NSU PYCL584 2022 April Week 10 Critical Thinking Latest

PYCL584 Diag/Tx of Adult Psych

Week 10 Critical Thinking

Mr. Fife

Mr. Fife is a 25 year old, Asian single man living with his mother and working at the post office where he has been employed since he dropped out of college after 2 years.  He complains of “nervousness” and says he is “just going through the motions” and “wants to lead a normal life and return to college.” His father abandoned him soon after his birth and divorced his mother.  During his adolescence and young adulthood he had no close friends, but formed several close relationships in college.  However, he states he became “super self conscious” when speaking to strangers and classmates, feel nervous and had difficulty speaking.  He had a “buzzing” in his head, felt like he was “outside his body,” had hot flashes and perspired.  He called these experiences “panic attacks” that came on suddenly when he was with people.  He became increasingly uncomfortable in social situations and was “afraid of doing something stupid.”  He finally dropped out of school. To deal with his discomfort he tried various drugs to medicate his symptoms and enjoyed some relief.  His physician discovered he had mitral valve prolapse and treated him with medication, but it provided no change in his anxiety.

Mr. Fife feels that at the post office he does not have to deal with people.  He avoids public restrooms and uses a stall rather than a urinal.  He has 2 best friends but does not date and avoids group settings.  He has no problems with authority figures.

The purpose of this assignment is for you to practice applying what you are learning about mental health diagnoses, the diagnostic process, and infusing counseling principles into diagnosis.

Analyze thiscase in an 8-page (minimum) paper. You do not need a cover page or references, and strict adherence to APA style is not necessary. You can also use first person language as needed. Your paper should have sections that address the following topics (minimum 1 double-spaced page per section):

Relevant symptoms: What psychological, emotional, social, or biological/physiological symptoms do you observe while listening to the case? In this section, don’t just list symptoms; you need to cluster symptoms according to DSM-5 disorder criteria (think criterion A for various disorders). Also make sure to be specific; for example, “anxiety” and “feeling anxious” are not symptoms, but feeling on edge, worrying, shaking, etc. might be. Finally, discuss any relevant cultural considerations/issues that could be impacting the case.

Substance/medical etiology: Discuss any relevant substances, medications, or medical conditions that could explain the symptoms from the previous section. If possible, rule out any substance/medication-related or medical diagnoses and clearly explain why you would rule them out. If these diagnoses cannot be ruled out, justify why this is the case.

Stressors/Clinical History: Identify any potential stressors that occurred in relation to symptomology; if there are any, do they explain the symptoms and why/why not? Discuss the timeline of symptoms to the extent possible, including when the symptoms began, how long they last, and the frequency at which they come and go. Note that timelines may vary for different sets of symptoms. If there are gaps in the clinical history, note them as well.

Diagnostic impression: Offer a DSM-5 diagnosis (you can offer more than 1), including DSM-5 code numbers, relevant subtypes and/or specifiers. Also include the ICD code numbers and the impact of utilizing the DSM version compared to the ICD version on billing and epidemiological disease monitoring. Clearly justify your diagnoses by linking the symptoms to the DSM-5 criteria and to the clinical history. Make sure to address clinically significant distress and/or functional impairment caused by symptoms for each diagnosis offered.

Rule Outs and Differential Diagnosis: What are potential competing mental health diagnoses for this client that you can definitely rule out based on what you observed? What are potential mental health diagnoses for this client that you cannot yet rule out, but would need to rule out if you continued working with this client? Make sure to justify both in the context of the symptoms you listed and what remains missing from the clinical picture.

Case conceptualization: How is it that this person came to have these particular problems? What prevention efforts might have mitigated these problems? Where are these problems stemming from (e.g., intrapsychic issues, early relationships, learned behaviors, faulty cognitions)? What are this person’s strengths? You are encouraged to utilize counseling theory to inform this section.

Treatment recommendations: What type of intervention/treatment would you implement with the client? What crisis intervention models might be helpful and when? If you were working with this client, what would be your treatment goals be? Which counseling theories would you draw upon to help this client? Why? Would the person benefit from psychotropic medications? Why or why not? What ethical and legal considerations specific to clinical mental health counseling might be at play here?

Personal reactions: What are your personal reactions to this case? What was it like for you to try to diagnose this case? What was easy for you and what was more of a struggle with this case study? Moving forward, what can you do to get stronger with diagnosis?

Relevant Accreditation Standards Met: