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Clinical Psychology and Gender Dysphoria

Advancement of Clinical Psychology with Gender Dysphoria

Clinical psychology is recognized as a psychology branch that deals with the assessment and treatment of abnormal behavior, mental illness, and psychiatric problems (Brennan, 2003). Clinical psychology integrates the science of psychology with treatment of complicated human problems, which makes it a challenging and rewarding field. American psychologist Lightner Witmer introduced the term in 1907. Witmer defined clinical psychology as a field that studies individuals by experimentation or observation, with the intent of promoting change. A clinical psychologist will try to reduce any psychological distress suffered by a patient and enhance their psychological well-being. Previously clinical psychology focused on the psychological assessment of the patients, and there was little or no attention been paid to treatment. This scenario changed after World War II in the 1940s because there was increased demand for trained clinicians. A clinical psychologist will offer psychotherapy, diagnosis of mental illness, and psychological testing.

Gender dysphoria refers to a condition where an individual experiences distress or discomfort because of a mismatch with their biological sex (Steensma, Biemond, de Boer, & Cohen-Kettenis, 2011). The assigned biological sex at birth is done depending on the genitals appearance. The gender that a person identifies with is their gender identity. Biological sex and gender identity are the same for most individuals, but there are cases where there is a discrepancy. This discrepancy or mismatch will cause distress and uncomfortable feelings, which are referred to as gender dysphoria. This is not considered a mental disorder, but rather a medical condition that can be sorted with treatment. There are many ways that this condition will manifest itself in an individual. A person will identify with the opposite gender yet they have normal and secondary sex characteristics of one gender.

A clinical psychologist would be in a position to assist an individual suffering from gender dysphoria. The psychologist would perform a psychological assessment of the individual to determine why they identify more with another gender. The psychologist will attempt to lessen the burden by offering the individual help and treatment.

Religion and psychology

Psychologists have studied religion and religious practices for a long time. According to Leahey (2014) researchers have tried to understand various religious experiences like prayer, cult, and mystical experiences. This study began in early twentieth century, but it faded and was revived in the 1980s by the American Psychological Association. The APA began to investigate formally the aspects of religion in psychology. Most psychologists regard William James as the founder of this field. He was the author of the first psychology textbook Varieties of Religious Experience in 1902. Psychologists have tried to explain and understand the ways a person can be deemed religious. There are supernatural happenings that science cannot explain from a rational point-of-view.

People suffering from gender dysphoria and are religious are more likely to recover from their disorder. Religion has been shown to improve a patient’s mental disorder if they are truly religious and spiritual. This is because the patient has found meaning in their life, and this assists them to overlook what is ailing them. Religious affiliation would offer a person suffering from gender dysphoria some relief, and this would be beneficial to the person. The person would not have to suffer mentally, as they would have their religion to assist them understand the feelings they are undergoing. The person would rely on religious texts to formulate and comprehend the situation, which would assist them in coping with their feelings.

Biology of psychology

The biology of psychology applies the principles of biology in the study of psychology. This theory attempts to investigate biological processes that underlie abnormal and normal behavior (Colomb & Brembs, 2010). Having a biological perspective is vital in three ways comparative method, investigation of inheritance, and physiology. The comparative method studies and compares different species of animals. This helps in understanding human behavior. Investigation of inheritance provides the psychologist with information regarding what the animal has inherited from its parents and the mechanisms of inheritance. Physiology analyses how the hormones and nervous system work, how the brain functions, and how structure changes can affect human behavior. Using these three biological aspects, a clinical psychologist can explain human behavior. This theory was formulated in the 18th and 19th century. Charles Darwin was the first to formulate this theory when he was working on his natural selection theory, as he was observing animals during his travels. Biology has the potential to explain a person’s behavior. Biology of psychology supports nature over nurture, because the theory only analyses biological functions and structures. Nurture plays a big role in a person’s behavior, and it is vital for a psychologist to analyze the person’s behavior using their nurture too.

Biology does play a huge role in gender dysphoria. Using biological studies, a clinical psychologist would be able to establish why a person is suffering from gender dysphoria. Scientifically testing explanations will assist the psychologist to arrive at conclusive results. Clear predictions can be made from the analysis done, and one can see if the condition is genetic or is due to neurotransmitters. Biology of psychology has contributed immensely to the treatment of clinical depression that is mostly suffered by gender dysphoria patients. Genetics knowledge is vital especially for patients suffering from gender identity. Having the capability to perform gene mapping, the clinical psychologist can understand why the condition is manifesting itself in the patient. Having such data, the psychologist can offer a comprehensive treatment that might include suggesting undergoing a sex change.

Theories of intelligence

Intelligence is amongst the highly talked about subjects in psychology, but there has not been a standard definition of what precisely forms intelligence. There have been two different definitions from researchers in regards to intelligence. One defines intelligence as a single general ability, and the other believes that it covers a range of skills, aptitude, and talents (Miele & Molden, 2010). Theories of intelligence emerged around 1904 when psychologist Charles E. Spearman published his first article on intelligence. Spearman proposed what is known as the g factor, which means general intelligence. Spearman believed that there is only one way to define intelligence. The most recent ideas regarding intelligence were by Howard Gardner. He described intelligence based on skills and abilities, which enabled him to come up with eight intelligences. Robert Sternberg is another modern theorist who concurs with Howard, but he ascertains that some of the intelligences Gardner proposed could be viewed as individual talents. Stenberg proposal was a triarchic theory of intelligence, which distinguished intelligence using three aspects. There is also emotional intelligence, which is described as an ability that assists a person to perceive, understand, regulate, and express emotions. Other researchers have maintained that this are not forms of intelligence, but rather forms of personality traits.

Intelligence is vital for clinical psychology as it assists the psychologist to analyze gender dysphoria. Employing analytical intelligence would allow the clinical psychologist to use his or her problem solving abilities in order to offer guidance to a patient. Encouraging the patient to use his practical intelligence in order for them to adapt to the changes taking place in their body. The client should be encouraged to express their feelings and not be ashamed, which would ensure that the psychologist could use their observation and listening skills to determine the best treatment course. Intelligence is gained through practice and study by using appropriate tools. Problem solving is also a vital aspect of intelligence, which allows a person to understand a problem and transform it into a problem they can clearly define.

Theory of psychoanalysis

The theory of psychoanalysis refers to the influence that the unconscious mind has on a person’s behavior. Sigmund Freud is the pioneer of this theory in late 19th century. Freud held on the belief that a person’s mind was made up of three elements namely the ego, the superego, and the id (Stern & Stern, 2013). Freud also defined psychosexual stages that defined the unconscious and dream symbolism, both of which have remained popular topics among modern psychologists. Erik Erikson is another theorist who expounded on Freud’s theories. He stressed upon growth throughout a person’s lifespan. His theory of psychological stage is still influential today in the understanding of human development. The conscious mind is one of the aspects that Freud was interested with, and he defined it as everything that was inside a person’s awareness. The ego has developed a defense mechanism, which it uses to guard against anxiety. The y safeguard the mind from thought and feelings that the conscious mind cannot deal with. The unconscious is a reservoir of thoughts, feelings, memories, and urges that are outside a person’s conscious awareness. The unconscious influences an individual’s behavior although they are not aware the underlying influences.

Using this theory one can see that a person’s unconscious mind has an influence on their behavior. In regards to gender identity, a patient suffering from this condition would find that they are not willingly in control over what they feel or experience. The individual could be struggling with feelings they harbor in the unconscious, which have a direct effect on their behavior. Attempting to control or fighting these feelings could lead to mental torture, and this might result in mental disorders. The internal war that a person might be going through would only manifest itself in their behavior. Trying to suppress some of the unwanted thoughts and impulses would be appropriate for the individual struggling with gender identity, but without guidance from a qualified person, they might fail.

Existential vs. humanistic theories

The existential theory states that continuously searching for the meaning of their life. Humanistic theory states that individuals are striving constantly to be the best version of themselves. The humanistic theory views humanity in a positive manner, but existential theory tends to delve into the dark side of humanity. The humanistic theory came into focus in the mid-20th century as a response to Freud’s psychoanalytic theory (Waterman, 2013). These two theories recognize that individuals have the ability to make their own independent choices and to lead their own lives. Both humanistic and existential theories stress on the positive side of human nature. Using either of the two theories, a psychologist will view the patient as a whole, which means they look at the individual as having great positive potential who only needs therapy to assist them realize their potential. Watson, Goldman, and Greenberg (2011) states that the humanistic theory views in individual as a good person and the community forces them into bad things. The existential theory will assume that each individual has the capability for both evil and good in them. The choices a person makes are what define if they are good or evil.

These two theories would demonstrate that the clinical psychologist should be more understanding and only attempt to encourage the individual to realize their true potential. In seeking a remedy for the person suffering from gender identity, the clinical psychologist will listen to the patient and will attempt to guide them towards making their own choice. Using these methods would ensure that the patient makes a conscientious decision that they would feel is their own. It would not matter if the decision is the correct one or the best, but rather that the person made that decision with guidance from the psychologist. The only grey are is that a humanistic psychologist would view the person’s past actions as overly good, and they have only been influenced by society. If the psychologist were an existential psychologist, they would believe that the patient has the potential to do evil, and they opted to be evil.

