Reference no: EM133536311

Questions:

• What led to Kareem's admission to the University Hospital?
• Why did Kareem's previous therapist decide to discontinue treatment with him at the time of his admission to the hospital for an overdose?
• How many individuals with borderline personality disorder attempt suicide?
• Describe Kareem's typical intimate relationships before he began treatment with Ms. Seals.
• What was Kareem's "greatest fear" that led to his frequent suicide attempts?
• How did Kareem's behavior meet the DSM-5-TR criteria for borderline personality disorder?
• Describe the concept of dialectical behavior therapy. Be sure to describe the main points of this type of treatment.
• What is Ms. Seals's primary goal during the pretreatment stage? How did she relate this to Kareem in their initial therapy sessions?
• What were the primary modes Ms. Seals told Kareem would be part of his treatment program?
• List the four specific skill areas covered in the first stage of treatment with Kareem.
• Why is it common for certain individuals to use self-destructive behaviors when they are disappointed by life events?
• How did Ms. Seals handle Kareem's cutting behaviors, not only to help him prevent the behaviors but also to support him when he relapsed?

Case Study:

Kareem, a 28-year-old cisgender, homosexual, single, and unemployed Black man, was admitted to University Hospital after deliberately taking an overdose of benzodiazepines and alcohol, with the stated intention of dying by suicide. He made this suicide attempt when the man he had been dating for 2 months told him he was moving to another city and wanted to end their relationship. Kareem lost consciousness from the overdose, and after his roommate found him unresponsive in his bed, he was taken by ambulance to the hospital, where he would spend the next 2 days in the intensive care unit.

Because doctors at the hospital were reluctant to discharge him until they were certain that he would receive follow-up counseling, Kareem called his therapist and asked him to tell the hospital staff that he was indeed in counseling. The therapist, however, did not respond as Kareem expected. He pointed out that this was his third suicide attempt in the past 2 years, and, as a result, he was unsure that their therapy was effective. In fact, the therapist did not think that he should continue to treat Kareem. He described the suicide attempts to the social worker on the intensive care unit as another example of Kareem being "manipulative," and said that he was using the suicide attempts and other forms of self-harm to draw attention to himself and to avoid confronting his underlying feelings about his childhood traumatic experiences.