Choose one disorder from one of the following three categories:
• Anxiety Disorders
• Obsessive-Compulsive and Related Disorders
• Trauma and Stressor Related Disorders
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For each Self Reflection Assignment, respond to each of the following prompts for your chosen diagnosis:
• Considering your own worldview and belief system, why do you believe people develop the diagnosis you chose to discuss?
• What potential biases or beliefs arise for you regarding clients who struggle with the diagnosis you chose to discuss?
o What will you do in the future to mitigate these biases?
• Identify at least one code from the American Counseling Association (ACA) Code of Ethics and discuss how the code is relevant to the discussion of your chosen diagnosis.
• Considering the Dispositions Descriptions from Module 1, identify at least one Disposition that you plan to cultivate to work with clients who display the diagnosis you chose.
• Considering the ASERVIC Spiritual and Religious Competencies, identify at least one competency that you plan to cultivate to work with clients who display the diagnosis you chose.
You will organize each self-reflection by using the current edition of APA headings. Start each self-reflection with the title of the assignment (DSM-5-TR Self-Reflection) and then use the following Level 1 APA headings (Worldview, Biases, ACA Code, Disposition, ASERVIC Competency).
Biases
A potential bias that arises for me regarding clients who struggle with PTSD is a tendency toward "trauma hierarchy" or "sympathy fatigue." The bias operates in two ways: First, I might implicitly judge a client's trauma severity based on its objective nature (e.g., prioritizing combat trauma over developmental or psychological abuse), assuming that a seemingly less life-threatening event should result in less profound symptomology. Second, the constant exposure to raw, distressing trauma narratives in the counseling role can lead to secondary traumatic stress or compassion fatigue. This can manifest as an unconscious desire to rush the client past the narrative phase, or a subtle belief that complex trauma is too deep-seated to be fully resolved, limiting my hope for the client’s progress.
To mitigate these biases in the future, I will commit to a three-pronged strategy:
Clinical Supervision and Consultation: I will consistently utilize supervision, specifically seeking to process any feelings of hopelessness, frustration, or countertransference that arise when working with clients with chronic PTSD.
Focus on Subjective Impact: I will intentionally shift my focus away from the objective event and onto the client’s subjective experience and internal symptoms. I will regularly use validation statements to affirm that their response is a normal reaction to an abnormal event, regardless of the trauma type.
Resilience and Strengths-Based Framing: I will actively frame the client's work within the model of Post-Traumatic Growth (PTG), focusing on identifying the client's existing strengths, internal resources, and survival skills. This ensures the client is viewed as a survivor, not merely a victim, counteracting the bias of hopelessness.
Sample Answer
Worldview
Considering my own worldview and belief system, I believe people develop Post-traumatic Stress Disorder (PTSD) through a dynamic interaction of biological vulnerability, psychological processing deficits, and existential shattering. My worldview is fundamentally biopsychosocial, meaning I see the diagnosis as arising not from a single cause, but from a failure of three systems to adequately cope with an overwhelming event. Biologically, trauma causes significant dysregulation of the HPA (hypothalamic-pituitary-adrenal) axis, leading to a state of chronic hyperarousal where the amygdala (the brain's threat detector) remains overly sensitive. Psychologically, the individual's existing coping mechanisms and cognitive schemas are insufficient to integrate the traumatic memory, causing it to be stored as fragmented, raw emotional data (flashbacks, nightmares) rather than a coherent narrative. Existentially, the trauma often shatters core beliefs about safety, justice, and personal control, forcing the individual to confront the harsh randomness of life and the fragility of self. Therefore, PTSD arises when the nervous system remains stuck in threat mode, the mind cannot process the facts, and the spirit is left grappling with a suddenly unsafe and unjust world.