Behaviorist and cognitive theories

Behavioral theory is a learning theory that is based on the idea that all behavior a person or animal acquires is through conditioning. Conditioning would occur through interacting with the environment. John Watson and B.F. Skinner advocate for the theory. The theory was prominent in the early twentieth century, and it is in wide usage today in therapeutic settings in order to assist patients in learning new behaviors and skills. John Watson believed that it was possible to train, measure, and change behaviors. Behaviorists hold on the belief that people’s responses to environmental stimuli will shape their behaviors. Cognitive theory focuses on the internal states like problem solving, motivation, thinking, attention, and decision-making. The theory is mainly concerned about the development of an individual’s thought processes. It analyses how the thought processes influence the individual’s understanding and interaction with the world. The first cognitive theorist was Jean Piaget, who proposed that children think differently from adults. Piaget did propose a cognitive theory that accounted for the sequences and steps of a child’s intellectual development. Classical conditioning refers to behavior training where a natural occurring stimulus is paired with an answer. Next, the naturally occurring stimuli is paired with a neutral stimulus. Eventually, the neutral stimuli will evoke an answer without the naturally occurring stimuli. Operant conditioning is learning behavior by using rewards and punishments. In operant conditioning, the correct response is rewarded, but the wrong answer is punished.

Clinical psychology can employ cognitive and behaviorist theories to teach the client new behaviors or conditions for solving their problem. Using behavioral theory the psychologist could teach the client new skills and ensure that they do not harbor the negative feelings in regards to their gender. It is possible to train the client to start liking themselves and their gender and ignore the negative feelings. However, this learning could be unlearnt because the negative feelings are still there, and they might be triggered by something different. Using cognitive theory the psychologist could identify the problem, and way of motivating or changing the clients thinking process. This would be more helpful, and it might have lasting effects.

Diversity issues

Diversity issues face each person everywhere they go. There are many issues of diversity that a person might be faced with, but for individuals suffering from gender identity crisis the diversity issues are mostly with their gender and sexual orientation. How people are treated by the society is not an easy thing to identify. This is only possible by hearing from the person or having to undergo such an experience. In the case of gender dysphoria, there is discrimination, and this causes many issues for the individuals. American history indicates that it is only prior to 1800 that transgender was accepted. After the 1800s, transgender individuals were incarcerated for faking their gender. It was unacceptable for a man to live as a woman. The mere notion of undergoing a sex change was unfathomable. Individuals suffering from gender dysphoria were persecuted all throughout the 1800 to 1950. There was no psychological help readily available to these persons. Between 1950 and 1960, organizations and publications for transgender started appearing, but the law and medicine field did not react favorably to these advancements. The first publicized person to undergo a sex reassignment surgery was Christine Jorgensen in 1952, which created a worldwide sensation. Christine Jorgensen was denied a marriage license when she attempted to marry a man in 1959, which resulted in her fiancee losing his job.

Psychological, social, and medical support services were established in 1966 for people suffering from gender dysphoria. In 1968, the National Transsexual Counselling Unit (NTCU) was established. It was the first peer-run support organization in the world. There was a lot of transgender activism during the 1950s and 1960s, but this period also had heavy discrimination for people known to be transsexual. Harry Benjamin an American Physician, coined the term transsexual. The American Psychiatric Association officially classified transgender individuals as having a gender identity disorder. This move was highly controversial, but it ensured that transgender people could access health care. Initially, the Diagnostic and statistical Manual referred to the condition as gender identity disorder, but this was replaced with gender dysphoria. This move was intended to demonstrate that being transgender does not necessitate for treatment since it is not a disorder. It only becomes a disorder when the person experiences gender dysphoria. This meant that not everyone who was a transgender had the disorder. During the late 1980s, the term transgender became commonplace, and it referred to all non-conforming gender people.

In order to support full equality, the APA adopted a resolution on gender expression nondiscrimination, and gender identity in 2008. The association also recognized the necessity and benefits for gender transition treatments and requested that insurance companies provide covers for these treatments after professional evaluations deem them medically necessary. Before a transgender undergoes a sex change, the physicians will require that they undergo an assessment by a clinical psychologist. The psychologist would analyze the client and if appropriate provide written consent that the client would benefit in health if they underwent the gender transition. Treating the client first for any psychiatric conditions, which ensure that the client is prepared for the procedure. Clinical psychologists would also be called upon to offer their services during the transition period. This will enable the client to adapt slowly to the new changes and learn how to handle different situations. Currently, the APA is working on guidelines that practitioners treating transgender clients should follow.

Transgender people still face stigma within the society. A study conducted by Norton and Herek (2013) established that transgender people encounter rejection, which is significantly harsher that any of the negative attitudes that gay, lesbian, and bisexual people experience. A 2011 report by the Institute of Medicine found that there were high rates of attempted suicide, substance abuse, and HIV infection amongst the transgender adults. Eliason, Dibble, and Robertson (2011) posits that the marginalization of transgender people had devastating effects the report concluded. A majority of the transgender men and women have indicated they struggle with shame, isolation, and depression from the stigma caused by how they are treated by others. Recent reports have shown that transgender people are highly discriminated, and some have lost their jobs, bullied, or even physically abused.

References

Brennan, J.F. (2003). History and systems of psychology. Upper Saddle River, N.J: Prentice Hall.

Colomb, J., & Brembs, B. (2010). The biology of psychology:’Simple’conditioning? Communicative & integrative biology, 3(2), 142.

