CLINICAL CASE STUDIES

I am including the material you need for your Clinical Case Studies (see below). One way of looking at these is to see them as a sort of “final essay exam” where you will demonstrate the application of what you have learned in class. These cases are not about children or neurological disorders, so you don’t have to worry about those.

We have covered important areas of Psychopathology, and while there is a ton of information about each chapter, it helps to keep in mind “fundamentals”. If you take for instance “anxiety”, you may see it as a primary emotion dealing with the perception of threat. This threat could be punctual and objective as in most cases of phobia for example, or more diffuse and intangible as with Generalized anxiety disorder or existential angst. The perceived “threat” could be external or internal. A difficult situation you may soon be facing, and you are worry about, may be perceived as an external threat, while psychological conflict in your life may be seen as more of an internal one. Things as you already know are almost never so clear-cut, as situations may have elements of both. An officer I once treated and was cheating on his wife was anxious about being discovered (external), and he felt guilty over the conflict of his values (internal). We may also be aware of what is that we are anxious about, but sometimes, the reason lies deep in our consciousness and is more difficult to understand. Anxiety, as you already know is commonly present in depressive states (and other disorders as well), to some degree or other, and in doing Therapy with anxious patients you need to tease things out carefully to get to the bottom of the problems.

If anxiety is fundamentally some sort of threat to our being, depression is the emotion relayed to our experience of “loss”. This loss could be present loss or historical loss, which we connect with current events ( a man once abandoned by his mother as a child, reacts with severe depression to the break up of a relationship). The loss could be real or symbolic (losing a wife, a job, money in the stock market; or losing one’s pride, prestige, hope), and in addition to anxiety, anger is often present in depression, but rarely acknowledge it. Anger is often an important element in the cases of suicide in which the action, while physically directed against the self, is often “intended” against a particular individual in the person’s life.

As we continue to study about these disorders, I would like for you to think about what is the fundamental characteristic by which you could encompass the presentation of this disorder, and while there are numerous ways in which a person may suffer and struggle against the stings of life, they tend to fall and group in predictable patterns.

CLINICAL CASE STUDY

OK, as promised this is the Clinical Case Study. This is actually a very simple assignment and typically, if you follow directions, you would do very well. Read the directions from the Syllabus (which I have included here for your convenience) and follow the format I give you in the bottom of this page.

Basically for each Case Study you will need 3 pages; the first one with title, name etc; the second one with an outline covering 5 topics (see below) and the third one is the one you will expand a little more, and that’s it! EASY, relax and you will do just fine. Please turn in BOTH Clinical Studies in ONE WORD document indicating Case Study #1 and Case Study # 2. I will grade each Case Study and give you a total grade for both. So, let’s say you get 4 points for the first one and 3 for the other; you will get 7 points out of possible 10 points.

Please follow this direction because when I have to grade dozens of these assignments, in addition to the papers THE FORMAT makes it easier for me to read and understand; if I have problems tracking you, that will not be good for your grade:)

For additional help as you try to decide what disorder you are contemplating, you just need to consider everything up to week on Personality Disorders (coming up soon) and the chapter in schizophrenia, which as you would see in the cases below it is unlikely 🙂

CLINICAL CASE STUDY

As per your Syllabus:

Clinical Case Study

Towards the end of the semester, I would give you two (2) clinical scenarios and I will like for you to write a 2-3 page summary FOR EACH in which you will include your assessment, diagnosis and treatment recommendation. I will give you very specific guidelines together with both Case Histories later on the Term. You will turn your assignment with both Case Studies clearly indicating Case#1 and Case #2 in a WORD DOCUMENT. Please follow directions, as the biggest issue I keep having with students is not adhering to guidelines. Briefly, your assignment needs to include the following:

1. The methods and strategies you would use in order to perform the initial assessment.

2. Which diagnoses would you consider?

3. What is your case formulation? That is more comprehensive than just the diagnosis. For example let’s say you are considering ‘Major Depression” as a Diagnosis. Your case formulation may be something like this: “this patient has suffered significant recent loses in his life, and in the context of possible biological vulnerabilities (ie; history of maternal depression) and limited psychological resources he has developed a depressive condition”. In the case formulation you may also include possible interpersonal, psychoanalytic or existential dynamics if you consider them important.

