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Case Conceptualization

Case Conceptualization

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Published by Shannon Ann
Dennis Reynolds...need I say more?
Dennis Reynolds...need I say more?

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Categories:Types, School Work
Published by: Shannon Ann on May 11, 2013
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Shannon JohnsonIntro to Counseling - Howard05/09/13Case Conceptualization Assignment Cognitive Behavioral Therapy (CBT) is a therapy often used for those withirrational thoughts and behaviors. Out of all psychotherapies, CBT is one of the onlytherapies that is supported through research to be effective. One of the reasons CBTis so effective is because it has standardized intakes and treatment protocols. CBT'smain goals are to identify the irrational thoughts proposed by the client, questionthe legitimacy of the thought, and work on extinguishing negative thoughts that arepreventing the client from leading a fulfilling life. The idea is that once the irrationalthought is gone, the cognitive training will allow the client to behave in a healthier,more productive manner. CBT is effective for clients with anxiety and depression,personality disorders, PTSD, severe depression, and phobias.In the show, "It's Always Sunny in Philadelphia" one of the main characters isDennis Reynolds. Dennis Reynolds plays the brother to Deandra Reynolds and is akey member to the "gang" that owns the bar where most of the scenes take place.Although Dennis presents himself to be very confident and aware of hissurroundings, his inner self is constantly ruminating about things he is unhappyabout. Dennis' presenting concerns are: his inability to create lasting relationships,his inability to relate to others, a tendency to drive people away, and lack of overallachievement in comparison with his aspirations. Due to these concerns, Dennis hasbeen stuck in limbo the last 8 years of his life, achieving little in comparison to what he did back in his "glory days" in high school and undergraduate. Dennis used to get all the pretty girls back in high school and college and feels he still has the capacityto get decent looking girls these days, but he is unable to find a girl that matches upto his standards. Dennis has comprised the D.E.N.N.I.S. system for the girls he dates:D- Demonstrate ValueE- Engage Physically
 
N- Nurture DependenceN - Neglect EmotionallyI - Inspire HopeS - Separate EntirelyDennis claims this system works for seducing any girl, and he is proud of the work he has been able to produce thus far. Dennis still hasn't found the right girl yet anddoesn't know if he needs to. Dennis has admitted to keeping a stash full of sex tapesof girls he's filmed, unknowingly, while they were engaging in sexual matters. Hehas also admitted to showing these tapes to multiple friends of his, all of which seemto underappreciate his art. Dennis' parents are divorced; His mother recently passedaway from a plastic surgery gone awry, and his father has been single for awhilenow staking "any meat that may come his way". Dennis, on the exterior, seemsextremely confident and recounts experiences in a way that makes him the star of each event. This is the extent of the background I have on Dennis at the moment. At this time, I think it is safe to say that Dennis has Narcissistic Personality Disorder.This is evidenced by his delusions of grandeur, his lack of empathy, and failure tosustain relationships.From the CBT perspective, Dennis has a laundry list of irrational thoughtsthat are interfering with his ability to lead a healthy and successful life. Dennis'thoughts are a direct contributor to his inability to behavior properly towardswomen, develop healthy long-standing friendships, and move on with his life in amanner that he always imagined. If I were Dennis' therapist, I would first work ongetting a thorough background summary. It would be beneficial to have a set list of thoughts that Dennis currently possesses that are not actually supported in fact.Some including: The D.E.N.N.I.S. System, the thought that it's okay to film women invulnerable positions when they least suspect it, the thought that he is admired andadored by everyone, and the thought that he needs to give up on previous dreamsand aspirations due to lack of achievement. Once I got a thorough set of irrationalthoughts, I could confront Dennis in separate sessions, focusing on one majorirrational thought at the time, asking him how this thought works for him in reality.
 
Is it beneficial to think of women as transient creatures that he can neglect andseparate from at the drop of a hat, when really he yearns to be with a woman that iscompatible with him? Is it beneficial to work in a bar that he's actually losing moneyon and his dad has to help out (and eventually ends up 100% owning) when hecould be finishing up his education and going for dreams that he always had? Is it beneficial to humiliate friends and constantly be thinking of ways to undercut themwhen he struggles with forming long-term friendships? Once I could get Dennis torealize some of the things he's doing to sabotage his own goals, I could start helpinghim brainstorm ways of behaving alternatively. Maybe instead of engaging in theD.E.N.N.I.S. system every time he meets a woman, he could come up with a new,more respectful acronym that would allow him to get to know the girl on a lessshallow basis. It could be beneficial to ask him what he looks for in a friend and thenfocus on ways he can offer those same qualities to the type of friends he's searchingfor. In summary, I would try to find common ground with Dennis and get him to seehow he's sabotaging his own life; Then, I would suggest behaviors to replace themaladaptive ones. I would have to realize that Dennis has a very thin skin and is alsovery intelligent, so there would need to be creative ways of demonstrating to himthat these thoughts are maladaptive. Perhaps, I could have Dennis run experimentsin his
own life…journaling the outcomes of treating women with respect vs treating
him the way he has and see if it has any personal effect on the way he feels about himself. Of course, I would have to phrase it as "This week, let's try the S.H.A.N.system: Shared Thoughts, Hugs, Autonomy, and Nurturing." I feel the journalingaspect of these experiments would be crucial, as it would give Dennis a way of recording the feelings he experienced right after these "social experiments" insteadof giving him time to reflect overnight and undermine the experience. In addition tojournals, I would have friends and family of Dennis come in and reflect on Dennis'behavior. Although Dennis mentions an inability to form long lasting relationships,he and his sister have managed to hold on to a couple of high school friends that areindicative of some mental illness as well; But, it couldn't hurt to get second opinionsfrom both Dennis' family and friends. Both of the suggestions would get Dennis out of his cyclic loop of irrational thinking and force him to see things outside of his own

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