Case Study . Advanced therapy plan

You’re entitled to draw diagrams to illustrate your counselling case formulation/case conceptualisation and therapy plan anticipated practice/skills requirements.
The paper will be assessed on the basis of the evidence of the knowledge:
1. Multidimensional and multi-diagnostic Case formulation
2. Advanced therapy plan/or case conceptualitions
3. Anticipated practice/skills requirements.
4.Covering the client assessment, dealing with mental health issues, counselling for co-mobility client issues, employing & dealing with significant issues in the therapeutic relationship, methods for monitoring & maintaining clients & counselling safety, specialist therapy methods & skills, clear planning for multi-disciplinary team working, supervision, & reference to Cognitive Behaviour Therapy model with citations to relevant research literature.
CASE STUDY
A referral of a patient for 2 years counselling, Ms B is a single 35 years old who?s been discharged from Psychiatric ward after admission for self-harm. M B is known to the Department, having a long history of repeat admissions for self-harm & Para-suicide over the course of her adult life, & further history of involvement with the child & Adolescent Mental Health Service, since she arrive in US when she was 10 years old. Varieties of agencies have been involve with Ms B & continues to be involvement by her GP & Occupational health care at home.
Ms B?s history includes the following information summarised from a variety of records.
Ms B was born in Russia to what appears to be a normal professional couple, her dad was involve with the security industry so he was often worked away from home for long hours.
Ms B mother was taken ill after Ms B?s birth, for the first 4 years she was looked after by her aunt & her boyfriend who lived nearby.
Ms B has been seriously mistreated during this 4 years by her aunt & boyfriend.
Following this Ms B?s parents divorced, she went to live with her father & his new wife.
Ms B mother died at some point during this time, suffering from severe mental illness. Ms B does not know the details of her mother?s death, but she does blame herself for it.
When Ms B was over 5 years old, her stepmother gave birth to a boy, who become the centre of the household & Ms B describes being marginalised, & ignored for the rest of her childhood.
Eventually the family moved to US, & Ms B describes being bullied & abused at her US school, & she struggled with the change of education systems. Lonely & isolated Ms B has described being depressed & the start of self-harming, predominantly through cutting her thighs.
From as far back as Ms B can remember, she describes ?going to my safe place? an imaginary place in her mind, & that she has found it very difficult to return to the ? here & now? in terms of being fully ?embodied? & in terms of ?time?.
On a week-long school field trip to Italy, Ms B age 18 left the Hotel & wandered through the City until the early morning when she alleges she was gang raped at the point of knives. It is clear alcohol was involved in this incident. When she got back to the Hotel, the Police were called but no action was taken, & upon return to the US from Italy , Ms B state that the relationship with her parents broke down, as she was blamed for encouraging the rape.
At some point Ms B started running away from home. A pattern only stopped when Ms B got Housing Department accommodation & she broke all ties with her family. There is evidence of serious on-going alcohol abuse, illicit drug taking in the past, continuing self-harm, & a lack ok self-care.
Relationships with most people have been fraught, whether family, friends, boyfriends & a whole range of healthcare staff, with Ms B originating many official complaints about her treatment within the National Health Dept.
Ms D has variously been diagnosed with Clinical Depression, Anxiety Disorders, and PTSD & Borderline Personality. There are some additional notes, which are unverified, by one Clinical Psychologist to whom Mr Stevens appears to have built some working alliance, that Ms b can become Dissociative. This is currently not verifiable.
Ms B is currently taking anti-depressants & we have removed her from a variety of other medications so that she can engage in the long term counselling with you. This can be reviewed as needed & the dosage reduced in time 7 with progress. Please consult with Community Psychiatric Nurse who visits Ms B on a monthly schedule.
Please keep I informed on a regular basis of your progress & that the Department?s out of hours emergency support line, which is now available for Ms B.

CORE TEXT
1.Rafael, E, Bernstein, D.P Young J(2011) Schema Therapy. Routledge
2.Gabbard, G.O Beck,J. S & Holmes (2008) Psychotherapy
3.Allen, J, G (2010) (2nd Edition)Coping with Trauma: Hope through Understanding American Psychotherapy
4.Cozolin, L (2010) (2nd Revised Edition) The Neuroscience of Psychotherapy