Case Study on "Analyzing Different Mental Crisis Cases"

Case Study 10 pages (3020 words) Sources: 2 May 3, 2019

[EXCERPT] . . . .

QUESTION 1

1. Case #1 – Jenna

Jenna is a six-year-old Caucasian female who currently resides with her foster parents, her older biological sister, and two foster brothers. Jenna and her siblings were taken from her biological parents because of suspected sexual abuse and neglect. It is reported that Jenna lived in a home without food, water, and utilities. Jenna’s foster parents report that her biological mother “may have some disabilities and has never had the financial means to take care of her children.” Jenna’s biological brother is in a separate foster home. He is suspected of sexually abusing both Jenna and her older sister. It has been reported that he sexually abused Jenna, while her sister was helplessly told to watch. Jenna has expressed this trauma with agitated behavior. The traumatic event is re-experienced by repetitive play where she stimulates herself on furniture. Jenna avoids the stimuli associated with the trauma by avoiding conversations associated with sexual abuse. Jenna avoids activities, places, and people associated with the trauma except for her sister who was also a victim. Jenna also has a sense of a foreshortened future. She frequently brings up death with her foster parents. Jenna has persistent symptoms of increased arousal that were not present before the trauma as indicated by irritability and outbursts of anger nearly every day with her biological sister and her foster father. Jenna is also hyper vigilant and does not want her foster father around. The disturbances have lasted for over a month and have caused clinically significant social impairment to the point she is unable to attend a full day of school due to emotional breakdowns.

1) What intake information should be obtained and assessed to formulate a provisional DSM-5 diagnosis? Select AS MANY as you consider essential.

• History of learning disabilities.
• Length of time problematic behaviors have persisted.
• Changes in sleeping patterns.
• Substance use.
• Attention problems.
• Details of sexual trauma.

g. Hypervigilance or increased arousal.

In order for us to establish a provisional diagnosis we need to understand the duration that the client has been having or showing the symptoms, details regarding their sexual trauma, the attention problems mentioned in the case, and hyper vigilance. This information will assist us in making an initial diagnosis of the client's mental disorder, which might be revised when we have more information.

2 points   

QUESTION 2

1. What assessment tools might offer meaningful information on this client? Select the ONE most appropriate option. (Refer to Case #1)

a. Beck Anxiety Inventory

b. Attachment Questionnaire for Children (AQC)

c. Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA)

d. Child and Adolescent Needs and Strengths (CANS)

The Child and Adolescent Needs and Strengths (CANS) tool is the most appropriate tool to use in order to get meaningful information regarding the client. The tool is aimed at offering support for care planning and this can only be possible once one has all the information necessary regarding the client. With this tool it is possible for one to uncover information about the client since the tool is administered from a communication perspective. The toll focuses on the child and not on the service that is offered to the child.

2 points   

QUESTION 3

1. Based on the available information, what would appear to be the most appropriate provisional DSM-5 diagnosis? Select the ONE most appropriate primary diagnosis. (Refer to Case #1)

a. Disruptive Mood Dysregulation Disorder (296.99)

b. Posttraumatic Stress Disorder (309.81)

c. Acute Stress Disorder (308.3)

d. Adjustment Disorder with Mixed Disturbance of Emotions and Conduct (309.4)

Acute Stress Disorder is the initial diagnosis for the client and this is based on the symptoms that have been presented in the case. The client has avoidance symptoms that they use to avoid the stimuli for the traumatic event (American Psychiatric Association, 2013). She constantly avoids talking about the trauma. During play the client does demonstrate arousal symptoms where the client stimulates herself on furniture.

2 points   

QUESTION 4

1. Based on the provisional diagnosis, what interventions might work best as you begin to work with this client? Select AS MANY as you consider indicated. (Refer to Case #1)

a. Group Therapy

b. Behavioral Rehearsal

c. Grounding Techniques

d. Play Therapy

e. Flooding Techniques

f. Medical Referral for Anxiety Medication

g. Assertiveness Training

Behavioral rehearsal is aimed at practicing and imagining behaviors, responses, and social skills for the client (James & Gilliland, 2013). This way the client can be prepared for when they might need to use them in reality. Grounding techniques allow the client to remain in the present and to not focus on what happened in the past. This will assist in reorienting the client to the here and now. Since the client has overwhelming anxiety this technique will be helpful in enabling them to manage these feelings. Play therapy assists children aged between 3 and 12 years to freely express their repressed emotions and thoughts via play. This will enable the client to express herself and allow the therapist to observe the client's decisions, choices, and style of play. The main goal is to help the client to learn how to express herself in a healthier way, be more respectful and empathetic, and discover positive ways for solving problems.

2 points   

QUESTION 5

1. In developing a collaborative treatment plan with the client, identify immediate goals to be addressed. Select AS MANY as you consider correct and necessary. (Refer to Case #1)

a. Reunification with Biological Family

b. Addressing Sexualized Behaviors

c. Increasing Emotional Regulation

d. Preventing Revictimization

e. Reenactment of Traumatic Events

The immediate goals for the client would be to ensure that the client symptoms do not progress for too long. It is for this reason that we have selected the immediate goals to be addressing sexualized behavior, increasing emotional regulation and preventing revictimization. By addressing sexualized behavior, we will be able to deal with the client trauma and allow her to heal. Emotional regulation will enable the client to better deal with her emotions and to learn how to express herself in a healthy manner. Preventing revictimization will ensure that the client does not suffer from the same trauma again.

2 points   

QUESTION 6

1. Case #2 – Morgan

Morgan is staying at a local shelter after she experienced a natural disaster that destroyed her home three days ago. She is a 25-year-old lesbian female who was living with her partner. She has a flat affect and makes no eye contact as she talks about having to vacate her home in the middle of the night as the waters were filling her condo. Her partner did not make it out and drowned in the storm. She has not made contact with any of her other relatives who she says she has been distant from for “many years.” She mentions that before the storm she was taking “some meds to help with my moods” but is not sure of the medication name. Since she arrived at the shelter, she has laid in her cot, not taken any showers, eaten very little food, and avoided any contact with shelter workers or other families. She has a significant startle response when approached and has difficulty remembering basic information. She cries herself to sleep and has moments where she screams out at night after having “nightmares about drowning.”

What intake information should be obtained and assessed to formulate a provisional DSM-5 diagnosis? Select AS MANY as you consider important.

a. Substance abuse history

b. Medical history

c. Educational history

d. Military history

e. Quality of family relationships

f. Psychiatric history

g. Employment history

h. Threat to self or others

The intake information will allow the therapist to determine what could be ailing the client. Information regarding substance abuse, client's medical history, quality of family relationships, and psychiatric history are vital in order to understand the client. This information will assist in establishing a diagnosis for the client and to uncover information that is vital for making a conclusive diagnosis.

2 points   

QUESTION 7

1. What assessment tools might offer meaningful information on this client? Select… READ MORE

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