Utilizing the information learned from this week’s chapters and reviewing the case examples in the text for practice, review the case below to:
a) Identify the Biological, Psychological, and Social variables impacting the client
b) Assess for Competence
Students must complete this assignment using two formats:
1) Submit the attached form/diagram which is similar to the examples used in the text. The diagram should be completed using applications from the case vignette listed below and provide a “snapshot” of your assessment. Examples from the chapters can be used for reference. – 5 points
2) Submit written feedback using APA 7th edition format with the 3 variables (bio/psycho/social) and competence utilized as headers. This submission should include an expansion of the assessment diagram and provide support to the assessment given utilizing information from the text and any other empirically supported sources. Submissions for this assignment should include a title and reference page along with proper APA format which includes in-text citations, double space, 12 font, Time New Roman, etc. Excluding the title and reference page, your response should be approximately 1-2 pages in length. – 10 points
When Dion’s wife was able to get him to agree to an inpatient comprehensive evaluation, she was desperate. Dion was 38 years old and had been unemployed for several years and was essentially non-functional. After partying all night and shopping all day for a week, his wife stated that she would leave him if he did not check into a psychiatric hospital. Dion presented to the admitting psychiatrist as a fast-talking, happy, seductive man, with no evidence of hallucinations or delusions.
Dion’s issues began 7 years earlier when he was working as an insurance adjuster. He had a few months of mild, intermittent depressive symptoms, anxiety, fatigue, insomnia, and loss of appetite. At the time, he thought the symptoms were stress-related from work as he was back to his usual self within a few months.
A few years later, a physician noted an asymptomatic thyroid mass during a routine physical examination. One month after removal of the mass, a papillary cyst, Dion noted dramatic mood changes. Twenty-five days of remarkable energy, hyperactivity, and euphoria were followed by 5 days of depression, during which he slept a lot and felt that he could hardly move. This pattern of alternating periods of elation and depression, apparently with few “normal” days, repeated itself continuously over the following years.
During his energetic periods, Dion was euphoric, optimistic, and self-confident, but also short-tempered and easily irritated. He functioned well on only a couple of hours of sleep per night and sometimes he did not sleep at all for several days at a time. He spoke very rapidly, and people complained that they had trouble getting a word in edgewise during conversations. His judgment at work was erratic. He spent large sums of money on unnecessary and, for him, uncharacteristic purchases that he could not afford, such as a high-priced surround-sound system and several Doberman pinschers. He also had several impulsive sexual flings. During his depressed periods, he often stayed in bed all day because of fatigue, lack of motivation, and depressed mood. He felt guilty about the irresponsibility and excesses of his prior several weeks. He stopped eating, bathing, and shaving. After several days of this withdrawal, Dion would rise from bed one morning feeling better and within 2 days be back at work, often working feverishly, though ineffectively, to catch up on work he had let slide during his depressed periods.
Although both Dion and his wife denied that he used any substances other than when he binged on alcohol during his hyperactive periods, he was dismissed from his job 5 years ago because his supervisor was convicted that his overactivity must have been due to drug use. His wife has been supporting him financially ever since then.
When he finally agreed to a psychiatric evaluation 2 years ago, Dion was minimally cooperative and noncompliant with several medications that were prescribed, including lithium carbonate, sodium valproate, and antidepressant medications. His mood swings continued with few interruptions up to the current hospitalization.
In the hospital, his physical examination, blood chemistry, blood cell counts, computed tomography (CT) scan of his brain, and cognitive testing were unremarkable. After a week, he switched to his characteristic depressive state.
After 3 weeks in the hospital, Dion’s mood was stable on sodium valproate. He left the hospital, very quickly found a new job, and did well the following year. Feeling well, he decided that he did not need the medication and stopped taking the sodium valproate. Within weeks, his previous symptoms returned and had to be hospitalized again.