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    Vignette Analysis

    VIGNETTE ONE

    John is a 42 year old Latino male who comes into therapy at the suggestion of his wife. He tells you, “I can’t seem to get out of bed in the morning and I don’t see why I should have to”. John has just been laid off from his job of 25 years as an architect. His children are grown up and on their own. John reports, “I wish I could just go to sleep and not wake up. My kids are gone; my wife has a great career, lots of friends, and what do I have-nothing! Why bother”. During your interview with John, he admits that he cannot deal with loss or change, and that he has been depressed in the past. John is resistant to therapy, because he feels that “no one can help me and I’ll never be happy again.”

    1. Using the information in the texts on cognitive behavioral therapy and depression, what are some of your thoughts about John?

    2. Devise a behavioral experiment for John.

    SAMPLE ANSWER:

    My thoughts about John are that he is going through severe depression and he is in need of therapy, either behavioral or drug-related. Cognitive behavioral therapy (CBT) is a psychotherapeutic approach: a talking therapy. CBT aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure in the present.

    VIGNETTE TWO

    Jane is a 27 year old woman from a strong Irish-Catholic background. She comes into therapy upon the ultimatum of her new husband because of her spending money and obsession with the home shopping channel, which she watches all night. Jane says, “since we got married he is such a pinch penny and let me tell you about the awesome deal I just got. I have this special ability to be in the right place at the right time. Did you know that tomorrow there are half-off sales at the mall and by the way, I can’t help it if I like having a good time”. During the interview, Jane appears relaxed but keeps shifting her position in her chair. When you ask her if she has ever been depressed, she tells you, “sometimes the world seems dark and heavy and did you know that your picture frames are crooked?”

    1. Using the information in the texts on cognitive behavioral therapy and bi-polar disorder, what are some of your thoughts about Jane?

    2. Devise a behavioral experiment for Jane.

    SAMPLE ANSWER: My thoughts about Jane are that she is undergoing Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or more depressive episodes. The elevated moods are clinically referred to as mania or, if milder, hypomania

    VIGNETTE THREE

    Maria is a 35 year old Salvadoran female who enters treatment with you to, “fix my relationship”. She tells you that her live-in boyfriend has threatened to leave her if, “I don’t grow up and get a job”. She says that she doesn’t feel that she should have to work, that, “If he truly loved me, he’d let me hang out all day while I figure out what I want to do. People should like what they do and not sell their soul for a paycheck”. Although Maria denies suicidal ideation, you notice some superficial scarring on her wrist, which she insists was an “adolescent thing” from the past. You also notice bruises on her upper arms. “Oh, that is from my old man. He got me so ticked off I swung at him and he had the nerve to grab me and toss me against the wall.” Maria insists that it is never her fault when they fight and that he always starts it. She claims to love him no matter what he says or does and that she can’t stand the thought of being alone.

    1. Using the information in the texts on cognitive behavioral therapy and personality disorders, what are some of your thoughts about Maria?

    2. Devise a behavioral experiment for Maria.

    SAMPLE ANSWER: The thought that comes to me while reading about Maria is that she suffers from personality disorder. Personality disorders are a class of personality types and enduring behaviors associated with significant distress or disability, which appear to deviate from social expectations particularly in relating to others

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