4. What is your treatment plan?

5. What else would you have liked to know about this patient, which was not given to you in the case scenario, and you think it may have been very useful in order to reach a diagnosis and develop a treatment plan?

This is not a difficult task, but requires a little thinking from your part. The important point is that I need you to show me how you do the assessment, followed by a diagnosis, good case formulation and a reasonable treatment plan. Don’t write more than 3 pages FOR EACH CASE STUDY (about 1000-1200 words for EACH). You will have this task towards the end of the semester (see schedule below) and it will be worth a 10 % of your total grade. As with any other assignments, this is your own work, not a team effort. Sharing or copying another student’s work will result in a failing grade for the class.

This is the format I would like for all to follow, again PLEASE follow directions.

This should not be a difficult assignment. The point is that I would like for you to show me HOW YOU ARE APPLYING THE KNOWLEDGE YOU ARE OBTAINING IN CLASS. Like always, if you wait for the last minute, you may not be able to do the work you are capable of doing.

ESSENTIALLY YOU WILL BE TURNING IN THREE PAGES FOR EACH CASE STUDY. PLEASE MAKE SURE YOU TURN IN BOTH IN ONE SINGLE WORD DOCUMENT

1. THE FIRST PAGEHAS YOUR NAME AND TITLE.

2. THE SECOND PAGEYOU WILL WRITE BRIEF DESCRIPTION OF FIVE TOPICS: METHODS, DIAGNOSIS, CASE FORMULATION, TREATMENT PLAN AND ADDITIONAL INFORMATION YOU MAY WANT TO KNOW.

3. THE THIRD PAGEYOU WILL EXPAND ON THE TOPICS ABOVE.

OK, here is the format.

FIRST PAGE:

Title of the Assignment and your name (Title Page/ first page).

EXAMPLE: Clinical Case Assignment

Mr. John Doe

SECOND PAGE , I would like for you to LIST your answers to the 5 topics This means a short summary for each five topics like this:

EXAMPLE:

(First topic): Methods and Strategies: This means the types of assessments or procedure you would use to get information on the patient.

For example: Interview patient, review record, etc.

(Second Topic): Diagnosis: Here you will put your primary diagnosis for example:

For Example: Generalized Anxiety Disorder.

In addition, I would like you to add any other Diagnoses to consider:

Panic Disorder, Simple Phobia, etc.

(Third Topic): Case Formulation: (I want two or three sentences at most).

For Example: “ The patient’s anxiety is present in multiple settings and situations, following a period of intense stress. This anxiety has significantly impacted her social and professional functioning, leading her to seek help”.

(Fourth Topic): Treatment Plan: Here I want you to list the types of treatment or interventions you would recommend (try to be as specific as possible). Make sure the treatment you recommend are treatments that typically are used for the diagnosis you gave to your patient. In other words, think about it and just don’t throw everything in there:

Example: a. Relaxation Training

b. Insight-oriented Therapy

c. SSRI’s

(Fifth Topic): What Else I would like to know: Here you will add any other information you would like to know about your patient, which may help you to formulate a proper diagnosis and treatment plan.

Example:

1. Medical history

2. Drug screen.

3. Interview family members

THIRD PAGE: On the third and final page, I would like for you to expand on the topics above, telling me for example how you arrived to the diagnosis and what other diagnoses you would consider and why; what is your treatment plan and reasons for it, what else you would like to do or know and/or or any other aspect you think is important for me to know. You may also discuss any particular interpersonal or intra-psychic dynamics pertaining to any of these two cases. Please no more than 3 or 4 paragraphs.

I want you to relax, you are in control in this assignment, you need TO DEDICATE a little time and thought and you will be fine