Eliason, M.J., Dibble, S.L., & Robertson, P.A. (2011). Lesbian, gay, bisexual, and transgender (LGBT) physicians’ experiences in the workplace. Journal of homosexuality, 58(10), 1355-1371.

Leahey, T.H., Greer, S., Lefrancois, G.R., Reiner, T.W., Spencer, J.L., Wickramasekera, I.E., & Willmarth, E.K. (2014). History of Psychology. San Diego, CA: Bridgepoint Education.

Miele, D.B., & Molden, D.C. (2010). Naive theories of intelligence and the role of processing fluency in perceived comprehension. Journal of Experimental Psychology: General, 139(3), 535.

Norton, A.T., & Herek, G.M. (2013). Heterosexuals’ attitudes toward transgender people: Findings from a national probability sample of U.S. adults. Sex Roles, 68(11-12), 738-753.

Steensma, T.D., Biemond, R., de Boer, F., & Cohen-Kettenis, P.T. (2011). Desisting and persisting gender dysphoria after childhood: A qualitative follow-up study. Clinical Child Psychology and Psychiatry, 1359104510378303.

Stern, M.M., & Stern, L.B. (2013). Repetition and trauma: Toward a teleonomic theory of psychoanalysis. New York, NY: Routledge.

Waterman, A.S. (2013). The humanistic psychology — positive psychology divide: Contrasts in philosophical foundations. American Psychologist, 68(3), 124.

Watson, J.C., Goldman, R.N., & Greenberg, L.S. (2011). Humanistic and experiential theories of psychotherapy.

Realm of Abnormal Psychology Cluster B a level history essay help

Cluster B Personality Disorder

In this article some of the latest research regarding the Cluster B personality disorders has been given along with their etiology, diagnosis and treatment. Further some research related to the causes, preventive measures and treatments of such disorders has been discussed here as well. The article also presents biblical and cultural points-of-views regarding the disorder. Lastly, various viewpoints associated with the counter transference related to the treatment of the patients with these personality disorders have been addressed as well (Kraus & Reynolds, 2001).

According to the definition of personality disorder it is ‘a continuing pattern of behavior and inner experience which is a lot different from the culture that an individual lives in, this sort of behavior or experience is inflexible and pervasive, starts either during the initial years of childhood or adolescence and although it is generally stable but can become stressful over the years. It has been seen through various neuro-imaging, endocrine and electrophysiological measures that the various personality components like aggressiveness and impulsivity have neurobiological correlates. Personality and even more the personality disorder is anticipated to have an effect on an individual’s functioning and in some of the cases this might actually result in others reacting to the individuals with personality disorder. Therefore, it is logical to expect the individuals with personality disorders to react to their medical illness, treatments and doctors in different manner (Douzenis, Tsopelas, & Tzeferakos, 2012).

The DSM-IV-TR views the Cluster B personality disorders such as borderline narcissism, antisocial andistrionic personality as the subdivision of the personality disorders which are known to be emotional, dramatic and show erratic behavior. Cluster B is the most frequently studied personality disorder and the reason for this is that it contains antisocial as well as borderline personality disorder (BPD). It is significant to note here that the medical co-morbidity of histrionic and narcissistic personality disorders is lacking according to the knowledge of the author. On the other hand the most studied personality disorders in the field of psychiatry are BPD and antisocial. (Douzenis, Tsopelas, & Tzeferakos, 2012).

There is an associated of the cluster B personality disorders with lifestyle and behavior because of which they can prove to be quite problematic not only for the patient but also the people around him. Even though a lot of attention is being given to cluster B personality disorders however, their link with the medical problems hasn’t been studied that much. There is a great need for the relationship between medical illness and personality disorders to be studied (Douzenis, Tsopelas, & Tzeferakos, 2012).

Historical Context

The metaphor of a pendulum has mostly been used to describe the history of psychiatry with the opinions of the psychiatrists regarding the mental disorders swinging back and forth among the biological and psychological understandings. Within the clinical and historical literature as well as various other scholarly groups like sociologists, the pendulum is considered to be a very dominant motif. However, the use of pendulum as a metaphor has recently been challenged by Jonathan Sadowsay (2005) in one of his studies as he argues that the use of this metaphor exaggerates the differences as well as conceals the continuities among the psychological and biological traditions.

Sadosky’s ideas have been drawn upon by Nicolas Rasmussen (2006) and he has applied them to depression’s history between the years of 1940s and 1950s, this was a time when psychoanalysis was at its top. It was suggested by him that the extended use of amphetamine as anti-depressant shows that there is a need to revise the categorical divide which exists between the psychoanalyst and their psychiatrist colleagues (Pickersgill, 2010).

More and more expansion of the psychiatric comorbidity can be seen with every consecutive DSM-I to DSM-IV revision. It is the diagnostic system’s design that the reason lies within as the DSM-IV is a categorical, descriptive system which separates the psychiatric symptoms and behaviors into a number of diagnoses and makes use of some of the exclusionary hierarchies in order to get rid of the numerous diagnoses. In the DSM’s original version there were many concepts and Emil Kraepelin’s structure of mental disorders’ classifications was used. In comparison to the previous revisions, a ‘one disease-one diagnosis’ model was used by the DSM-I and DSM-II according to which the clinician made use of the qualifying phases in order to try and assign one all-encompassing diagnosis like “with psychotic reaction” and “with neurotic reaction” (Pincus, 2004).

