Vignette Number GAP 022
Speciality:
General Psychiatry
Date:
10 October 2001
Vignette:
In your outpatient clinic you see a 25 year old married woman
who presents with symptoms of depressed mood and anxiety over a 2
year period. Her marriage is under stress. She discloses to you
that she was repeatedly abused by her stepfather between the ages
of 8 and 12. She has never told anyone about it and insists it is
confidential.
How would you assess and manage her case?
Suggested Probes:
- Are there wider professional responsibilities than to the
patient herself?
- How would you deal with the possible risk to other children
from the alleged perpetrator?
- What treatment options will you consider in the
short-term?
- Disclosure has implications, other than merely those of the
patient.
- Responsibility to protect children who may be at risk.
- Treatment options to include pharmacological and psychological
therapies, including marital therapy.
- Advantages and disadvantages of involving the partner.
- Risk of "perpetuating" abuse by prolonged exploration by male
therapist.