In the given scenario, John is faced with the task of overcoming numerous difficulties in his personal and work life. The failure of the main character to make inroads within, to be understood and participate in social activities can be interpreted as a form of psychological disorders. The essence of this task lies in the ability to point out the possible pathologies with which he may have and to determine the treatment that would apply for the improving of his condition as well as potential barriers which he would face and how to overcome them during the therapy process. The present analysis will explore in detail about John’s case by considering several psychological theories and therapies which can be applied in this case to produce overall knowledge as well as some of the potential solutions.
Disorders Present and Rationale
Social Anxiety Disorder (SAD) and Avoidant Personality Disorder (AVPD)
The symptoms presented give a clue of the co-existence of social anxiety disorder (SAD) and avoidant personality disorder (AvPD) in John. Social anxiety disorder is a form of anxiety that involves panic aroused at the prospect of social contact, which drives the affected individual into avoidance of social situations and produces a great deal of distress (Frandsen et al., 2019). John’s fear of wrongly assessed by somebody, avoiding connections with other people, and his symptom like he is always on the verge of a heart attack when he talks, talks even more about SAD.
Additionally, liking this unusual kind of pair of footwear with longer strides and larger crowds might point to AvPD, since people fear attention and judgement leading to the avoidance of the social and professional activities. John is slackened by his diminished expressive capabilities and mentality and enters into desocialization, the progress of which impairs the quality of his life and inhibits his career advancement (Frandsen et al., 2019). The treatment of the psychosomatic disorders in particular by therapies targeted and which are crucial to the alleviating John’s distress and improving the functioning of him in various domains of life.
Recommended Therapy and Rationale:
Cognitive-Behavioral Therapy (CBT)
Within the cognitive-based behavioral therapy (CBT) regarding the social anxiety disorder (SAD) and the avoidant personality disorder (AvPD) cognitive-behavioral therapy (CBT) would be the most helpful to John. CBT concentrates on seeking irrational situations and beliefs and the replacement of them with more truth and adaptive ones. What CBT can do for John is to correct the cold thinking regarding social and public speaking interfaces which, further on, can be achieved through gradual exposure to rejected scenarios through systematic desensitization and changing misinterpretations. Additionally, CBT may make him aware of the different ways to control anxiety such as relaxing exercises that overall less the anxiety. Research has always been found to be the CBT method being the most effective treatment, that helps to deal with SAD and AvPD in long-term as it provides relief from symptoms and improves functioning (Alomari et al., 2022). The therapy plan dominated by group settings and self-study can help John resolve his fears and develop the needed assertiveness applicable while in social and professional situations.
Alternative Diagnosis and Recommended Therapy
Selective Mutism and Acceptance and Commitment Therapy (ACT)
The other diagnosis that can be taken into account is Selective Mutism which is a disorder that is marked by persistent inability to speak in some social situations although one may possess the ability to speak fluently in others situations. The general diagnosis applicable might be like that of John, if his difficulties are all about speaking in public or in front of authority figures rather than a broader anxiety. In this scenario, ACT indeed might be an efficient addition to the tool box. ACT focuses on cultivating psychological flexibility, being mindful and taking in any emotions internally, instead of any attempt for control or elimination of same (Caletti et al., 2022). Understanding of cognitive approaches might help John tolerate his feelings about anxiety and also willing to face the public speaking which results to anxiety reaction.
Potential Problems in Therapy and Rationale
Resistance to Exposure Exercises
John might portend situations by procrastination or saying no to disaster therapy (CBT) that has exposure activities in case of social anxiety disorder (SAD) and (AvPD) little personality disorder. One the main concerns for him may be overcoming situations in which he is panicked, such as public speaking or crowds, which would be a big issue and can develop a resistance for therapy and thus hamper therapy progress. This lack of compliance may spring from inherent fear as seen in shyness, trying to hide one’s self, or failure, hence, the need to involve the therapist in joint intervention. For the therapist to build rapport with John and developing a trusting handling context in which John can slowly conquer his fears is very vital (Clemmensen et al., 2020). Through recognizing the deeper issues causing the avoidance and applying step-by-step exposure techniques, John can progressively decrease his avoidant behavior and eventually perfect a more suitable new coping method which will allow him more progress in therapy.