However, a different approach was taken by DSM-III according to which big number of comparatively psychiatric diagnosis were used which were defined rather narrowly and gave operationalized diagnostic criteria. For instance, the single DSM-II category ‘phobic neurosis’ was split into 5 DSM-III categories which are social phobia, agoraphobia with panic, separation anxiety disorder, simple phobia and agoraphobia without panic. It is not surprising at all that the amounts of distinctive psychiatric diagnoses which are described by the DSM-IV are almost double as that of DSM-II (Pincus, 2004).

Cause of the Illness

In the light of this argument, the present diagnostic criteria for DSM, it is not possible to identify the Cluster B Personality Disorders without the proper use of moral notions and terms (Charland 2006, 119). Therefore, these disorders are moral instead of mental (Reimer, 2013)

The patients who suffer from the personality disorders have deep seated pathological patterns of behavior, thought and feeling which can be traced all the way back to early adulthood or adolescence. Other than the actions that are found in majority of the people, these people who suffer from personality disorders make a subjective distress or they suffer from functional impairment due to their maladaptive, inflexible and pervasive ways with which they interact with other people (DSM-IV; American Psychiatric Association. 1994).

Mostly the personality disordered patients aren’t aware of their pathology (Millon & Davis, 1996). A very common condition through which the issues related to the comprehension of neurobiology get exemplified is the antisocial personality disorder. Conflicting results have been demonstrated by the postmortem studies that have been conducted on the antisocial personality disorders. In the serial killers who underwent the postmortem examination some abnormalities were found in their amygdala. Although it is also possible that these individuals might have suffered from various other disorders such as depression or substance abuse that can change the structure of brain. There aren’t any reliable neuropathological studies that can show particular association between pathology and antisocial behavior. In case of majority of personality disorders, failure of insight is a major clinical feature. Irrespective of the symptoms the people who suffer from the personality disorders show different amounts of inability when it comes to understanding the affect that their behavior might have on other people. The capacity of an individual to monitor and examine himself gets diminished because of the insight failure (The Neurobiology of Personality Disorders).

Treatment

Psychotherapy has been observed to be the preferred treatment for the Cluster B personality disorders (Gabbard, 1994, 1995a), even though there are still discussion being conducted regarding pharmacotherapy (e.g., Kapfhammer&Hippius, 1998). It is the case methods that the literature which guides us about the suitable approach to psychotherapy is based upon instead of the clinical methods. According to the latest reviews regarding the treatment methods, more importance is being given to interpersonal/psychodynamic and cognitive-behavioral perspectives with regards to the treatment of such disorders (Gabbard, 1994, 1995a; Rosenbluth & Yalom, 1997). Discussions have also been conducted regarding the integrative approaches which deal with blending cognitive and psychodynamic perspectives (e.g., Horowitz, 1997). (Kraus & Reynolds, 2001).

The treatment for these disorders with regards to the cognitive-behavioral approaches is based upon the identification of the illogical beliefs, describing and easing the expression about such beliefs through the strengthening of healthy choices and behaviors that are made by the patient. The way that the interpersonal psychodynamic treatment approaches work is that they are based on the management and understanding of transferential and unconscious features of the therapeutic relationship, recognizing as well as working through the resistance mechanisms and by harmonizing the ability of a patient to not just experience but also think about their feelings and emotions (Kraus & Reynolds, 2001).

Generally speaking it is very difficult to diagnose and treat the people who have cluster B personality disorders. The patients who have antisocial or narcissistic personality disorder might challenge the group leader for the group’s control whereas those who have borderline personality disorder might try to ‘provoke’ the group into saving them. Group therapy however, can prove to be very helpful as, it can help the patients in learning about autonomy, community, intimacy, relationships and individuation within the proper limits and setting (Rutan & Stone, 1993). With the help of covert and over role identification (Gemmill & Kraus, 1988) and various other methods of framing and conceptualizing the group life it is possible for the Cluster B patients to comprehend the ways in which their individual symptoms as well as interpersonal world affects each other (Kraus & Reynolds, 2001).

Prevention

About 9% of the U.S. population has been documented to have personality disorders. There are a number of methods through which the health of these patients can be improved by the family physicians. Some of these methods are pharmacotherapy, brief interventions and psychotherapy. There are three clusters that the personality disorders are divided into, these are A, B and C. Schizoid, paranoid and schizotypal personality disorders are included in cluster A; antisocial, borderline, narcissistic and histrionic personality disorders are included in cluster B; whereas, avoidant, obsessive-compulsive and dependent personality disorders are included in cluster C and this cluster has been noticed to be a lot more prevalent than the rest of the two clusters. Family physicians can treat majority of the patients who suffer from these disorders. Omega-3 fatty acids, mood stabilizer as well as 2nd generation antipsychotics will probably benefit the patients who suffer from the borderline personality disorder. Those who suffer from the antisocial personality disorder can benefit a lot from the antidepressants, mood stabilizer as well as antipsychotics. Problem solving on the basis of solution as well as motivational interviewing are some other forms of therapeutic interventions (Angstman & Rasmussen, 2011).

