"The Roommate" Entry 5

I think one challenge that I could encounter as the therapist in treating Rebecca would be her accepting the fact that she needs help.  Rebecca may believe things are okay and be in denial that she has issues that require treatment.   Another challenge that could arise is committing to therapy. Although Rebecca is committed to school and show interest in classes she might not feel there is a need to come to therapy as scheduled. Therapy may not be as important to Rebecca as other things in her life.
Trust would present a problem with the therapeutic relationship. Rebecca being suspicious of others can cause distrust with the therapist.  If there is no trust then Rebecca may not be open with her feelings.  Social skills may also be a challenge. Rebecca is not good with communicating to others or appropriately responding.  If the anger and hostility is not eventually controlled it will challenge the development of a healthy therapeutic relationship.  The third challenge would be the delusions that tend to lead to obsession.  The therapeutic relationship would be in jeopardy if the delusions or obsessions occur toward the therapist.  

"The Roommate" Entry 4

As mentioned in previous entries Rebecca suffers from delusional and suspicious thoughts of others and this not only makes her angry and violent but keeps her from being sociable. Cognitive restructuring is a technique that can be used to help with the short term goal of joining a social club to interact. This will help Rebecca to replace her negative thoughts with more reasonable ones to prevent violent acts and behavior from occurring.

Relaxation can be useful in helping with the short term goal of focusing on something good a few times a day. The deep breathing technique will help Rebecca calm her racing thoughts and angry feelings.

Rational-Emotive Imagery and Exposure techniques can be utilized with the long term goal of minimizing or eliminating delusions. Rational-Emotive will help Rebecca identify, dispute and replace or reduce the irrational thoughts. With Exposure Rebecca will practice coping skills and gradually change false or erroneous perceptions through action.

"The Roommate" Entry 3

Problems that could benefits from intervention is delusions and violent acts.  Help is needed in these areas because Rebecca imagines that the people who has any type of relationship with her roommate is bad news or no good for the roommate and feels she need to perfect her. She has a fixation on her roommate and believes their relationship is more than what it really is, not realizing it is a one way feeling. These delusions lead to violent behavior towards other people who gets involved or close to the roommate.

Rational emotive techniques such as disputing and interpersonal skills training would be short term goals. Disputing will identify the irrational beliefs or delusions and challenge Rebecca to validate these ideas which then can be reduced and or replaced. Interpersonal skills training will help Rebecca learn how to interact and treat others.  A long term goal would be breathing exercises. When feelings of hostility come about deep slow breathing exercise can be calming, relieving the mind of anger and change Rebecca's focus.

Treatment being successful for Rebecca would mean she is able to control her negative reactions towards people by utilizing her interpersonal training using appropriate interaction and communication. She would also have better control of delusions and hostility when refocusing her thoughts through breathing exercises which would reduce or eliminate the violence.