You are to pretend you are now a certified psychologist! Read the following case studies. For each one you are first asked to make a general diagnosis (e.g., Anxiety Disorder, Mood Disorder, Schizophrenic Disorder, and so on). Be as specific as you can. For example, instead of saying “Anxiety Disorder,” you can say “Generalized Anxiety Disorder” or “Obsessive Compulsive Disorder.”
After you make your diagnosis, formulate a treatment plan. You can choose from any approach you desire (humanistic, interpersonal, group, psychodynamic, behavioral, cognitive, or biological). Discuss how you would implement this treatment plan for the patient. Please use each treatment plan no more than two times. It will allow you to explore various perspectives.
1. Rob, a 47-year-old male, sat across from the therapist with his eyes cast downward, speaking noticeably slowly and softly, expressing how tired he was not only from the week, but also from life in general. He stated that his days are mostly spent lying on his girlfriend’s couch, watching television. or just staring out her picture window watching neighborhood children play. Although his history includes working as a licensed pilot, an engineer, and an entrepreneur, he currently is not motivated to pursue any work. He claims that he is “…. just too tired,” and that he experiences chronic leg pain from an old gunshot wound he experienced years ago during an ill-fated business deal that went “..Really bad.” Rob fears that this time his feelings of sadness and fatigue will not improve, and that he will never again feel energized and “alive.” His description of feeling “alive” includes having lots and lots of energy, being able to stay up and work/play for days at a time, and having moments of “genius” during which he can do most anything. He describes one incident during one of his last “alive” episodes during which he “maxed out” his credit cards, put a down payment on a plane, and began putting together a flight school. He felt at the time that “…the world was (his) oyster and there wasn’t anything (he) couldn’t do.” However, it was during this time that his girlfriend threatened to leave him, claiming that his behavior was erratic, impulsive, and
at times frightening. During this argument, he broke down a closed door to get to her and threw her glass coffee table through a window. After 6 months of being apart, he started his current episode of feeling sad and tired, and they are working toward restoring their relationship. Rob is seeking help to figure out “…who (he) really is”, and whether he would rather be “alive” or continue to have this relationship with his girlfriend. He recognizes that he sometimes gets into trouble during his energized periods.
2. Elizabeth is a 50-year-old woman who maintains a spotless home, and is often concerned about any sources of contamination. She routinely cleans her home with disinfectants, and insists that it is still contaminated by “germs and bugs.” She also likes to have all objects in her home perfectly ordered and organized, and becomes agitated, irritated and anxious when any object is moved out of place. She frequently has recurring thoughts of all the negative consequences that could occur if things were to become dirty or disorganized. These imagined consequences are often disproportionate to the actual threat posed by them. Her cleaning/ordering routines seem to temporarily relieve this anxiety. Her routines have become so important to her, that at times they have prevented her from being on time to appointments. She also lacks social ties because she is afraid that visiting friends may contaminate her home, or that she may contract some disease as a result of these social contacts.
3. Sam is a 25-year-old man. Two months ago, he was seen at his local emergency room for what he feared was a heart attack. While walking his dog, he suddenly felt his heart pounding, became dizzy and nauseous, and felt tingling in his hands and feet. Feeling that something was desperately wrong, he immediately returned home and asked his room-mate to take him to the hospital. Tests revealed that there was no indication of a heart attack, heart disease, or any other disorder that might account for his symptoms. Since his first episode, Sam reports there have been a couple of similar episodes, and that he is constantly concerned that he might have an episode at any time.
4. Edna is a 25-year-old woman brought in for evaluation after being arrested for assisting her boyfriend in a series of hold-ups of convenience stores. She has received no mental health treatment, but has consistently been in trouble with the law since she was 12 years of age. Her numerous infractions include bar fights, petty theft, and minor fraud. While she seems angry at having been caught, she does not feel any guilt and she expresses no remorse about harming her victims. In general, ever since she was a teenager Edna has been emotionally detached from other people (including her boyfriend) — even though she can come across to other people as “charming” when it suits her purposes. Although Edna is very intelligent, she often acts impulsively, especially when it comes to satisfying her needs.
5. Henrietta is a 38-year-old woman. She is the married mother of three children. She runs a daycare center in her home. Although Henrietta is able to take care of her family and her home business while she is inside the house, she is rarely able to venture far from her home. Whenever Henrietta steps outside of her house she becomes fearful and feels very tense. Her husband does all of the grocery shopping and errands, and Henrietta’s family has not been out to a restaurant or gone on a family vacation together for 12 years. When the daycare children that Henrietta cares for need a change of scenery, Henrietta does not go outside with them. Instead, Henrietta’s assistant takes the children outside. Henrietta describes her house as her “comfort zone” and says that she is not an anxious person as long as she stays in her comfort zone. She reports that if she moves beyond her “comfort zone” she becomes increasingly terrified and even feels “a little woozy.” Henrietta has not tried to test the limits of her comfort zone for several years. Instead, she arranges her life “in a comfortable fashion.”
6. Melanie married into a wealthy family, gave birth to a beautiful baby girl, and thought that life was perfect. Having grown up in an impoverished environment, she thought that the rest of her life would be the picture of happiness. Although she loved her husband, her marriage began to crumble when he began a sexual affair with a wealthy client. Shortly thereafter, the husband filed for divorce and successfully was able to get full custody of their daughter. His high-priced lawyers had convinced the judge that the baby should have only minimal contact with Melanie. A few weeks after this decision, Melanie disappeared, and her immediate family members became very concerned, calling the police to investigate the case. Two weeks later, police detectives found Melanie living in a town 100 miles away, and going by the name of “Alice” rather than “Melanie.” Indeed, Melanie really believed that her name was “Alice.” She was employed in a small café and appeared to be living a normal life there. When approached by the police, Melanie seemed confused and stated that they “…..have the wrong person.” By the next morning, however, she awoke aware that she was in fact Melanie, and seemed disoriented and puzzled because she could not figure out how or why she was living in this remote town. Melanie seemed to have no recollection of “having been Alice” or of her life as a waitress in the small café. She was only aware of feeling distressed because she had “….lost (her) little girl” in the divorce proceedings with her husband.
Activity adapted from:
“Diagnose the Disorder.” (n.d.): n. pag. Web. 4 Jan. 2017.