Intervention which is based on mindfulness, active listening and improving the connection to those values of the patients that he/she cherishes the most tend to be most successful for the family physicians. Interventions of this sort were mainly designed for the family physicians and the concerns regarding job satisfaction and emotional endurance are addressed by these interventions while at the same time they allow the physicians to care for the patients who suffer from the personality disorders as well. A collaboratively created safety and crisis plan should be considered by the physicians when the personality disordered patients are being treated by them, especially for the ones who have borderline personality disorder (Angstman & Rasmussen, 2011).

Cross-Cultural Issues

According to DSM it is a manual that can help in diagnosing the mental disorders. The American Psychiatric Association (APA) published it. Someone who knows that the manual has been published by a medical association might find it very surprising that the latest edition of this manual has a portion on ‘Personality Disorders,’ in which a few of the disorders have been defined completely in form of aberration from the moral norms. The question is if it is possible that in fact the cluster B personality disorders are moral instead of mental? Is their addition to the DSM merely a coincidence of ‘medicalization of morals’? (Reimer, 2013)(Alarcon & Foulks, 1995)

The formation of a cultural axis has been advocated by a few of the authors to be an independent factor when it comes to diagnosing these psychiatric condition generally as well as the personality disorder (PDs) specifically. It is the powerful cultural influence regarding the idea of self-formation, its independence as well as the instant socio environmental happenings that their views are based upon psychopathology (Hallowell, 1934; Hamilton, 1971; Dohrenwend & Dohrenwend, 1974; Mezzich & Goode, 1994). The most important problem which is often faced by a diagnostician who works across the cultures is the necessity to separate the typical personality, ideal personality as well as the atypical personality from cultural functionality’s standpoint. The most common way through which the ideal personality kind is revealed is when the people are questioned about how they would like to live and raise their children (Alarcon & Foulks, 1995).

Biblical World View

When one is observing the doings of God, Bible comes in very handy. It shows us a very complex image of an individual who has performed impressively in a lot of various segments of life but who has also done some uncertain things. It also tells us about a person who has been able to achieve a lot of his goals but who also failed to achieve some minor ones.

Dr. J. Henry Jurgens is a professor at the Yale University Divinity School as well as a practicing psychiatrist who in the May 2, 2001 issue of The Onion, Rev. said that it seems that God has bipolar disorder. Jurgens further said that he has been able to get to this conclusion after researching and studying his patients for many years and also after being in long session with the God through prayer. The bipolar disorder, according to the article is ‘described by the elation cycles after which comes sessions of a lot of despair and depression, and if this disorder isn’t diagnosed and treated in time it can prove to be very dangerous for the patient as well as the people around him. According to Jurgen with the help of this particular diagnosis of the bipolar disorder the contradictory and confusing features of cosmos which have confused the theologians and philosophers can be explained.

Conclusion

The cluster B personality disorders such as borderline and antisocial are linked to the drug addiction, alcoholism as well as the improper treatment of the condition. According to the research that has been reviewed in this paper it is evident that the presence of some personality disorder can prove to be a very harmful factor for the well-being of that individual even if initially this doesn’t seem to be the case. This observation increases the need for the screening of personality disorders in people. Another important thing to keep in mind here is that behavioral and emotional instability are two of the most basic characteristics of these disorders and these characteristics can result in long-term medical illness as, it will be difficult to keep the patients on any medication or therapeutic plan for a long while. Some of the major traits of personality which are related to these cluster B disorders are hostility, anger and impulsiveness and all of these traits can be of great significance with regards to the medical treatment. Therefore, it is very important to test the individuals in routine for personality disorders and take proper measures to diagnose them (Douzenis, Tsopelas, & Tzeferakos, 2012).

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Clinical Psychology Worksheet Essay history assignment help in uk: history assignment help in uk

Clinical Psychology Worksheet

What are at least two legal issues associated with clinical psychology? Provide an example of a situation that could be legal but unethical. Explain your response.

