For this Application, review the client case study provided below. Consider the characteristics of the client. Which specific characteristics might you consider important in developing an Axes I through IV diagnosis? The Assignment (34 pages) An Axes I through IV diagnosis of the client in the case study An explanation of your rationale for assigning these diagnoses on the basis of the DSM-IV-TR.
Casestudy: Sexual Disorders and the practicing Psychologist
Husband: It’s pretty frustrating. Not just for me, but for the both of us. I mean I feel like I’m letting her down. I mean we do other things. But I just can’t seem to get an erection. It’s no fun.
Wife: We’re hanging in there though.
Psychologist: Well it seems as if you guys support each other. And you’ve had a complete physical, right?
Husband: Yes. I’ve been checked out by both my GP and a urologist. Nothing medically showed up. I’m pretty healthy. I mean I barely even drink. Maybe a couple of beers or a glass of wine now and then butThe one doctor tried putting me on some of those medicines for erectile dysfunction. Like the ones advertised on TV. But they didn’t work. I just can’t seem to get it up. Which is how we ended up here. This is out of the blue for both of us. I’ve never had this before. I’ve never even been to see a therapist. We just want to work this out. (Grabbing his wife’s hand firmly and looking at her).
Psychologist: Ofcourse, you do. So what else is going on with you, maybe at home or at work?
Husband: I think things are pretty good overall. Wouldn’t you say honey?
Wife: Yeah, no problems. None that I can think of. We have two children. They’re wonderful, doing just great. And things are fine for me at work. I’m a nurse. I work part-time.
Husband: And I’m in marketing. I just went through my annual review and I got flying colors. So no stress there.
Psychologist: Well that’s good to hear. Well, it sounds like you’re not seeing any other issues related to this?
Husband: (Shaking his head) No.
Wife: Well, maybe. You haven’t been sleeping well.
Husband: Oh yeah, that’s right. I toss and turn a lot. Been worried about this I guess. Oh, and I’ve been taking some online business courses. I’m going after my MBA. I work on the computer a lot of nights. And I probably have that on my mind when I come to bed.
Wife: Yeah, a lot of nights.
Husband: Come on. It’s not that bad.
Wife: No, actually sometimes it is. I’ve told you, sometimes it’s like the computer comes first. Not all the time, but
Husband: It’s my MBA, honey.
Psychologist: So you’re saying is that it feels as if he’s a little disengaged from you and the family.
Psychologist: Hmm. So since the erectile dysfunction became an issue for you, have you sought out any other sexual outlets? Do you masturbate?
Husband: (Long pause) Yes.
Psychologist: And are you able to ejaculate?
Husband: (Another long pause) Yes.
Wife: But how? I thought you couldn’t?
Husband: Looks at her, then looks away sadly.
Psychologist: By any chance, do you use pornography to help you masturbate?
Husband: (Looking down) Yes.
Wife: (Looks at him angrily) That’s what you’re doing on the computer at night? Masturbating to porn?
Husband: I’m sorry.
Wife: Look at me.
Husband: (Looks at her)
Wife: No more lies. What else haven’t you told me?
Husband: (Looks at counselor) It’s not just at night. I look at it during the day. Sometimes once, sometimes twice, sometimes more. And my job review really wasn’t all flying colors. I got caught looking at it at work. I got reprimanded. It was bad. (Looking at his wife) But don’t worry. I’m not going to get fired. I swear. I haven’t use the computer there like that for months. You have to believe me. Please.
Wife: (Shaking her head) You swear you’re not using your work computer. But what about that new cell phone they gave you? Using that for your porn now?
Husband: (Looks away)
Wife: Oh, my god.
For many beginning psychologists, one of the most difficult topics to broach with a client is the topic of sex: sexual orientation, sexual behavior, or sexual problems. Specifically, erectile dysfunction is one such topic. Erectile dysfunction is generally characterized by a male’s inability to produce or maintain an erection. At times, males refrain from discussing the topic for many reasons. Among the most prevalent reasons is that the dysfunction is perceived as a
threat to the client’s manhood. By using professional sensitivity and consideration of other personal factors such as cultural awareness and client privacy, psychologists may produce a comfortable environment in which to lead the client into discussion.
For this Application, you review the client in the case study in the Learning Resources. Apply Axes I through V diagnoses. Remember, Axis V concerns a psychologist’s assessment of a patient’s ability to function in daily life. Be sure to pay particular attention to symptoms of the disorder and the influence of the disorder on the client as well as the client’s significant other.
The Assignment (34 pages)
- An Axes I through V diagnosis of the client in the case study
- An explanation of your rationale for assigning these diagnoses on the basis of the DSM-IV-TR
- An explanation of what other information you might need about the client to make an accurate diagnosis
- A brief description of additional individuals you might include in your assessment and explain why
Support your Application Assignment with specific references to all resources and current literature used in its preparation. You must utilize the uploaded resources provided below first before searching for other sources on the web.
Goldman, H. H., Skodol, A. E., & Lave, T. R. (1992). Revising Axis V for DSM-IV: A review of measures of social functioning. The American Journal of Psychiatry, 149(9), 11481156.
Retrieved from the Walden Library databases. Hartmann, U. (2009). Sigmund Freud and his impact on our understanding of male sexual dysfunction.Journal of Sexual Medicine, 6(8), 23322339.
Retrieved from the Walden Library databases. McCarthy, B., & Thestrup, M. (2009). Men, intimacy, and eroticism. Journal of Sexual Medicine, 6(2), 588594.
Retrieved from the Walden Library databases. McCarthy, B. W., & Fucito, L. M. (2005). Integrating medication, realistic expectations, and therapeutic interventions in the treatment of male sexual dysfunction. Journal of Sex & Marital Therapy, 31(4), 319328.