Part I
DSM Diagnosis
According to the revelation made by the client before the psychologist, he is suffering from erectile dysfunction. An erectile dysfunction is a sexual disorder that affects male adults and is characterized by the inability to establish and maintain an erection sufficient for satisfying sexual activity ( Paris, 2015; Boskey, 2013) .
Explanation r ationale for the DSM diagnosis
T he client reveals that he is a pornography addict. The addiction has developed to the extent that the client strives to find every little excuse to watch porn (Laureate Education Inc , 2012). Another important point is that the client acknowledges that he masturbates a s regularly as four times a day. Thus , the re is a combination of porn ography addiction and masturbation which worsen the condition . This is because t he mechanical pressure applied to the penis using the hands is not as strong as that provided by the virginal walls of the female reproductive system. In this case, the client is unable t o sustain an erection for satisfying sexual activity since he finds his partner unable to produce sufficient excitation to make him ejaculate.
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Extra information required
Despite the client’s candidness, there is a need for more information so as to ascertain the problem and recommend the most appropriate psychological intervention. For instance, the client needs to reveal the exact duration that he has been masturbating and addicted to pornography. Addiction is tackled in stages and therefore, knowing the right stage of addiction is vital in recommending the most effective remedy.
Individuals required in the assessment
The only person needed in this case is the client’s spouse. Unfortunately, the client is married and with a family. The effects of the erectile dysfunction disorder are therefore likely to spill over to his family relationships and break up his marriage. While the wife seems s upportive at the start, she may begin to get irritated and emotional on the realization that the husband has been keeping the condition from her for a long time . Hence, having the wife around will facilitate joint counseling to help the husband overcome addiction as well as aid the wife in handling h er husband ’s condition.
Providing a conducive environment
It is evident from the video that the patient’s w ife is increasingly becoming emotional as the husband opens up about his condition . The first strategy for providing a conducive environment for the client to reveal more details about his condition is thus by making the wife understand that by o pening up, her husband is likely to get help . This is unlike keeping quiet or lying about the condition . Similarly, there is need to assur e the two partners that the revelations made will not lead to any negative impacts on their matrimonial union.
Part II
DSM Diagnosis
The 13-year-old client described in the second case study has a mental disorder known as g ender dysphoria or gender identity disorder. Gender dysphoria is defined as a mental disorder in which the affected persons develop strong and persistent feelings of identification with the opposite sex and hence show increased discomfort with their assigned gender often leading to distress or impairment (Drescher &Byne, 2012 ).
Explanation r ationale for the DSM diagnosis
The description of the client ’s signs and symptoms point towards a typical case of a g ender dysphoria disorder. For instance, according to the parents, the young girl has shown open dissatisfaction and disappointment in her gender . This implies that the girl desires to be a boy as opposed to her assigned gender. To further show her obsession with the opposite gender, the client dresses and acts like a boy. Further , she openly confessed that she has always wanted to be a boy for as long as she can remember. A comparison with the diagnosis guidelines in the DSM reveals that the client shows exact symptoms of people suffer ing from g ender dysphoria. The client is at an advanced stage of the disorder , and failure to seek intervention might easily lead to distress.
Extra information required
There is a need to get additional information about the sexual orientation of the client. For instance, she could be a hermaphrodite with suppressed male hormones . Likewise, she could be having male features. In this case, the client needs to open up about her body and its functionality. For example, there is a need to know whether the client experiences menstruation or even feels any sense of attraction to either fellow girls or men. In some cases, the society is quick to label people like the client as lesbians or bisexuals without due consideration of their sexuality (Paris, 2015).
Individuals required in the assessment
The client ’s parents are the only people needed in the assessment process. The parents play two major roles. Firstly , the parents are the first people to notice the client’s condition and therefore understand her better than anyone else . Secondly, it is vital to keep the client ’s confession confidential since sharing the same with the public could lead to a psychological trauma. Given the fact that the client i s extremely free with her parents, she is likely to open up more quickly about her condition in their presence. This is as opposed to a situation whe re the assessment is carried out before strangers.
Providing a conducive environment
In a bid to provide a conducive environment, t here is a need to assure the young girl that her condition is neither queer nor unique but a common condition that affects people in her age. Such encouragement is likely to make the girl feel that she is in the right hands . Likewise, it i s likely to assist her in get ting the necessary help to overcome her mental state.
References
Boskey, E. (2013). Sexuality in the DSM 5: Research, relevance , and reaction. Contemporary Sexuality , 47 (7), 1-5.
Drescher, J., & Byne, W. (2012). Introduction to the special issue on “The treatment of gender dysphoric /gender variant children and adolescents .” Journal of Homosexuality , 59 (3), 295-300.
Laureate Education Inc. (2012). Psychopathology: Sexual dysfunction, schizophrenia spectrum, and other psychotic disorders [Video file]. Retrieved from https://class.waldenu.edu
Paris, J. (2015 ). The intelligent clinician’s guide to the DSM-5 (2nd ed.). New York, NY: Oxford University Press.