There are some fairly obvious examples that could be used, but one in particular is discussed on the Guide to Psychology website’s legal section. The author notes that many people seeking psychotherapy engage in deception to one or more degrees. Reasons for this could include shame, guilt, fear and so forth. This is not an unexpected part of the process when it comes to psychologists and other clinicians are treating a person. However, the ethical and legal landscape of treating such a person comes to the forefront when any number of things emerge such as if the person commits a crime and uses their mental condition as a legal defense, they are ordered by the justice system to be psychologically tested, evaluated or diagnosed, is ordered by the judicial system to receive psychotherapy and/or sues someone on the grounds of psychological damages. The legal and ethical implications to the provider are obvious in that there has to be doubt cast on absolutely everything that was said up to that point. As an example, someone could claim an insanity defense in court using just about any underlying mental condition as a general cause for “losing their mind.” Some people are sociopathic to the extent that they will “fake it” and this includes in therapy. Clinicians and psychologists in general have a duty to be very diligent and thorough in their assessments. They need to go by the book absolutely every single time. It may not be illegal to offer an incomplete or unproven diagnosis to a person investigating a person’s behavior but corroborating something that cannot truthfully be asserted with certitude is unethical to say the least. Another legal issue would be asserting a diagnosis in court that is not proven or certified as per the proper diagnostic criteria due to a bias against the person involved. While it might not be labeled as perjury, it technically would be and it would be a huge ethical violation because the diagnosis is not keeping with proper technique and psychological practice in general (Guide to Psychology, 2015).

What are at least two ethical issues associated with clinical psychology? Provide an example of a situation that could be ethical but illegal. Explain your response.

One ethical issue with clinical psychology would be the blurring or crossing of boundaries. For example, engaging in a sexual relationship with a prior client is not the best idea but as long as there is not an active patient/psychologist relationship going on, it is generally not a huge deal. However, things would be a lot different if a patient reveals something to the effect that there might be abuse in a household but that they are not sure. It could be that the psychologist sees some major red flags that make abuse almost a certainty but not proven. Let us also assume that the psychologist learns that they know the family in question or someone in it. If the psychologist tips off the family member they know as to the abuse (suspected as it may be), that could technically be construed as ethical but it could also get the psychologist in very hot water with the authorities. A more real-world example would be the case of James Holmes, the Aurora theater shooter. His psychiatrist warned campus police about Holmes without

