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SOCW 6090 Week 10 – Assignment: Final Project

Assignment: Final Project

The sign of an effective clinician is the ability to identify the criteria that distinguish the diagnosis from any other possibility (otherwise known as a differential diagnosis). An ambiguous clinical diagnosis can lead to a faulty course of treatment and hurt the client more than it helps. In this Assignment, using the DSM-5 and all of the skills you have acquired to date, you assess a client.

This is a culmination of learning from all the weeks covered so far.

To prepare: Use a differential diagnosis process and analysis of the Mental Status Exam in the case of Sandra to determine if the case meets the criteria for a clinical diagnosis.

Submit a 1000-word paper in which you:

· Provide the full DSM-5 diagnosis. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may need clinical attention).

· Explain the full diagnosis, matching the symptoms of the case to the criteria for any diagnoses used.

· Identify 3 of the close differentials that you considered for the case and have ruled out. Concisely explain why these conditions were considered but eliminated.

· Identify the assessments you recommend to validate treatment. Explain the rationale behind choosing the assessment instruments to support, clarify, or track treatment progress for the diagnosis.

· Explain your recommendations for initial resources and treatment. Use scholarly resources to support your evidence-based treatment recommendations.

· Explain how you took cultural factors and diversity into account when making the assessment and recommending interventions.

· Identify client strengths, and explain how you would utilize strengths throughout treatment.

· Identify specific knowledge or skills you would need to obtain to effectively treat this client, and provide a plan on how you will do so.

To submit your completed Assignment for review and grading, do the following:

– Master Degree Level

– Ultra-High Quality

APA

Must be Original Work and contain at least 4 references and citations. Must reference the following:

Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.

Chapter 15, “Diagnosing Substance Misuse and Other Addictions” (pp. 238–250)

American Psychiatric Association. (2013r). Substance related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm16

Capuzzi, D., & Stauffer, M. D. (2016). Foundations of addictions counseling (3rd ed.). New York, NY: Pearson Education, Inc.

Substance Abuse and Mental Health Service Administration (SMHSA). https://www.samhsa.gov/

CASE SANDRA

INTAKE DATE: July 2020

PRESENTING PROBLEM:

Patient was brought to counseling by her mother. Following an argument with her parents, she threatened to cut her wrist. Prior to this threat, Sandra’s mother says she started screaming and became very angry with her after discussing her eating habits.

PSYCHOLOGICAL DATA:

Sandra is a 14-year-old white female who resides in Pennsylvania with her parents and older sister. She appears to be of average intelligence as she was able to respond to numerous questions in an articulate and intelligent manner. She was well versed about world history and current affairs. Her mother confirms that she has always done pretty well in school, maintaining a “B,” average, although IQ testing indicates she could do better. She has always been somewhat of a perfectionist and likes to do well, and studies hard to get good results. Sandra participates in various school activities (e.g. chorus, school newspaper). Sandra is quite shy and reserved in character but is generally well-liked by people.

She started going out with a boy from her class and feels very happy. After a few weeks, her boyfriend dumped her and begin going out with her best friend. Sandra feels an overwhelming sense of betrayal and hurt, and tried to talk to her family about it, who tells her “there are plenty more fish in the sea,” and not to worry about it. Sandra feels ashamed and embarrassed of her feelings and very alone. Not only has she lost her boyfriend but also her best friend, and no one around her seems to understand the severity of what she is going through. To Sandra, whose life as a teenager revolves heavily around her friends, she feels she has lost everything.

In order to cope and distract herself, she plunged herself into her studies, though her concentration is off. She began eating less since she loses her appetite quickly, and within a few weeks people started commenting on how fantastic she looks with her weight loss. She went to a party one night in a tight fitted dress and received a large amount of attention from the boys. In a very difficult and painful time, Sandra finally finds she was praised for something, and began to more consciously restrict her food intake to ensure that she continues to lose weight and feel good about herself. At times, Sandra finds herself eating more than she wants and goes into the bathroom and induces vomiting to rid herself of the extra calories. She has done this about 3 times over the past several months.

MEDICAL HISTORY:

Sandra had a complete physical by her doctor in June 2020. The doctor identified that Sandra was thin but remained in her weight range for her age. He also confirmed that she continued to have her menses. She denied any dieting or fasting to the doctor.

More recently Sandra’s family began to worry about her, as she did not want to eat evening meals with them. Sandra’s friends also comment on how thin she is getting and jokingly put her on the scale. Sandra still maintained a weight within her height and body frame. Sandra sees this as a positive thing, believing it is praise and attention from others, but she has become completely obsessed with food. She goes to bed at night counting the calories she has had in the day, and rigidly planning what she will eat the next day.

