Question

Well, I'm Lillian, and I'm here because I was in a really significant car accident about nine months ago and a couple weeks. And I guess, well, I used to really be in control of everything. I was really good at being kind of a lynch pin of my family and being able to make sure everybody got to where they needed to be. I was able to support people emotionally and get them to where they needed to be, and I really drove things. And now I mean, I literally now can't drive anything. I can't drive a car because I'm terrified, and so that has major limits for my family. I used to be able to go to all of my daughter's basketball and field hockey games, and now I can't get in the car to go to those. And so someone else's mom has to do that. And so that's been really hard to see someone else basically take over as the mom for her. And with my husband it's been really stressful. He's been great, but I think he misses the old me as much as I do. And it's like it's not just with him. It's like I'm looking -- it's like I'm at a picture window at my house like and I'm looking in at my family. To me it looks like they're doing great, and I'm proud of them. They're doing as well as I could hope given that they don't -- only have half of their mom. But I feel like I'm not really part of the family like I would like to be. And before this I was really active, and I knew how to set a goal and how to achieve it. And now I feel like I can't do the simplest thing. I can't even take care of myself let alone my kids. And I'm getting to the point now where I'm worried that --

[ Pause ]

>> You know, the kids can't quit their mom but people do leave wives. In fact, he was the one who suggested that I come because I need to get a hold of myself, get a hold of my life and I guess get what control I can have back and get back and be part of my family. Now that you've been able to meet Lillian and learn more about her concerns prepare a response to her using three specific helping skills. These are offering a summary, self-disclosure and interpretation.

Questions:

1. Outline the types of behavioral assessments you might use with Lillian. What are the advantages and disadvantages of each?

2. What specific information would you need to gather from Lillian and why?

3. How could you teach Lillian to assess her own fear levels?

Answer 1

1. The types of behavioral assessments to be used with Lillian are:

a) Behavioral observation - here, the main aim would be to observe Lillian. Her every behavior needs to be observed. Advantage is that, the observer can directly check the accuracy by asking questions and clarifying from the observer. It also helps the observer to see and observe situations which cannot otherwise be artificially created in a lab. However disadvantage is that, the person who is being observed might be cautious and might change the behaviors accordingly.

b) Self reports about ones' own behaviors/ behavior diaries - Advantage is that we can get an insight into the real issue, get more clarity about the problem at hand and also get to know what is the thought process of the patient. However disadvantage is that there is a possibility of distortion and hence reliability might get compromised.

2. I would like to gather information like, when the discomfort exactly began, when does she feel distressed the most, is she having nightmares or flashbacks, does she feel like she is having a panic attack if she gets closer to a car (these questions will help me eliminate other disorders like PTSD and panic disorders or discover a comorbidity).

3. Lillian can maintain a diary or a self report inventory where she can jot down when does she feel the maximum distressed and thus she can assess her own fear levels.