The case of Katrina Original Research Article

The case of Katrina, a 25-year-old, married woman with a history of multiple psychiatric hospitalizations due to recurrent, impulsive suicide attempts, pervasive suicidal ideation, depression, and intrusive memories of sexual abuse, was presented to several experienced clinicians of various theoretical backgrounds. Regardless of the diagnostic label they assigned to the case or their theoretical orientation, the clinicians largely agreed on two levels of intervention: (a) the use of dialectical behavior therapy (DBT) and situational analysis in combination with other cognitive behavior therapies (CBTs) and interpersonal and behavioral interventions to address Katrinaʹs current problems; and (b) interventions focused on Katrinaʹs in-session behaviors and the use of the therapeutic relationship to provide Katrina with an opportunity to learn new, more adaptive coping skills in a safe and accepting environment. In this case conference, we invited several experienced clinicians—Nancy Caldwell, Kenneth Chase, Gerald Davison, Robert Kohlenberg, James McCullough, Shelley McMain, John Norcross, and Mavis Tsai—to share their wisdom and skill in applying their therapeutic approaches to the case of Katrina. Their response papers summarized Katrinaʹs presenting problems; explicated their assessment plans; outlined case conceptualization; and suggested initial treatment plans. The information presented to the therapists was collected over 1 month, during four intake sessions at an outpatient clinic. Sources of information include intake interviews, her hospital records, testing report, and reports obtained from her couples therapist. The patientʹs name and identifying information have been changed to protect confidentiality.