior, there are few measures that should be addressed. Normally, the first step is acknowledging that one has the problem and making deliberate efforts to curb it (Sniewski, Farvid & Carter, 2018). Alan has come to the clinic and admitted that he has the problem thus he is ready to take professional advice and help. The second step is removing things that bring temptation to masturbate or watch pornographic materials (Sniewski, Farvid & Carter, 2018). For Alan, being alone in the office and ease in access to these materials should be dealt with. For starters, he should look for a partner whom they can share the office with and who will limit his engagement to these behaviors. Secondly, he should out filters on every device to ensure that visiting these sites become limited. He can also channel his energy toward other things like exploring his talent through coding and writing since he is an IT professional. Additionally, he can join some sports to enhance his social life and get an alternative route to channel his energy. He also has to develop the right mindset and believe that he can curb the addiction. Case Study Assessment.

Accountability is also an ideal route to use for Alan. Already they use porn as part of their relationship with his wife. He also would like to be watching the porn with her only. They can develop an accountability measure to help Alan deal with his addiction problem and ensure that he only watch porn when they are together. Lastly, there is a need to work with a therapist to help him recover fully since his addiction began when he was 14 years. He should be taken through cognitive behavioral therapy by a therapist who understands the theories of sex and porn addiction. CBT is supported by numerous research on its positive impact because it helps in re-working brain maps, triggers and coping mechanisms (Sniewski, Farvid & Carter, 2018). He should also be taken through a comprehensive treatment plan which covers relapse prevention, love-map reconstruction, developing coping skills, arousal reconditioning and enhancement of real-life intimacy. Case Study Assessment.

Alan should also see a family therapist to help him repair the damage done within his marriage. It would help the wife support him and dispel the fear that he would engage in other affairs to fulfill his fantasies.  Lastly, he should join a self-help and support groups so that he can interact with people who are passing through similar predicaments. According to Sniewski, Farvid and Carter (2018), he can join a group modeled after 12-step program of alcoholic anonymous as it would help him learn about the disorder, get support and understand his condition, establish treatment options, coping behaviors and resources and prevent relapses. Case Study Assessment.