The Case of Ms. Q: A Demonstration of Integrative Psychotherapy Guided by "Core Clinical Hypotheses"

Abstract

This case study describes the treatment of a married mother—Ms. Q—in her mid-thirties who sought help for making major life decisions that involved her marriage, career, obligations as a parent, and self-development. A model and method for conducting theoretically integrated therapy as described in the author’s book, Clinical Case Formulations (Wiley, 2006), is illustrated through case formulation charts and narrative discussion of the choice points in therapy with Ms. Q. The treatment integrated clinical hypotheses from five theoretically differentiated categories: existential/spiritual (issues of choice, responsibility, commitment, meaning and creativity); psychodynamic (conflicting inner parts, immature “self,” and unresolved guilt and abandonment fears from past relationships); cognitive (faulty schemas about responsibility, parenting, and marriage); behavioral/learning (conditioned emotional responses and lack of skills in decision making, emotional regulation, and marital communication); and social/cultural/environmental (family systems factors, issues of culture and gender, and need for appropriate work environment.)