Question: In our world today, it takes time and patience to gain someone's trust, especially if an individual is a client that is seeing a psychologist. There are some cases where the client basically bares their soul. When a client tells their psychologist their deepest, darkest secrets, they are assured that no one else will ever know what has been discussed because there are rules, regulations, and standards that must be obeyed regarding confidentially. According to the A.P.A. "psychologist have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentially may be regulated by law or established by institutional rules or professional or scientific relationship". (A.P.A. 2010 Section 4.01)
In Bob Smith's case, his psychologist (Dr. Brewer) who he has been seeing for six months disregarded the ethical standards set by the A.P.A. When Dr. Brewer was gathering research about Bob, he was granted permission to speak with Bob's friends and classmates, but when asked for permission to contact Bob's mother, Bob refused to sign a consent form. When Dr. Brewer went behind Bob's back and hired a private investigator to find information about Bob's mother, Dr. Brewer acted in an unethical manner. In fact he violated the standards set for confidentially.
After Dr. Brewer talked to some of Bob's fraternity friends, he was told that Bob's personality had gone through significant changes about three years ago. Bob went from a happy-go-lucky guy that hung out with his classmates to being a loner. There were friends who thought Bob had started doing illegal drugs because of his weight loss, missing work, and becoming antisocial. In my opinion, Bob could have been abusing alcohol or drugs, but I think that the way Bob's personality started changing was because Bob was dealing with depression issues. According to an article "in addition to the self-inflicted damage caused by substance abuse and self-harm, relationships with family, friends, and intimate partners may be damaged by the higher degree of externalizing behaviors exhibited by men with depression (Cochran & Rabinowitz, 2000 as cited by Cole & Davidson, 2018 PsycARTICLES
Using a cognitive behavior approach, an individual can rely on the environment that he or she grew up in. In Bob's case, he did not have social climbing skills, which are one of the determining factors that led him into isolation. Although Bob's dad was more or less a weekend type parent, that could explain why he was a hard worker that was warm and caring and when he was home he wanted to spend as much time as he had to spend with his family. Bob's mother was just the opposite. She was strict and had the tendency to let small altercations turn into things that were much larger. Bob preferred to keep things as simple as possible so that he did not draw his mother's unwanted attention. According to an article " according to Foxall (2007), simple acts may best be explained in terms of behavior of the organism as a whole, but complex behavioral patterns, usually described by mental terms, can only be explained by neurocognitive psychology, in which the mind is conceived as an internal mechanism'. (Rachlin, 2007, p 131 para 1) In Bob's case in my opinion a theoretical approach would work because of past behaviors that the individual acted out would now be behaviors that could be avoided and perhaps turn negative feelings into positive ones.
When psychiatric disorders are diagnosed most of the people in our profession refer to the DSM-5 Manual. The DSM-5 Manual is what I used to research and find a diagnosis that would fit Bob's case. Bob was displaying depression symptoms such as considerable weight change, missing work fairly regular, and isolating himself from friends and family. According to an article "our current systems of classifying psychiatric disorders (DSM and ICD) have evolved over the past 60 years from the first edition of the Diagnostic and Statistical manual of Mental disorders (DSM-1) (1) to the current DSM-IV(2) and the sixth revision of the International Classification of Diseases (ICD-6) (3) to the current ICD-10 (4)". (Tandon, 2013 p 16 para 1)
1. Will Bob be able to trust another psychologist concerning confidentially issues?
2. Does Bob blame his parents for him not having better social skills and not being able to handle stress?