SUBSTANCE ABUSE HISTORY:

Sandra denies any drug or alcohol use. She states “I could do drugs if I wanted to. I don’t want to because it’s dumb.”

PSYCHIATRIC HISTORY:

Sandra denies any psychiatric history.

MENTAL STATUS:

Sandra was casually dressed. She was in a lively manner with good eye contact and the conversation flowed freely. Thought and speech patterns were clear. Affect was appropriate. She was oriented in three spheres. Sandra denies feeling depressed, anxious, or suicidal, although this was not a strong denial. When questioned about her family’s concern of her eating habits, she suddenly became quiet, teary eyed, lowered her head, and responded “you don’t understand it, I don’t want to hurt myself, there is nothing wrong.”

Diagnosis

Week 10: Substance-Related and Addictive Disorders

Drugs—prescription and non-prescription—have become part of American life.

While the culture often shifts which drugs are at the forefront of public discourse, in treatment settings of all types, social workers frequently have to address the boundary between reasonable use and the development of pathological patterns of behavior. The DSM-5 addresses 10 classes of drugs: alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics and anxiolytics, stimulants, and tobacco and other substances. The use of three of these drugs in particular—alcohol, opioids, and cannabis—is on the rise, especially for women, seniors, and youth.

This week you analyze evidence-based interventions for common substance use disorders and identify resources to assist individuals in recovery from various forms of addictions, as you apply learning to a case.

Learning Objectives

Students will:

· Analyze a case study focused on a substance use disorder utilizing steps of differential diagnosis

· Examine culturally aware engagement strategies and treatment options for treating a substance use disorder

· Recommend treatment and resources for a client diagnosed with a substance use disorder

· Demonstrate case collaboration skills when presenting a differential diagnosis

· Diagnose a mental disorder in a case study utilizing steps of differential diagnosis

· Create a culturally appropriate, evidence-based treatment plan utilizing client strengths

Learning Resources

Required Readings

Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.

· Chapter 15, “Diagnosing Substance Misuse and Other Addictions” (pp. 238–250)

Gowin, J. L., Sloan, M. E., Stangl, B. L., Vatsalya, V., & Ramchandani, V. A. (2017). Vulnerability for alcohol use disorder and rate of alcohol consumption. American Journal of Psychiatry, 174(11), 1094–1101. doi:10.1176/appi.ajp.2017.16101180

Reus, V. I., Fochtmann, L. J., Bukstein, O., Eyler, A. E., Hilty, D. M., Horvitz-Lennon, M., … Hong, S.-H. (2018). The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. American Journal of Psychiatry, 175(1), 86–90. doi:10.1176/appi.ajp.2017.1750101

Stock, A.-K. (2017). Barking up the wrong tree: Why and how we may need to revise alcohol addiction therapy. Frontiers in Psychology, 8, 1–6. doi:10.3389/fpsyg.2017.00884

Optional Resources

Best, D., Beckwith, M., Haslam, C., Haslam, S. A., Jetten, J., Mawson, E., & Lubman, D. I. (2016). Overcoming alcohol and other drug addiction as a process of social identity transition: The social identity model of recovery (SIMOR). Addiction Research and Theory, 24(2), 111–123. doi:10.3109/16066359.2015.1075980

Hagman, B. T. (2017). Development and psychometric analysis of the Brief DSM-5 Alcohol Use Disorder Diagnostic Assessment: Towards effective diagnosis in college students. Psychology of Addictive Behaviors, 31(7), 797–806. doi:10.1037/adb0000320

Helm, P. (2016). Addictions as emotional illness: The testimonies of anonymous recovery groups. Alcoholism Treatment Quarterly, 34(1), 79–91. doi:10.1080/07347324.2016.1114314

Petrakis, I. L. (2017) The importance of identifying characteristics underlying the vulnerability to develop alcohol use disorder. American Journal of Psychiatry, 174(11), 1034–1035. doi:10.1176/appi.ajp.2017.17080915

Hom, M. A., Lim, I. C., Stanley, I. H., Chiurliza, B., Podlogar, M. C., Michaels, M. S., … Joiner, T. E., Jr. (2016). Insomnia brings soldiers into mental health treatment, predicts treatment engagement, and outperforms other suicide-related symptoms as a predictor of major depressive episodes.

Journal of Psychiatric Research, 79, 108–115. doi:10.1016/j.jpsychires.2016.05.008

Document: Suggested Further Reading for SOCW 6090 (PDF)

Note: This is the same document introduced in Week 1.