Problem Analysis

Before starting treatment, it is imperative to conduct a thorough analysis of the problems. This is not identical to arriving at a formal diagnosis. Two patients may satisfy the criteria of a particular DSM-IV diagnosis, but a careful analysis might reveal that patient A would benefit more from method X whereas patient B would likely benefit more from method Y. Problem analysis is indispensable for constructing a treatment plan. In this context, it is useful to distinguish a micro-analysis from a macro-analysis (Emmelkamp, 1982).

A micro-analysis or functional behaviour analysis analyses the behaviour within a certain problem domain. The key questions that the therapist attempts to answer are the following. What are the situations in which the behaviour occurs? Which responses (emotional, physiological, cognitive, overt behaviour) occur? What are the consequences of the behaviour? For an illustration of a micro-analysis we refer the reader to Figure 4.2.

When conducting a macroanalysis, the therapist charts the various problem domains while seeking possible connections between the problems. For instance, a patient may be depressed and also experience marital distress. It is of importance to ascertain whether the depression is associated with the marital problems, or whether these are two independent problem areas. If there is a connection between the depression and the marital problems, the therapist should examine the nature of the relation. If the marital distress is fundamental to the depression it may be appropriate to direct early treatment efforts to improving the relationship. With some patients the relation is reversed; the depression causes the marital distress. In this latter case it is not useful to first address the distress. For an illustration of a macroanalysis we refer the reader to Figure 4.3.

Mending The Marriage

Mending The Marriage

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