Bess Case Study Applying the Right Treatment Essay

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Clinical Case Study: Bess

Cognitive behavioral therapy (CBT) would be an appropriate intervention to assist Bess in overcoming her OCD by targeting the psychological foundation of the disorder. Bess's neurosis is related to a strong, overbearing impact from her mother in her childhood, now verging on agoraphobia, which is having a negative effect on her social and psychological life. Her symptoms do not appear to have a strong biological basis, thus CBT should be an effective intervention.

The rationale for selecting CBT is that it provides a goal-oriented strategy for overcoming negative behaviors and replacing them with positive ones. Because Bess is a goal-driven person, who has been highly motivated in the past to accomplish tasks, this strategy should be helpful in re-orienting her with a more positive focus. Her confused sexual experience followed by the forced abortion on her mother's orders have substantially deprived Bess of any ability to function autonomously or with any real connection between her interior life and the world around her. She feels disconnected and deprived of an ability to "fix" herself: she is the same girl who struggled with the concept of being "saved" and being a "sinner" when learning religion under her Methodist tutors.

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This anxiety is manifested in an extreme manner by her obsessive-compulsive disorder, related to the rituals of undressing and cleaning. She is unable to "clean" something inside of her that she cannot even identify or be certain is there. Thus, the constant conducting and re-conducting of the same tired and "absurd" rituals become an overwhelming part of her daily existence. CBT could help to alleviate her of the obsession she feels by engaging her in a positive manner that will allow this burden in her mind to be lifted. It could also assist her in re-focusing her psychic energies towards more rewarding and fulfilling goals in both her private and social life.

Bess also suffers from clear signs of depression as she has always struggled to be happy under a mother who could not understand or tolerate her unhappiness. CBT could also be employed to assist in this case. During the cognitive therapy sessions, the therapist would be able to use "congruent" traits to help the patient deal positively and effectively with her "incongruence" -- in this case, Bess's inability to stop her rituals even though they are preventing her from being productive (McNeil, 2013, p. 8). Becks's "empirically….....

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