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Solved by verified expert:Hide Submission Folder InformationSubmission FolderM3 Assignment 2 SubmissionInstructionsAssignment 2: Cultural Immersion ExperienceCase study is attachedDiagnosing the Whole PersonIn this assignment, you will provide a discussion of cultural, developmental, neurobiological, social, and environmental considerations given the following vignette. Develop an appropriate diagnosis, correctly coded and recorded, and recommendations for treatment. Be sure to address any ethical considerations pertaining to diagnosis and treatment.Tasks:Click here to read a case vignette.Describe how the contextual factors described within the vignette might influence the diagnoses that are given and how or whether the contextual factors are addressed in the client’s diagnostic list. Create an appropriately written diagnostic profile of the client.Your final product should be a 2- to 3-page paper, written in APA format, and you should utilize a minimum of three scholarly sources. Your paper should be written in a clear, concise, and organized manner; demonstrate ethical scholarship in the accurate representation and attribution of sources; and display accurate spelling, grammar, punctuation, and references.
jane_case_study.pdf
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Case Vignette
© 2015 Argosy University
Case Vignette
Scenario:
Jane is a 56-year-old self-identified African American female. She is self-referred to your private practice.
During your initial telephone contact with Jane, she states she is depressed and also suffers from chronic
pain due to a back injury she received at work 2 years ago. She is seeking counseling services to help her
improve her daily functioning.
Jane misses the scheduled intake appointment with you. She calls you 2 days later and explains she
“forgot” about the appointment. You reschedule the appointment. Three days before the rescheduled
appointment, she calls you saying, in a very weary voice, that she was trying to locate your office and got
lost. You provide the correct date and time for her appointment and give her directions to your office. On
the day of her rescheduled appointment, Jane arrives 15 minutes late and completes her initial paperwork
(informed consent, medical history, etc.) in 20 minutes.
History of the Problem:
Jane reports she injured her back while at work 2 years ago. She was working as a licensed vocational
nurse and was helping to lift an obese patient onto a bed. Jane describes the patient as being of a
minority race and says, “You know, those people just sit around all day eating and getting fat off their
welfare checks. If it weren’t for them, I would be alright today.” She states she underwent surgery on her
back, followed by 3 months of “excruciating” physical therapy, and has gone through a “long, arduous
recovery” from the injury. She has problems sleeping because of the continued pain, which is “terrible
when it comes.” She has not worked since her injury and indicates she is in the process of seeking Social
Security disability benefits for her physical problems.
Jane has “dealt with anxiety and depression all [of her] life, especially when [she] felt unstable.” When
queried, she states her feelings of instability are related to the quality of her relationships with significant
others. She reports feeling sad much of the time and having difficulty initiating tasks. She believes she
does not “think” as well as she used to. She denies current homicide ideation and intent. She engages in
few activities due to her back pain and limited finances and states there are times when she cannot get
her breath and feels “chills or an internal vibration and chest pressure.”
She uses yoga, deep breathing, and soft music to reduce these symptoms. She also carries a balloon with
her, and if she is in a public setting and feels the symptoms, she goes to a restroom and inflates the
balloon. If the symptoms persist, she goes to the emergency room; she has been to the emergency room
six times in the past 12 months. She states that, sometimes, “PTSD kicks in.” For example, she explains
she was recently driving when an ambulance passed her with its lights and siren turned on. She had to
pull over and started crying.
Relevant Psychosocial History:
During the intake session, Jane reports her parents had a biracial marriage. Her mother was African
American, and her father is White. Jane states her parents lived together “off and on” during her
childhood. She indicates there were many verbal arguments between them, and she describes herself as
the “family peacemaker.” She believes she experienced stress and anxiety as a teenager because of this
parental strife and her role as a mediator. She denies any history of abuse by either parent though she
alleges that both parents drank to excess at times, which resulted in arguments sometimes. She further
notes her father was fired from a job he held for many years and told her it was due to the company hiring
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Diagnosis and Treatment of Behavioral and Emotional Disorders
©2015 Argosy University
2
Case Vignette
more minority workers “to keep the government happy.” Her mother is deceased; her father lives 2,000
miles away, and she has limited contact with him. Three of her five siblings are dead. One of her brothers
died in a car accident as a young adult, another brother died from cancer when he was 44 years old, and
her oldest sister, the firstborn, died of a heart attack 3 years ago, at age 64. She reports having a close
relationship with her twin sister, who resides locally, but describes her relationship with her youngest
brother as disconnected. Jane states she is the younger twin and the thirdborn child.
Jane married when she was 20 years old. She and her husband have two children, and she has three
grandchildren. She sees her daughter and her grandchildren frequently. However, she is “very
disappointed” her son married a woman who is Hispanic and describes her relationship with her son and
daughter-in-law as “strained.” She states her husband drank, was physically violent (which included
aggression directed at her), and “cheated” on her. She reports he was never abusive to their children and
“was always an exceptional father.” Jane states her husband died 20 years ago as the result of a car
accident. She was driving her family home from a family reunion late at night on a rural road. Her
husband leaned against the car door, which was not shut tightly, and fell out of the car. Jane immediately
sent their two children to find a house from where they could call an ambulance. It was approximately 30
minutes before the ambulance arrived; by that time, her husband had died. Jane becomes tearful while
relaying this information. After his death, Jane took an antidepressant, Prozac, for 1 year. Jane reports
that following the loss of her husband, she was sad, cried every day, had no energy, lost weight, had
difficulty falling asleep at night, and felt responsible for his death. She also continues to experience the
accident, is “jumpy,” tries not to think about the accident, has difficulty paying attention, and feels
“numb.”
Jane reports that several years after her husband’s death, she started dating a man who was an alcoholic
and abusive and did not let her “mourn” her late husband. During this relationship, she checked into a
motel one evening, took sleeping pills and Xanax, and woke up to a maid knocking at the door. She was
hospitalized as an inpatient at a psychiatric hospital for 3 weeks. She denies this was a suicidal act and
states that she was simply trying to get some rest away from the chaos of her boyfriend and children. She
indicates she has not participated in counseling since her brief hospitalization. Jane denies any history of
alcohol or drug abuse.
During the intake session, Jane compliments you on several aspects of your office décor. As previously
stated, she cries several times when recalling her husband’s death and her marriage to him. She states
she has never discussed some of these topics with others before now. She believes you are especially
understanding of her situation and that, because of this, she can confide in you. The day after the intake
session, Jane calls and leaves you a voice message saying she has been thinking about your session and
there is more information she wants to share with you because you were such a “good listener.” She goes
on to say, “There have been periods when I couldn’t do anything but go back to bed,” that she has missed
many appointments over the past year, and that she often misplaces things around her home. Four days
after the intake session, Jane calls and leaves a second voicemail for you. She says she “didn’t want
anybody to think less of (her)” and she has difficulty socializing and can’t be away from her home for very
long without feeling anxious. She ends her voicemail message by apologizing for “causing you more work
if I’ve caused any.”
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Diagnosis and Treatment of Behavioral and Emotional Disorders
©2015 Argosy University
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