Negative Self-Perceptions
John has developed some self destructive perceptions and it is very common for people with anxiety issues to acquire such beliefs. These may have worsened his anxiety and made it very hard for him to remain socially active. These negative thoughts and ideas often lead to his losing the primary motivation, confidence in the therapy process, and create complications in trying to fight and modify the maladaptive thoughts and behaviors. Sensitivily the therapist will have to discover and reframe these deep set belief system which are making John to have a lack of harmony and positivity in him. And through cognitive restructuring and self-esteem improvement, John gradually will be changing his perception of the environment and develop healthy self-concepts. It can be crucial for the counselor to create an atmosphere where John can be helped realize that his negative view is based on misunderstandings and misinterpretation of situations around him (Alomari et al., 2022). It is through dealing with these core matters that he could chisel walls of resilience as well as confidence that will later sustain him in his struggle for psychological well-being.
Relapse and Setbacks
Despite progress in therapy, the events of time progress during therapy, even setbacks can happen for John especially during stressful periods or negative triggers. He would possibly experience setbacks which if it lasted for some long time, he would have feelings of discouragement, frustration or selfdoubt, that eventually would you his progress. Consequently, it should becomes a therapist’s task forecasting and giving John strategies which will help him not just get rid of the symptoms of anxiety disorder, but also prevent relapsing. Through cultivating resilience and adaptability he can tackle therapy struggles gaining the traction required for sustaining the momentum towards healing (Alomari et al., 2022). With the help of constant support and skill development, John can gain the very thing required to deal with difficulties and go ahead despite setbacks, which ultimately will contribute toward positive mental health.
Interpersonal Challenges
John’s difficulties in assertiveness and in communication of socialization does not end on the therapist premise, but also distorts his loved ones and those around him like the therapist. Lack of skill to form sentences openly, he might face various problems, either it is misunderstandings or communication imbalances between him and the therapist (Alomari et al., 2022). Consequently, the establishment of a trusting and supportive therapeutic alliance is the fundamental factor for the opportunity of he to analyze his fears and vulnerabilities without any fear of being judged.
In conclusion, John’s case scenario demonstrates the intricacy and complexity of psychological disorders which requires careful analysis and an individualized treatment plan. Learning about the possibilities of Social Anxiety Disorder, Avoidant Personality Disorder, and Selective Mutism can help John get ready for his treatment and he can consider experimental cognitive behavioral therapy or acceptance and commitment therapy. This could be a step in his way towards overcoming difficulties and increasing the quality of his life.
However, it is essential to acknowledge those hindrances which he may experience counseling for example resistance, procrastination, and the concurrent causes. The work of a therapist applying a collaborative, patient-based approach can be effective in conquering the difficulties by John forming new strategies of coping and regaining confidence in himself both in social and professional life, as this analysis shows that is necessary to seek professional help and aims at demonstrating the enormous significance of psychological practices in regard to people with anxiety, avoidance, and communication issues.
References
Alomari, N. A., Bedaiwi, S. K., Ghasib, A. M., Kabbarah, A. J., Alnefaie, S. A., Hariri, N., Altammar, M. A., Fadhel, A. M., & Altowairqi, F. M. (2022). Social Anxiety Disorder: Associated Conditions and Therapeutic Approaches. Cureus, 14(12). https://doi.org/10.7759/cureus.32687
Caletti, E., Massimo, C., Magliocca, S., Moltrasio, C., Brambilla, P., & Delvecchio, G. (2022). The role of the acceptance and commitment therapy in the treatment of social anxiety: An updated scoping review. Journal of Affective Disorders, 310(310), 174–182. https://doi.org/10.1016/j.jad.2022.05.008
Clemmensen, L., Bouchard, S., Rasmussen, J., Holmberg, T. T., Nielsen, J. H., Jepsen, J. R. M., & Lichtenstein, M. B. (2020). STUDY PROTOCOL: EXPOSURE IN VIRTUAL REALITY FOR SOCIAL ANXIETY DISORDER – a randomized controlled superiority trial comparing cognitive behavioral therapy with virtual reality based exposure to cognitive behavioral therapy with in vivo exposure. BMC Psychiatry, 20(1). https://doi.org/10.1186/s12888-020-2453-4
Frandsen, F. W., Simonsen, S., Poulsen, S., Sørensen, P., & Lau, M. E. (2019). Social anxiety disorder and avoidant personality disorder from an interpersonal perspective. Psychology and Psychotherapy: Theory, Research and Practice, 93(1). https://doi.org/10.1111/papt.12214
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