Description

1. Question: Case #1: Jenna – Jenna is a six-year-old Caucasian female who currently resides with her foster parents, her older biological sister, and two foster brothers. Jenna and her siblings were taken from her biological parents because of suspected sexual abuse and neglect. It is reported that Jenna lived in a home without food, water, and utilities. Jenna’s foster parents report that her biological mother “may have some disabilities and has never had the financial means to take care of her children.” Jenna’s biological brother is in a separate foster home. He is suspected of sexually abusing both Jenna and her older sister. It has been reported that he sexually abused Jenna, while her sister was helplessly told to watch. Jenna has expressed this trauma with agitated behavior. The traumatic event is re- experienced by repetitive play where she stimulates herself on furniture. Jenna avoids the stimuli associated with the trauma by avoiding conversations associated with sexual abuse. Jenna avoids activities, places, and people associated with the trauma except for her sister who was also a victim. Jenna also has a sense of a foreshortened future. She frequently brings up death with her foster parents. Jenna has persistent symptoms of increased arousal that were not present before the trauma as indicated by irritability and outbursts of anger nearly every day with her biological sister and her foster father. Jenna is also hyper vigilant and does not want her foster father around. The disturbances have lasted for over a month and have caused clinically significant social impairment to the point she is unable to attend a full day of school due to emotional breakdowns. What intake information should be obtained and assessed to formulate a provisional DSM-5 diagnosis? Select AS MANY as you consider essential.
2. Question: What assessment tools might offer meaningful information on this client? Select the ONE most appropriate option. (Refer to Case #1) Hint: Please be mindful of the age ranges the assessments are normed for.
3. Question: Based on the available information, what would appear to be the most appropriate provisional DSM-5 diagnosis? Select the ONE most appropriate primary diagnosis. (Refer to Case #1) Hint: Please consider duration of symptoms for trauma and stress diagnosis.
4. Question: Based on the provisional diagnosis, what interventions might work best as you begin to work with this client? Select As many as you consider indivcated (Refer to Case # 1) Hint: Please consider where you would start with the client.
5. Question: In developing a collaborative treatment plan with the client, identify immediate goals to be addressed. Select AS MANY as you consider correct and necessary. (Refer to Case #1) Hint: Immediate goals, think about where the early focus of counseling starts.
6. Question: Case #2: Morgan – Morgan is staying at a local shelter after she experienced a natural disaster that destroyed her home three days ago. She is a 25-year-old lesbian female who was living with her partner. She has a flat affect and makes no eye contact as she talks about having to vacate her home in the middle of the night as the waters were filling her condo. Her partner did not make it out and drowned in the storm. She has not made contact with any of her other relatives who she says she has been distant from for “many years.” She mentions that before the storm she was taking “some meds to help with my moods” but is not sure of the medication name. Since she arrived at the shelter, she has laid in her cot, not taken any showers, eaten very little food, and avoided any contact with shelter workers or other families. She has a significant startle response when approached and has difficulty remembering basic information. She cries herself to sleep and has moments where she screams out at night after having “nightmares about drowning.” What intake information should be obtained and assessed to formulate a provisional DSM-5 diagnosis? Select AS MANY as you consider important. Hint: Think about diagnostic criteria that relate to trauma and stress.
7. Question: What assessment tools might offer meaningful information on this client? Select the ONE most appropriate option for your work while she is at the shelter. (Refer to Case #2) Hint: Morgan is in shelter and has been there 3 days.
8. Question: Based on the available information, what is the most appropriate provisional DSM-5 diagnosis? Select the ONE most appropriate primary diagnosis. (Refer to Case #2) Hint: Please consider duration of symptoms for trauma and stress diagnosis.
9. Question: Based on the intake data, identify immediate potential issues to be addressed as a crisis counselor while the client is in the shelter. Select AS MANY as are correct and necessary. (Refer to Case #2) Hint: Please keep in mind that crisis counseling is short-term.
10. Question: Based on the provisional diagnosis, what theories or models will likely work best for the client? Select AS MANY as you consider correct and appropriate in working with the client while she is at the shelter. (Refer to Case #2) Hint: Crisis intervention often starts with stabilization.
11. Question: Case #3: Bob – Bob is a 45 year old African American man. He was recently medically discharged from the US Navy due to extensive injuries he sustained during his last time in combat. He is separated from his wife and has two teenage children. He has a prescription for an opioid pain medication and discloses that he has been engaging in daily marijuana use and drinks about 5-6 beers a day “to cope.” He has an extensive history of childhood physical and emotional trauma. His mother was alcoholic and his father was physically abusive to him and his siblings. He says that he is struggling over the past few months with “what could have been” if he was not so “damaged.” He sounds very agitated, stating that the pain is unbearable and he “can’t stand it anymore.” He mentions that he might be better off dead. Based on the available information, what would appear to be the most appropriate provisional DSM-5 diagnosis? Select the ONE most appropriate. Hint: Please consider duration of symptoms for trauma and stress diagnosis.
12. Question: To better determine the client’s current level of functioning and behavioral problems, what additional data may be helpful? Select AS MANY as are necessary. (Refer to Case #3)
13. Question: Which of the following risk factors are present in the case description? Select AS MANY as you consider indicated. (Refer to Case #3) Hint: Focus on what you currently know about Bob.
14. Question: Indicate the responses that would be most appropriate for addressing potential suicidal ideation. Select AS MANY as you consider correct. (Refer to Case#3)
15. Question: Based on the provisional diagnosis, what interventions and referrals might work best for the client? Select AS MANY as you consider indicated. (Refer to Case #3) Hint: Please consider the difference between the No Harm Contract and the Suicide Safety Plan.