Research Paper on Development in Adolescence history assignment help company

Development in Adolescence
There is a need to understand the various developmental phases that a person undergoes. The adolescent stage is one of the most crucial stages in development as it provides the basis and setting that which a person constructs their sense of identity and solidifies personality. Various theories have been proposed to better understand people in this stage, including the psychoanalytic theory and psychosocial, behavioral, and cognitive development theories (Goossens, 2020). Carmen is an integral member of the Sanchez family. She is deaf and thereby has difficulty communicating with the rest of the family members, given that they cannot understand sign language. Her unique circumstances enable a closer view into teenagers’ development, especially given her disability.
Issues facing Carmen
The communication barrier is the major limitation facing Carmen. Her disability forces her to rely on sign language for communication. However, her family does not have fluency in sign language. Humans are social beings and have an integral need for companionship and social integration (Bano et al, 2019). However, Carmens disability has caused her to be unable to ensure effective communication with the rest of her family. This has resulted in the familys overprotectiveness and thereby the rising conflict due to her decision to pursue further education away from her family.
Carmens need for self-actualization has led her to opt for a college that is some distance away from her home. She would be the first to leave her familys community and venture out to pursue her goals. It is evident that she aims to prove herself that despite her disability, she can succeed and overcome its limitations. This goes contrary to her familys wishes causing the conflict that is emergent in her family. Her need for escape may also be deemed as a rebellious phase which is common in adolescents as they seek to create identities.
Given her Hispanic background and immigrant family, coupled with her hearing impairment, Carmen is likely to be discriminated against. The American society is critical and discrimination rampant against the minority communities. Carmens background may limit her success and be the source of her anxiety about her impending move to college. Social factors and contexts play a critical role in ones development and Carmens unique situation will define her interaction and adjustment to her new environment.
Financial backing is a major quality that will determine Carmen’s access to complimentary services geared to help her through life. Her family’s financial record is not as stable to provide her with the required opportunities to explore career opportunities. While college will enable her to expand her horizons, the opportunity to attend may be short-lived if she cannot access the necessary financial backing to continue with her studies.
Possible Interventions
Carmen could apply for a scholarship or bursary from various sources to support her quest for a college education. Her family’s financial status could not effectively cover her travelling, maintenance, and fee expenditure. Receiving aid from external sources can supplement and ensure that she can acquire the necessary resources to support her education and seek career options that would be best suited for her limitations and interests. A student loan can also be effective in catering to her needs, especially since she is unsure of accommodation opportunities.
Closer analysis of her situation can ensure that Carmen will make an effective decision about her future. Understanding her goals and the need to undertake further education will ensure that her decision to leave her familys community is not a rash decision based on her quest for freedom from her familys influence. Critically thinking about her decision will ensure that she gathers courage to undertake her choice and avoid any rash decisions that may be detrimental in her life. This review will also ensure that she can sit down and explain to her family why she has decided to seek out a college away from her community. In so doing, she can alleviate the conflict arising from her departure for college.
Carmen can ensure that her family is able to understand her by using sign language more often in normal contexts where the family members who are unable to understand can easily deduce meaning. This will prompt them to pay closer attention to her and eventually pick up and learn sign language through her. This habit will enable closer communication and interaction between Carmen and the other family members, ensuring inclusivity and promoting the close family bonds.
Carmen should also engage more social services to obtain more information about career opportunities for deaf people. Given her academic prowess and her desire to pursue a college education, Carmen should seek out career counselling to determine her interests and the professional opportunities that would be available to her according to her aptitude and interests. This will ensure that she can have a clear projection and understand what steps to take to achieve her potential. Realizing her limitations and opportunities for progress will provide effective guidance for future decisions and enable her family to offer support as she pursues her need for self-actualization (Rogers, 2019).
Development issues in Carmens older family members
Celia Sanchez is a woman who has restricted herself to certain limits that show her submissiveness. Her immigrant status is as a result of her husbands dream to move to America, while she believed that she would continue to reside in Mexico. She is a housewife and has dedicated her life to her family. Because of her life in service to her family, she has not had an extensive interaction with the American society and only communicated in Spanish. Her social and cultural development is still embedded in the Mexican system and she struggles to engage and integrate into the American society. Her social development skills are also lacking given that she only periodically leaves the house to attend church.
Hector Sanchez, the Sanchez family patriarch is reliant on his early experiences to make decisions about his current life. Given the racism he experienced as a youth, he is adamant against applying for public assistance even if his family is on the verge of financial bankruptcy. His spendthrift ways are a consequence of his developmental experiences and his medical conditions do nothing to dissuade his tendencies. It is evident to see the impact that his early experiences have had on his lifestyle.
Junior Sanchez works in the same industry and line of work as his father. The rising financial needs prompted him to abandon his academic career to acquire a job in manual labor. However, his goal to pursue and engage in the missed opportunity to attend college pushes him to try and get a degree while still working. This is evidently a long-overdue wish from his youth to acquire a college degree and pursue a career in a different profession.
Emilia still suffers from drug addiction she started during her teenage years. She had devoted a majority of her childhood to raising her siblings. Her quest for freedom, other experiences and identity pushed her to drugs, and because of limited family support, she has found it hard to quit and get rehabilitation. Her adolescent habits and the identity she created while taking drugs have taken a toll on her and followed her into her later years.
Gloria is constantly on the receiving end of domestic violence. Her religious background and upbringing have prompted her to blame herself for the abuse and avoid reporting her husband because she does not want him to be deported but wants a divorce. Her submissive attitude may be derived from her interaction with her mother and the ongoing abuse has led her to be more isolated from her family. Despite Carmens advice to report Leo, Gloria still blames herself for the beatings as a consequence of the errors she makes.
Alejandros situation is unique as he has a good job selling cars, goes to school, is quite popular, and excels in art. However, he feels unhappy, irritable, obligated, out of place, and lonely. He has had limited romantic relations despite his popularity and his attempt at trying a gay sexual orientation felt out of place. He is undecided about the career he aims to pursue and path he aims to take. This yields evidence to the lasting personality conflict arising from his identity, which was supposed to be formed in his earlier years.
The individual developmental issues in the Sanchez family influence and restrict Carmen from acquiring the necessary support to overcome the limitations of her adolescent life and seek out better opportunities for progress. Given that every member is closely knit by the roles they play and the need for proximity to the family, Carmen’s decision to leave the community for a distant college is viewed as contradictory and the family members aim to dissuade her from the decision.
Evidence-based Social Work Practice
Knowledge of developmental theories and the integral roles they play in peoples lives can ensure that various interventions can be promoted to ensure that Carmen is able to pursue her needs while ensuring that all members of the Sanchez family offer support and overcome their individual limitations. Career development skills can enable a social worker to understand and offer effective options for Carmen to pursue as a professional interest (Rogers, 2019). A counselors role in career development can be the means for Carmen to actualize her academic potential.
Effective counselling can ensure that Celia and Gloria Sanchez can overcome their self-appointed restrictions and act accordingly to achieve their individual needs and goals. Celia Sanchez can take a more active role in drafting the financial expenditure of the family and Gloria can escape the abuse from her husband. Through counselling, the two can take a more active role in the family and its cohesion.
Hector and Emilia can undergo counselling to overcome the influence that their earlier experiences have had on their lives. In so doing, they can form more productive habits and pave the way for tendencies that do not significantly affect the family and those around them. As the patriarch and the eldest sister, the moral support of the two will be significant for Carmen.
Alejandro can employ better strategies to consolidate his identity and personality. Without a concrete social identity, he feels out of place, but with quality counselling, he can identify what he desires and make valid decisions about what he wants to do with his life if he intends to quit his work selling cars.

References
Bano, S., Cisheng, W., Khan, A. N., & Khan, N. A. (2019). WhatsApp use and student’s psychological well-being: Role of social capital and social integration. Children and youth services review, 103, 200-208.
Goossens, L. (2020). Theories of adolescence. In Handbook of adolescent development (pp. 11-29). Psychology Press.
Rogers, A. T. (2019). Human behavior in the social environment: Perspectives on development and the life course (5th ed.). Routledge.