Case Conceptualization/Treatment Plan – The client has a problem of controlling anger and impulsivity leading to the aggressive behaviour.

  1. Demographic Information

Name: David

Age: 32

Gender: Heterosexual male

Ethnic Background: White

Marital Status: Married

Previous Treatment: Regular sessions with school psychologists between age 13 and 17 Counselling sessions after several assault-related arrests

Who referred client for treatment: David was referred by his probation officer

  1. Problem statement

The client has a problem of controlling anger and impulsivity leading to the aggressive behaviour.

  1. Case conceptualization

From my perspective, David is aggressive and impulsive because of not resolving some conflicts in the past. Based on Erickson’s psychosocial perspective and the recurrent aggression, David’s present conflict seem to be traced back to his past. Since he was a kid he has exhibited aggression indicating that there is an issue that was not addressed at a certain stage affecting his present. Through application of Erickson’s psychosocial perspective, David will be able to identify issues that were not addressed modify his character. David is smart and acknowledges that there is a problem although he thinks the problem is solvable. His weakness though is that he does not want to accept that there is a problem that needs addressing. This acts as a barrier to his recovery process. David is not yet ready to change but after understanding himself, he will be ready to change his behaviour.

Short-term goals

To assist client understand their unique lifestyles

To develop level of self-understanding

Long-term goals

To develop clients sense of belonging

To modify personality and character change

  1. Theoretical orientation and techniques

4.1 Theoretical approach

Psychoanalytic therapy will be useful in the case of David. David’s aggressive behaviour according to his history started since he was in grade school. Since childhood, David exhibited aggression and impulsive behaviour. His report indicate that he was frequently suspended from school before he left school at the age of 17. In addition, his records shows that between the ages of 13 to 17, he underwent various counselling sessions with his school psychologists. This past cannot be ignored in an attempt to help David and that is why the psychoanalytic therapy is the most appropriate. According to Erikson psychosocial perspective, psychosexual and psychosocial growth takes place together. The theory holds that each life stage has a task of establishing equilibrium between an individual and the social world.  According to Erikson, development is defined in terms of the whole life span which is divided into certain crises that need to be solved. Through these crisis, one is able to turn around or to regress. It is at these turning point that one can resolve conflict or fail.  In short, Erickson argues that life is as a result of choice an individual makes at every stage. Through this perspective, it will be possible to identify the stage at which David failed to resolve certain conflicts leading to current conflicts. This is because Erickson argues that each stage in life is related to the other. Understanding David’s development from psychosexual and psychosocial perspectives will be useful in helping him to address the current concerns.

4.2 Therapeutic techniques

4.2.1 Maintaining the analytic framework

In order to attain the set goals in the therapy, maintaining the analytic framework is essential. This includes various factors such as analyst’s anonymity, consistency and regularity of meetings, as well as starting and ending counselling sessions on time. In the psychoanalytic therapy, maintaining consistency is considered a therapeutic factor. Therefore, this technique play a major part in determining success of the therapy with David. Among the factors that will remain constant are service fees, venues, and approaches.

4.2.2 Free association

Free association technique encourages clients to say whatever crosses their mind with a purpose of opening doors to unconscious motivation, wishes, conflicts or fantasies. This technique will be useful in identifying the repressed material that is locked in the unconscious part of David. Through the said material during the free association process it will be possible to identify hidden meaning. Through the hidden meaning, it will be possible identify factors that triggered excessive anger in David in the past and create most appropriate means of controlling it.

4.2.3 Dream analysis

Through dream analysis technique, it is possible to uncover unconscious material. This technique is useful because it gives a client an understanding of some stages whose conflicts were unresolved thus manifesting today. In the case of David this technique will be useful in understanding the current behaviour.

4.2.4 Analysis and interpretation of resistance

Resistance in this case refers to barriers against therapy progress or something that prevents a client from producing unconscious material. In the case of David, records indicate that he has been reluctant in accepting that he has a problem when it comes to controlling his hunger. Through this technique, it will be possible for David to overcome attitude, of feelings that prevent him from confronting his weaknesses.

4.2.5 Analysis and interpretation of transference

This technique allows a client to express their desires, feelings, and beliefs to the therapist. By interpreting these current expressions of early experiences, David will be able to understand his current behaviour and to gradually alter some of his long-standing behavioural pattern. This technique is appropriate because it helps in achieving an increased awareness as well as personality change. In addition, the technique helps clients to understand how their past influences their present.

  1. Prognosis

For the short-term goals, that is to assist client understand his unique lifestyles and to develop level of self-understanding, within the first month, it is expected that the goals will be achieved. The long-term goals will take approximately six months to achieve. Seeing David accept that there is a problem that needs addressing will be a sign of improvement of the counselling process.

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