Diagnosis and Treatment Interventions - Research Paper Example

Treatment Plan

Instruments/Screens to Facilitate Diagnosis

• DSM-IV Chart
• Childhood Trauma Interview
• Sexual Addiction Screening Test
• Behavioral screening test (Total Sexual Outlet)
• PHQ-9 Patient Health test questionnaire to screen for depression
• Screening substance abuse 
• Self-report
• Interviewing

DSM-5 Diagnosis

Hypersexual/compulsive sexual behavior

Differential Diagnosis

• Compulsive sexual behavior (Obsessive-Compulsive Disorder
• Impulse disorder
• Sexual disorder
• Bipolar affective disorder
• Cyclothymic disorder
• Substance-induced anxiety disorder
• Depression

Ethical/Legal Consideration of the Diagnosis

The client used marijuana occasionally, smoking a single joint in a month. Smoking recreational drugs such as marijuana is illegal and hence he is smoking marijuana illegally.

However, as far as ethical issues are concerned, the client has several the ranges from sex with strangers, internet hook-ups, sex for pay, masturbation. He also reports having trouble once at work when pornography in his computer. He has now resorted to his phone and home computer for porn. The illegal use of marijuana from a tender age to present also falls in the ethical category as he may have exposed other people to marijuana be it those that are close to him or not, for example his children.

Short-Term Goals to Address the Diagnosis

The main goals, be they short term or long term are basically aimed at ensuring that the victim is separated from the addictive activity, identifying what triggers the sexual feelings, that the sexual urges are reduced or managed and that the emotions that emanate from activities such as masturbation are addressed. This is because victims often suffer from guilt, feeling of unworthiness or even feeling ashamed. It is also important to prevent the addiction from recurring, which is known as relapse prevention (Robert, 2017).

Psychotherapy is an important short term goal of addressing sexual addiction. This form of treatment addresses several issues in a therapy session that include identifying and changing negative thinking patterns and limiting beliefs, restoring back self awareness and insight, dealing with internal conflict, bringing unconscious issues into being and comparing interpersonal issues and the addiction (Robert, 2017).

Group therapy is also a form short term goal that entails a group of sex addicts supporting each other under the guidance of a therapist. It ensures that excuses as well as denial are confronted since the victims learn from each other’s experiences (Weiss, 2016).

Family and couples therapy may also aid in addressing the victim’s diagnosis in the short term (Weiss, 2016). He may visit a therapist together with his wife since his behavior is impacting both him and his wife. Emotional problems and unresolved conflicts can be resolved and this can help strengthen his support system by helping those close to him or even his wife gain a better understanding of his addiction (Weiss, 2016).

Long-Term Goals to Address the Diagnosis

Medication is a long term goal that addresses sexual addiction in a very big way. This is because some of the medicines aid in ensuring that obsessive thoughts and compulsive behaviors are eliminated (Cheng, 2007). Some may also ensure that symptoms such as anxiety and depression that accompany sexual addiction are also eliminated or minimized. Other medications also target particular hormones that are connected to sex addiction (Cheng, 2007).

Strategies to Promote Optimal Sexual Functioning

There are various mental treatments for the client. The first one is psychodynamic psychotherapy, where the patient will be trained to focus on increasing awareness of unconscious thoughts and behaviors and develop new insights into his motivations (Fong, 2006). The therapy sessions will also address on how to deal with internal conflicts and to evaluate the link between interpersonal issues and the patient’s sexual disorder. The other intervention for the patient could be cognitive behavioral therapy. For this treatment modality, the group therapy will include regular sessions for the client together with other people with the same sexual problem. This therapy will help the client to identify the unhealthy and negative beliefs and behaviors and replace the negative behaviors with positive behaviors (Fong, 2006). This therapy will be very helpful to the client because group members support each other and learn from each other’s experiences. The therapy will also offer the patient will the ideal setting to confront excuses, rationalizations as well as denial that is normally found in people with problems in sexual functioning. The lastly treatment that the client will be offered is family and couples therapy. This is because the client’s behavior is definitely affecting the wife and hence the therapy sessions will offer a chance to deal with emotions, unsettled conflicts, as well as problematic/enabling behaviors. More importantly, the sessions will help the patent to strengthen his primary support system because the wife will better understand his condition and support him in the journey to recovery (Fong, 2006).

