Open J Psychiatry Allied Sci. 2019 Oct 16. [Epub ahead of print]

Effect of socio-cultural factors in therapeutic intervention.

Nair VS, Moorkath F, MN V.


Comorbidity and presence of family dysfunction in personality disorders, namely borderline personality disorder have been found commonly with bipolar affective disorder clients. Dialectic behaviour therapy (DBT) though has shown efficacy in treatment of such conditions, at times due to the socio-cultural differences of the models adopted from the western concept, there is a felt difficulty in the formulation of the therapeutic model making it necessary to collaborate with other models for smoother formulation and improvement in the overall functioning in the clients. A 21-year-old female of bipolar affective disorder with emotionally unstable personality disorder traits was referred to a psychiatric social worker for assessment and plan of intervention inclusive of DBT and family-focused therapy (FFT). Twenty sessions, each lasting for one hour were conducted with the client and family, each on an inpatient basis to (1) Assess and grade the problems in hierarchy, (2) Understand the socio-cultural constructs in sessions, (3) Teach DBT concepts and relaxation techniques to ameliorate stress and help her to improve the relationship and dynamics with her family through FFT. At the time of discharge, the client had improved nearly 30%, and the client and family were more confident in facing social situations, emotional dysregulation, interpersonal issues, distress tolerance goals which has been explained in the context of the socio-cultural factors focusing on alliance, institutions, expectations, and cultural adaptation involved in therapy and the involvement it had in the therapeutic process.


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