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Old 08-27-2012
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Post pprimary vs secondary gain

q) a 50 yr old homeless man with h/o borderline personality disorder presents to a psychiatric care center for suicidal intentions and auditory hallucinations. he is quite insisted on being admitted..he says he's not in any medication ..he is under supervision of parole officer and was kicked out by his daughter's house for using drugs again. which of the following is example for primary gain of pt.?
a) avoiding his parole officer
b)temporary housing in winter
c)obtaining disability payment
d) rationalization of behavior
e) being a case study in journal

and also can you find tertiary gain in this pt..?
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Old 08-27-2012
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Is it Bb?
He's homeless... so I'm inclined to think that his primary goal would be to obtain housing in winter.
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Old 08-27-2012
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a) secondary gain because he has an external motivator (avoid parole officer)
b) primary gain because he has an internal motivator (don't have a place to live, he's illness would explain why he is not at her daughter's house, and he is in a hospital

tertiary gain involves a third party so maybe his daughter use his father illness as an excused for not taking care of him.

??? correct me if I'm wrong
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Old 08-28-2012
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any more answers for this one.....?
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Old 08-28-2012
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hmm i think , primary gain .. D) rationalization of bhavior

secondary gain b) temporary housing

tertiary gain A) probably ?
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Old 08-28-2012
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Post D

well, the correct answer is D) rationalization of behavior

primary gain is what the symptom does for pt's internal psychic concerns..primary gain motives are frequently unconscious and are directed to the internal anxiety rather than towards the acqisition of things/ avoidance of anxiety....

secondary gain is what the pt. obtain tangibly..often they are consciously gained motives....

tertiary gain is what the care taker obtains from treating the pt....


D) here the pt. could internalise( becoming suicidal) rationalize thoughts towards his daughter for kicking him out ..so, it's the primary gain

A,B,C) are examples of secondary gain......it's the pt. conscious motives for benefit

E) is the tertiary gain.....since, being a case study in journal pt. would not directly benefit
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