Evidence-Based Treatment Interventions to Support Strategies

Psychotherapy interventions have been shown to be effective in treating sexual problems such as hypersexual/compulsive sexual behavior. A study conducted by Kaplan & Krueger (2010) indicated that psychotherapy interventions aid patients in regaining control of sexual behavior and reducing shame and negative emotions associated with negative sexual behaviors. Cognitive behavioral therapy uses treatments used to address substance use addictions and aims at identifying the factors that trigger sexual behaviors and restructuring cognitive distortions on sexual behaviors. According to Turner (2009) the cognitive behavioral therapy was shown to reduce addictive behaviors, modify maladaptive core beliefs, as well as decreases perceived shame. In this study, therapists confronted unreasonable beliefs, stimulated problem-solving skills and also provided advice to the patients. The patients were led to focus on thoughts, feelings, as well as behaviors that stimulated their sexual urges and then patients were helped to explore impulse control, triggers, as well as negative thoughts and aimed at behavioral change. The result of this study indicated that patients recovered from their sexual addition.

In another study Rosenberg Carnes & O’Connor (2012) therapists used interviewing techniques in consolidating change and establishing a strong therapeutic alliance among all patients undergoing cognitive behavioral therapy. Psycho-education was used to improve and enhance knowledge of patient regarding their sexual disorder. Patients were helped to gain consciousness of their thoughts, feelings, as well as their emotional situations allied to the abnormal sexual behaviors (Rosenberg, Carnes, & O’Connor, 2012). Patients were also taught how to anticipate and handle situations that might result to their relapse, how to identify triggers, self-control techniques and how to change cognitive distortions. In the study conducted by Hardy et al (2010) psychodynamic psychotherapy was used to explore the core conflicts that promoted dysfunctional sexual behaviors among the patients. Themes of shame, avoidance, and low self-esteem were addressed and the study outcome indicated that the therapy was effective in decreasing and to control compulsive sexual behaviors. Finally, studies also show that couple therapy is effective in helping couples restoring trust, reducing shame/guilt, as well as establishing healthy sexual relationship between couples (Bird, 2006).

Relevant Research to Support Diagnosis and Treatment Interventions

Bird, M.H. (2006). Sexual addiction and marriage and family therapy: Facilitating individual and relationship healing through couple therapy. Journal of Marital and Family Therapy, 32, 297–311.

Cheng JY, Ng EM, Chen RY & Ko JS. (2007). Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies. Int J Impot Res. 19(1), pp:343–52.

Cheng JY, Ng EM, Ko JS & Chen RY. (2007). Physical activity and erectile dysfunction: meta-analysis of population-based studies. Int J Impot Res.  19(1), pp:245–52

Fong T. (2006). Understanding and Managing Compulsive Sexual Behaviors. Psychiatry (Edgmort. 3(11): 51–58.

Hardy, S.A. , Ruchty, J., Hull, T.D. , & Hyde, R. (2010). A preliminary study of an online psychoeducational program for hypersexuality. Sexual Addiction & Compulsivity, 17, 247–269.

Kaplan, M.S. , & Krueger, R.B. (2010). Diagnosis, assessment, and treatment of hypersexuality. Journal of Sex Research, 47, 181–198.

Rosenberg, K.P. , Carnes, P., & O’Connor, S. (2012). Evaluation and treatment of sex addiction. Journal of Sex & Marital Therapy, 40(2), 77–91.

Turner, M. (2009). Uncovering and treating sex addiction in couples therapy. Journal of Family Psychotherapy, 20, 283–302.

Weiss H. (2014). Predictors of sexual dysfunction incidence and remission in men. J Sex Med. 1(2).