Paper for Issue

Addressing Anxiety in Adolescence: A Case of an Integrated Approach to Treating Panic Disorder and Generalised Anxiety Disorder

Abstract

This case study explores the assessment and therapeutic management of a 14-year-old female adolescent presenting with Panic Disorder and Generalized Anxiety Disorder. Utilising an integrated approach combining Cognitive Behavioural Therapy (CBT) and Person-Centred Therapy (PCT), the treatment focused on addressing her anxiety symptoms, cognitive distortions, emotional regulation, and social functioning. Assessment tools were employed to guide diagnosis and monitor progress, including the Structured Clinical Interview for DSM-5 (SCID-5) clinical version, the Screen for Child Anxiety Related Emotional Disorders (SCARED) for parent and child, the Beck Depression Inventory and the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM). The Differential Aptitude Tests- Revised (DAT-R, Jung Personality Questionnaire (JPQ) and the Namibia Vocational Interest Inventory II (NAMVII) were administered. Results from these assessments guided a personalised treatment plan targeting Lulu’s presenting symptoms and vocational uncertainty. The client was diagnosed with Panic Disorder and Generalized Anxiety Disorder, guided by DSM-5-Tr criteria, and her treatment was informed by these classifications to provide targeted and evidence-based interventions. Key interventions included psychoeducation on anxiety components, cognitive restructuring, relaxation techniques, and assertiveness training. The therapeutic process also addressed relational issues, including her ambivalent feelings toward her absent father and social challenges within her school and hostel environment. Progress was monitored through self-report measures, demonstrating reduced anxiety symptoms, improved coping strategies, and enhanced emotional insight. The case underscores the importance of collaborative, individualised treatment approaches in adolescent anxiety disorders and highlights the role of family involvement in successful outcomes. The client’s consistent participation and active engagement throughout therapy significantly contributed to the positive treatment outcomes.

Incongruency between Gender Identity and Societal Expectations: A Case Report on Gender Dysphoria

Abstract

This report gives a narrative of Takesure Mariga’s (pseudonym) case on gender identity. The therapist used the Clinical Interview, the Patient Health Questionnaire (PHQ-9) and the Gender Identity/ Gender Dysphoria Questionnaire for Adolescents and Adults (Male to Female Version) to assess the client’s problem. The client’s score on the Gender Identity/ Gender Dysphoria Questionnaire was low and indicative of extreme gender dysphoria. The therapist based this case on the self-concept theory because dysphoria profoundly affects the self-concept of individuals grappling with gender identity issues. The goals of therapy were to help the client to reduce dysphoric feelings and improve his psychological well-being, help him to accept his gender identity, and also to develop skills to cope with gender dysphoria. The therapist used the Cognitive Behavioural Therapy, Narrative Therapy and the Solution Focused Brief Therapy considering several techniques from the three counselling approaches. The psychologist used psychoeducation, systemic therapy and homework as short term interventions and goal setting and gender affirmation as the long term interventions.

‘‘I Want to Punish Him’’: A Case Study of Systemic Family Therapy in Zimbabwe

Abstract

This case study presents the therapy journey of a 26-year-old Zimbabwean woman with self-diagnosed post-traumatic stress disorder (PTSD) rooted in childhood exposure to domestic violence. Clinical assessment using the PTSD Checklist for DSM-5 (PCL-5) and the Beck Depression Inventory-II (BDI-II) confirmed symptoms of trauma, depression, and suicidal ideation. The client’s unresolved emotional pain was compounded by substance use, academic failure abroad, unemployment, and estrangement from her abusive father. Therapy employed an integrative systemic approach drawing on family therapy, narrative trauma processing, and culturally sensitive adaptations such as a no-harm contract tailored to Zimbabwean realities. Collaboration with psychiatric services ensured medication support and risk management. The therapy explored maternal triangulation, intergenerational patterns of vilification, and cultural attributions of witchcraft within the family. This paper highlights how a contextualised family systems therapy, grounded in systemic thinking and supported by multidisciplinary input, can foster healing in clients with complex trauma, especially in African cultural settings.

From Darkness to Light: A Case Report on Grief, Trauma, and the Search for Healing

Abstract

This case study presents the therapeutic journey of Paula (pseudonym), a 26-year-old Zimbabwean woman struggling with grief, depression, and feelings of abandonment following the loss of her mother and grandmother, and a breakup with her boyfriend. Through a comprehensive assessment using clinical interviews, Mental State Examination, Burns Depression Checklist, and Grief Inventory, the psychologist diagnosed Paula with Other Specified Depressive Disorder (DSM-5 TR F32.89). Narrative therapy and forgiveness therapy were employed to facilitate healing, rebuild self-esteem, and promote forgiveness. A total of five therapy sessions were held, each session lasting approximately one hour. The therapy focused on reframing Paula's narrative, preserving positive memories, and fostering a sense of closure. The outcome of the therapy was positive, with Paula expressing relief and a renewed perspective of life. The case highlights the effectiveness of narrative and forgiveness therapies in addressing complex emotional issues and promoting mental well-being. It also highlights how unresolved issues impact a person’s view of other issues that may arise in life.

Navigating Emotional Distress: A Forensic Psychological Case Study on Recovery and Resilience

Abstract

This article presents a case study of a 23-year-old female patient hospitalised after a suicide attempt following a misunderstanding with her neighbour. The patient had a history of incarceration due to her criminal activities and was subjected to stigmatisation in her community. Psychological evaluations showed a low level of social support (Social Support Questionnaire - 6 = 5), minimal depressive symptoms (Patient Health Questionnaire - 9 = 3) and moderate hopelessness (Beck Hopelessness Scale =12). This analysis used the Labelling Theory (Becker, 1963) to examine how internalised criminal identity and societal stigma may have fuelled the patient's suicidal thoughts and feelings of loneliness and worthlessness (Joiner, 2005). The forensic psychological interventions that were used centred on improving coping mechanisms, social support networks, and cognitive restructuring to challenge internalised labels. By highlighting the connection between mental health and the criminal justice system, this case emphasises the need for anti-stigma strategies in treating suicidal thoughts in people who have served time in prison.