Kiran (23 years old) is your new client who seeks counseling. He was tearful during the intake session. He reported that he is experiencing very frequent bouts of low mood and that he is dissatisfied with his sleep quality on a daily basis. He is currently working part-time while studying Mechanical Engineering in a full-time university program. Kiran struggles to
concentrate due to thought intrusions, and he feels restless. He reports experiencing poor concentration across several tasks, which began during his JC days, but he was able to score well due to using academics as a distraction. Some of his thoughts are: “My father will die”; “My girlfriend does not like me”; “I am a defective adult because I have intrusive thoughts”; and “If I display happiness, something horrible will likely occur.” Kiran has to halt all tasks he is performing, temporarily, when these intrusive thoughts appear. He has to tap his hands and feet five times to neutralize the thoughts, in order to avoid a negative outcome. He has performed this habit of tapping over the past three years, but it has only become more frequent in the past seven months.
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Kiran is very fond of his father, and they share a close relationship. However, since Kiran’s parents’ divorce eight years ago, his father gradually began drinking and smoking excessively– currently two large bottles of beer, and one pack of cigarettes daily, on average. Kiran is very concerned about his father’s maladaptive coping habits. To Kiran, his father appears dependent on alcohol and smoking, and Kiran would regularly find him slouching over the work-table
feeling tipsy. However, his father denies the negative impact of his drinking and smoking and cites his ability to perform his job scope as valid proof that he can function well. Kiran’s discussions with his father about healthier ways of coping only end in arguments between the two of them, because his father does not see it as a problem.
a) Applying your knowledge of DSM-5 psychological disorders, what are the THREE (3) most plausible disorders which Kiran is experiencing? You are to justify your answers for each plausible diagnosis with FOUR (4) relevant symptoms, either from the case study or from your readings. Do include in-text references, where necessary.
b) Based on the fundamentals of addictions, one’s readiness for change is essential to ascertain prior to the commencement of interventions. Given Kiran’s father’s reported presentation from the case study, assemble a model for the stages of change, and highlight how his father could plausibly present at each stage. Elaborate on your answers.
c) Identify which level of substance use Kiran’s father is at for drinking and smoking. Justify your answers with relevant research and references.
d) Kiran appears helpless with his circumstances and the overall situation with his father. Develop a script containing the key points of what you would explain to Kiran to help him better understand his father’s refusal to seek help.
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