Which type of therapy would be advised for a patient with a history of three failed engagements who is concerned about being "too possessive"?

Choice A rationale

Interpersonal therapy (IPT) focuses on current interpersonal relationships and related issues like grief, role disputes, or social deficits. While the client's issue is relational, the core concern about being "too possessive" suggests an underlying, often unconscious, pattern of relating rooted in past experiences, which is better suited to psychodynamic exploration.

Choice B rationale

Psychodynamic therapy is the most suitable approach because it explores how early childhood experiences and unconscious processes (like transference and defense mechanisms) influence current relationship patterns and emotional conflicts. Possessiveness is often viewed as a maladaptive defense against deeper fears of abandonment, making an exploration of these historical roots essential.

Choice C rationale

Cognitive Behavioral Therapy (CBT) is highly effective for modifying distorted thought patterns and specific maladaptive behaviors (e.g., compulsions). While CBT could address the behavior of possessiveness, it might not fully explore the root emotional and developmental basis of the possessive tendency, which is crucial for lasting change in relationship dynamics.

Choice D rationale

Dialectical Behavior Therapy (DBT) is primarily designed for individuals with severe emotion dysregulation and impulsive behaviors, often associated with Borderline Personality Disorder. While it teaches valuable skills in mindfulness and distress tolerance, it is generally considered overly specialized for the possessiveness issue described without evidence of pervasive instability or severe self-harm.

Choice A rationale

Quaternary prevention is a relatively newer concept focused on protecting patients from medical interventions that are likely to cause harm. It involves identifying patients at risk of overmedicalization or unnecessary diagnostic or therapeutic procedures. This level of prevention is not directly applicable to the intervention stage for active suicidal tendencies.

Choice B rationale

Secondary prevention focuses on early detection and prompt treatment of a condition to limit disability and prevent severe progression. For a patient with major depression and active suicidal tendencies, the intervention (hospitalization, crisis intervention, initiation of pharmacotherapy) represents a critical effort to rapidly treat the acute phase of the illness, thus preventing suicide, which is a severe outcome.

Choice C rationale

Tertiary prevention aims to reduce the long-term consequences or disability of a chronic or already established disease. For major depression, tertiary prevention would include rehabilitation, ongoing support groups, and maintenance medication to prevent relapse and maximize functioning after the acute crisis has been resolved.

Choice D rationale

Primary prevention aims to prevent disease or injury before it ever occurs. This would include universal mental health education, stress management programs, or screenings for at-risk populations before they develop major depression or suicidal ideation. It is not appropriate for an actively suicidal patient.