Case Scenario
Selecting and Delivering Foundational Interventions
Four case vignettes. For each, work through four decisions: which PLISSIT level applies, which foundational intervention fits, what you would actually say to introduce it, and whether anything here needs a referral. The fourth decision is independent of the others. An intervention being within your scope does not mean nothing else needs to happen alongside it.
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Reference
PLISSIT levelsPermission, Limited Information, Specific Suggestions, Intensive Therapy. The level describes what this client needs from you now, not how serious the problem is.
Foundational interventionsPsychoeducation, sensate focus and non-demand touch, lubricant and positioning guidance, structured communication, mindfulness and attentional refocusing, self-exploration.
ReferralAssessed separately. A presentation can sit comfortably at Specific Suggestions and still require a medical, physiotherapy, or specialist mental health referral running in parallel.
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A Note on What Is Missing
None of the four vignettes sits at Permission alone. That is deliberate. A client at the Permission stage has not yet given you enough to select an intervention for, and choosing one anyway is the error this chapter is written against. If a presentation leaves you unable to name which foundational intervention fits, that is usually accurate information about where the client is rather than a gap in your knowledge.