Assignment: Clinical Plans
Assignment: Clinical Plans
Assignment: Clinical Plans
Clinical Assessment and Treatment Plan
Assignment: Clinical Assessment And Treatment Plan
Complete the University of Phoenix Material: College of Social Sciences Master of Science in Counseling Biopsychosocial Interview DSM-5, located on the College of Social Sciences Resources web page, based on Case 21.7, and include a case conceptualization. Your response should be a minimum of 700 words.
Research common treatment goals for the chosen diagnosis.
Complete the University of Phoenix Material: College of Social Sciences Treatment Plan, located on the College of Social Sciences Resources webpage. Your response should be a minimum of 350 words.
Include a minimum of two sources.
Format your reference page and treatment plan consistent with APA guidelines
Client Name: Delores Hoffman
Age: 27 years old
Marital Status: Never married
Occupation: Office manager
Delores Hoffman called to make an appointment to see a counselor due to her “growing preoccupation with suicide.” The intake worker screened her for suicide risk and discerned she had no history of past attempts or a present plan. Nonetheless, an initial appointment was arranged for later that day.
As you meet Delores Hoffman in the waiting room, you notice that she is well dressed and attractive. Before you approached her, she had been staring out the window, virtually motionless.
As you enter your office, she says, “I guess I scared everyone talking about suicide. That is why I got an appointment so fast, isn’t it?”
“Quite probably. Was that your intent?” you ask.
“Not really. I forget that not everyone feels like I do. It just doesn’t seem like such a big deal to me,” she explains.
“Well, based on what you said to the intake worker, it must concern you some. Isn’t that why you wanted to see someone?” you clarify.
“Well, yes, it is. But not in the sense that I’m going to run out and do something. I think I’ve been depressed my whole life. Certainly as long as I can remember. So somehow, this seems logical— just more of the same.”
“Can you tell me exactly what feelings you’ve had for so long?” you ask.
“Sure. I’ve just never been happy. I’ve never really liked myself. I’m just a big nothing. Always have been. No energy, no plans, no future, nothing to look forward to. I thought I was used to it and I had accepted it. Some people have lives worth living; the rest of us take up space,” she observes.
“And you say you’ve always felt this way?” you prompt.
“Well, that’s probably an exaggeration. Certainly I’ve felt this way since I was 10, maybe 12. Younger than that, I don’t remember very well. I don’t think I thought about much of anything. But around that age, I realized I didn’t really have anything going for me. Do you know what I mean?” she asks.
“I hope to understand, but I need you to tell me more. How did you decide you didn’t have ‘anything going for you’?”
“Pretty simple. Some people are really smart; I’m not. I’m not retarded or anything but just not brainy. Some people are beautiful; I’m not. I’m not ugly or anything but just not remarkable. I’m not ambitious. I’m not clever. I’m destined to just go along, probably get married, get left by my husband after the kids are grown, and end up lonely,” she explains.
“That sounds pretty hopeless,” you observe.
“That’s right. I don’t mind too much, you know. It’s just the way it is,” she reports.
“Okay, I’m starting to get a picture, but I’d like to ask you some things about your childhood. Can you tell me what your family was like?” you ask.
“They’re okay, I guess. Just dull people like me. I have two sisters, one older and one younger. We lived in a nice suburban neighborhood. If my parents had any problems, we kids didn’t know about them. Everything was ordinary and orderly.”
“Did you ever tell anyone about how you felt about yourself?” you ask.
“Not really. We didn’t talk about much in my family. We just did the things we were supposed to do,” she explains. “I can’t tell you anything else about them really. I haven’t really seen them since I left home.”
“Okay. So if I understand you correctly, you’ve felt somewhat depressed or at least unhappy with yourself for most of your life. Has something changed, though, to make you concerned enough to want to see someone?” you ask.
“Well, yes. For the past 6 or 7 months, I’ve been feeling much worse. I think it’s about my boyfriend. He moved in with me around the time things got worse. I know that sounds weird. I’m supposed to be happy to find someone who seems to love me. We’re planning on getting married in the summer. 441 442But really, my life has sorta fallen apart since he moved in,” she says.
“Can you tell me specifically what changes have occurred?” you ask.
“Well, it’s almost everything! As soon as he moved in, I pretty much lost interest in him sexually. Of course, he hasn’t lost interest, but it’s just going through the motions for me. I can’t sleep right either. At first, I thought it was just sharing a bed, but I don’t know. When I try to go to sleep, it takes forever. Then, I wake up before my alarm goes off! I’ve never had a great deal of energy, but I’m really dragging now,” she says.
“Okay, have you lost interest in any other things in the same time frame?” you ask.
“Well, I used to really enjoy cooking. Now it just seems like a chore. I’ve probably lost 15 pounds since he moved in just because I don’t want to cook! He’ll go ahead and get some fast food or something, but I just don’t eat,” she explains.
“Any other things you’ve lost interest in?” you persist.
“I guess. I mean I don’t really enjoy anything anymore. I know how strange that sounds. I really feel bad about it! He’s a nice guy, and I don’t want to hurt him but … I don’t know, I just feel like I’m ruining his life.”
“Anything else?” you ask.
“Well, I’ve sorta lost interest in my job. I’ve worked for the same company for a long time. I’ve been the office manager for the past 4 years. It’s been a good place to work, but it just seems like a drain now. People at work keep asking me what’s wrong, and I really don’t have anything I want to tell them. Does this make any sense?” she asks.
“I think so. I need to take us back to your initial concern. Tell me about wanting to kill yourself.”
“Oh, that’s a little strange. I daydream about it all the time. Instead of focusing on what I need to do or something, I dream up ways to end it all. Isn’t that stupid?” she asks.
“No, I certainly wouldn’t call it stupid. What you’ve described to me makes it clear that you are very unhappy with your life. Do you think you’ll act on any of these plans you ‘dream up’?”
“No, not really. I know that seems strange since I’m so preoccupied with it, but I’m afraid to die! I don’t know why all these thoughts are in my head, really. Do you think I might be going crazy?” she inquires.
“No, I don’t think you’re crazy! I do think you need to take some hard looks at yourself and your life. No one can just go along being as unhappy as you are. Does that sound like something you’re willing to do?”
“I think it is. Really, I know it is. I’ve thought about seeing a therapist for a long time. I wouldn’t have made this appointment if I weren’t ready to try something,” she says.
21.7–1 How would you assess the threat of suicide with Delores at this point? Are there any changes you would watch for in working with her?
21.7–2 What strengths do you see in Delores?
21.7–3 What thoughts and/or behaviors would you like Delores to self-monitor?
21.7–4 What is your preliminary diagnosis for Delores?