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May 12, 2008 -- FROM THE EDITOR:
Announcing the publication of our thirteenth module Volume 4, Module 2):
Targeting Catholic Rituals as Symptoms of Obsessive Compulsive Disorder: A Cognitive-Behavioral and Psychodynamic, Assimilative Integrationist Approach
by Hector Garcia
with Commentaries by
** Brett Deacon and Elizabeth Nelson
** James Mandala
Editor's note: This module is organized around a case study by Dr. Hector Garcia, conducted while he was a clinical psychology graduate student. Dr. Garcia’s training program afforded him the opportunity to pursue a two-phase, multi-theoretical treatment with Bridget, a single, 21-year-old undergraduate student who at first presented with depression and “scrupulosity,” a condition involving obsessions and compulsions that center on religious themes.
The first phase of the treatment involved a manualized, cognitive-behavior therapy approach and similarly oriented supervisor that focused on the obsessive-compulsive symptoms. While the emotionally loaded and frequently unclear distinction between healthy versus psychopathologically-driven religious practice raised very important ethical and technical challenges for Dr. Garcia’s role as a student therapist, after 27 sessions, Bridget’s obsessions and compulsions had been virtually eliminated. Bridget was then eager to pursue other difficulties, such as the impact of her interpersonal style on her relationships with men. Based on a variety of circumstances, Dr. Garcia then initiated a second phase of treatment with a new, psychoanalytic treatment model and supervisor lasting another 52 sessions, also with promising results.
Reflecting on this experience, Dr. Garcia conceptualizes the connection between the two phases within the model of assimilative integration, and he discusses the process of going from a more to a less structured type of treatment.
Commentaries are provided by Brett Deacon and Elizabeth Nelson, who view the therapy through a cognitive-behavior lens, and James Mandala, Dr. Garcia’s supervisor for the second, psychoanalytic phase of the case, who views the therapy from that perspective. In Dr. Garcia’s response to the commentaries, he includes a distinctive, 5-year quantitative and detailed, qualitative follow-up with Bridget.
The whole series presents a unique opportunity to explore the process and impact of different treatment models with the same client and therapist, with implications for both practice and training.
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1. Case Context and Method
2. The Client
3. Guiding Conception with Research and Clinical Experience Support
4. Assessment of the Client's Problems, Goals, Strengths, and History.
5. Formulation and Treatment Plan
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Vol 4, No 2 (2008)
Table of Contents
Case Study
| Targeting Catholic Rituals as Symptoms of Obsessive Compulsive Disorder: A Cognitive-Behavioral and Psychodynamic, Assimilative Integrationist Approach | Abstract PDF |
| Hector A. Garcia | 1-38 |
| On the Nature and Treatment of Scrupulosity | Abstract PDF |
| Brett Deacon, Elizabeth A. Nelson | 39-53 |
| Treatment Paradigms in Psychology | Abstract PDF |
| James Mandala | 54-62 |
| Meaning and Pragmatism in OCD Treatment | Abstract PDF |
| Hector A. Garcia | 63-74 |


