Article ID: 23-003
This paper reports a case study in which we assisted a patient who was admitted to a juvenile prison for homicide by assault, and then hospitalized for interventions to expand his range of behavior. The patient complained of “homicidal impulses” and refused to have interpersonal contact outside the protection room. Additionally, the reported having aggressive and contemptuous thoughts as internal reactions to interpersonal stress. Therefore, as an in-session intervention, we provided value clarification while avoiding an unconstructive discussion of homicidal impulses, thus allowing the burden of the impulse and the subjective intensity of stress to be quantified. Shared self-monitoring allowed the patient to expand his range of behavior while visualizing and preventing high-risk situations. Exposure to interpersonal situations may have provided an opportunity for behavioral experimentation that weakened the intensity of the belief that “I would kill someone.” Furthermore, alternative behaviors to aggressive scripts may have been formed because of the expanded behavioral repertoire of cognitive coping, reporting burdens, and seeking help when overwhelmed.
