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CSME|CAPDA Medico-Legal Summit - D. Olga Komissarova
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Medico-Legal perspective of George Kelly’s Personal Construct Theory. Optimal versus Disordered Functioning
Dr. Olga Komissarova, M.Psy ABD

Kelly’s Personality Construct and his proactive approach to the clients’ anticipation of events, to construing their own experience and to interpretation of experiences of others created a solid base for North American clinical psychology. Personal Construct Theory proclaims that there are many ways for one to construe one’s world that are also reflected in our behaviour. By accepting the Fundamental Postulate as the way of anticipation of events, which provides information about personality development and underlying processes, practical psychologists explore clients’ polarized thinking.

Because of that exploration, human behavior is perceived as proactive rather than reactive, and humans are perceived as individuals, who can reconstruct their personality and environment to achieve optimal functioning, rather than disordered individuals, who are dependent on therapist and continuous clinical support that emphasizes longstanding mental health issues. Therefore, behavioral activation in therapy and wellness programs allow clients to obtain positive experiences, reducing time in therapy.

From the medical-legal perspective, clients, who have been comprehensively assessed by independent medical evaluators using standardized clinical personality tests, such as PAI, MMPI and MCMI, would benefit from the positive behavioral approach that ensured clients’ optimal functioning with secured funding for available wellness programs. This process required follow up from the treating clinician, to check up weather client’s needs are met.

Constructivists suggested that a person experiences anxiety when personal construction failing him, and threat when a person perceives changes in his core structure as unavoidable. Guilt, Aggression and Hostility are also addressed in Kelly’s theory, not as emotions, but rather individual crisis due to changes in personal construct system. Looking for alternatives and greater opportunities to safely practice and to expand their personal construct system from replications to the full extent provides a positive perspective to personality development and growth.

I remember the article, written by a young American journalist, who was diagnosed with schizophrenia. As she was describing her experience at the time of mental health crisis, including hearing voices and having an extreme anxiety, she emphasized that creating a balance between her physical and emotional needs and including relaxation helped her to overcome that crisis.

One of my clients, who was gradually losing his vision, did not give up any pleasure from dancing, cooking and participating in community life. Staying involved and active physically and socially could be a general recommendation provided by assessors in addition to therapy that teaches relaxation skills, distress tolerance, emotional regulation and interpersonal effectiveness on different levels of communication. Helping clients to perceive their situation from a positive perspective with gradual return to work and living a productive life appeared to be achievable when clinicians focus on optimal versus disordered functioning.

Copyright © 2016 Canadian Society of Medical Evaluators

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