Week 7 Case Study Discussion
Collaboration is a key part of social work practice. Most MSW professionals engage in these processes during the postgraduate practice years that each state requires before their licensing moves from supervised to independent status. Even beyond those requirements, peer consultation and collaboration are key aspects of most social work practice settings.
For this Assignment, your Instructor has paired you with a consultation colleague. Imagine that you and your colleague are working with the client featured in the case study your Instructor assigned. Your task is to provide a diagnosis and present your findings in the Week 7 Discussion.
Your diagnosis can come from any part of the DSM-5, so frequent communication and research with your colleague may be needed. Your colleague is there to help you think out, consult on, challenge, research, and polish your process before you record and post your own final analysis of this case in Week 7.
The collaboration that begins in this Assignment is intended to provide a safe venue for developing your differential diagnosis and case discussion skills with your colleague. This week you meet with your assigned partner at least once via Collaborate Ultra and begin considering the assigned case. In this Assignment, you describe that meeting and any initial analysis of the case.
To prepare:
- Using the case study provided to you by your instructor.
- Consult the Case Collaboration Meeting Guidelines document found in the Learning Resources.
- Read ahead to the Week 7 Discussion instructions so that you can plan and reflect accordingly.
Note: In the Week 7 Discussion, you make your final findings presentation as an individual, not with your partner.
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Submit a 1- 1/2-page paper in which you describe your team meeting. In your write-up, make sure to address the following:
- Describe the quality of your working relationship with your colleague.
- Critically reflect on strengths of collaborative relationship and areas for improvement.
- Describe your case in 100–150 words.
- Identify the red flags in your case study to be further evaluated.
- Outline your and your partner’s plan for further research and consultation, identifying specific tasks that you are each doing in this regard. Week 7 Case Study Discussion
ed Readings
First, M. B. (2014). Handbook of differential diagnosis. Washington, DC: American Psychiatric Association. Retrieved from http://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edspub&AN=edp2452076&site=eds-live&scope=site
Note: You will access this e-book from the Walden Library databases.
Chapter 1, “Differential Diagnosis Step by Step” (pp. 14–24)
Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.
Part 1, “The Basics of Diagnosis” (pp. 3–56)
American Psychiatric Association. (2013j). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm01
Note: You will access this e-book from the Walden Library databases.
American Psychiatric Association. (2013l). Other conditions that may be a focus of clinical attention. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.VandZcodes
Note: You will access this e-book from the Walden Library databases.
Walsh, J. (2016). The utility of the DSM-5 Z-codes for clinical social work diagnosis. Journal of Human Behavior in the Social Environment, 26(2), 149–153. doi:10.1080/10911359.2015.1052913
Note: You will access this e-book from the Walden Library databases.
Blackboard. (2018). Collaborate Ultra help for moderators. Retrieved from https://help.blackboard.com/Collaborate/Ultra/Moderator
Note: Beginning this week, you use a feature in your online classroom called Collaborate Ultra. Your Instructor will assign you a partner and then give you moderator access to a Collaborate Ultra meeting room. This link provides an overview and help features for use in the moderator role.
Document: Case Collaboration Meeting Guidelines (Word document)
Note: Download these guidelines and consult the Assignment instructions. You are encouraged to orient yourself to these instructions and take action as early in the week as possible.
Document: How to Write a Diagnosis According to the DSM-5 (PDF)
CASE of Sigmund
DEMOGRAPHIC DATA:
This is a voluntary intake for this 53 year old Jewish male. Sigmund has had several psychiatric hospitalizations in the past. Sigmund has been married for 29 years and has been separated from his wife for the past ten months. He has been living alone for the past five months. His wife and three daughters live two blocks from him. Sigmund has had difficulty in jobs and has not been at any job longer than three years.
CHIEF COMPLAINT:
“I miss my family and do not want to live without them”.
HISTORY OF ILLNESS:
Sigmund reports first seeking psychiatric treatment when he was sixteen years old. He was prescribed anti-depressants, but does not remember what kind. Since they helped his mood he remained on anti-depressants for several years. In his late teens he began drinking. His use of alcohol continued into his early thirties. At thirty four years old he attempted suicide after his wife and children left him. He was hospitalized in a psychiatric unit for thirty days. At that time Sigmund was put on lithium, with continued successful results for several years, resulting in reconciliation. Week 7 Case Study Discussion
In December 2018 Sigmund returned to his psychiatrist because he was becoming depressed again, feeling sad, fearful and suicidal. He was given Parnate. Soon after, both Sigmund and the psychiatrist did not think this was working very well and the psychiatrist added Ritalin to his medication regiment. During the next three months Sigmund felt on top of the world sometimes lasting for 10 days. He then would have angry outbursts. His wife asked him to leave the home. He then took an overdose of Klonopin. Sigmund was then prescribed ECT (shock treatment). Sigmund returned home after the shock treatment but reported that it was an inhumane experience and felt anger towards his wife believing she forced him to receive ECT to return home.
Sigmund continued on anti-depressants and lithium. Mrs. Sigmund was getting continuously concerned about their financial state because Sigmund would constantly be buying big items that they could not afford. They would have arguments about this all the time. By the end of August he was asked to leave his home again because he used pills as a suicidal gesture. He began drinking again to cope with the separation. This use and behavior continued up to his current presentation for intake.
PSYCHOSOCIAL HISTORY:
Sigmund reports growing up as tumultuous. His mother beat him and would lock him out of the house when she became angry. His mother separated from his father on several occasions and sometimes would throw Sigmund out of the house with the father. His mother made all the decisions and his father played a more passive role. Both parents would often have physical fights and Sigmund would try to break up the fighting from as early as he can remember.
Sigmund is the only child from his parents union. He has an older brother from his mother’s previous marriage. Sigmund does not have any contact with his brother. Sigmund was initially considered an underachiever in the early years of school. He had trouble being in fights with other kids because they use to make fun of his wrinkled clothes. Sigmund always wanted to be a doctor. He spent the following five years after college graduation taking courses but never completed his graduate studies.
Sigmund has no legal history. He worked in the family business through high school and college. He became a project coordinator at his next job. He stayed there three years. Week 7 Case Study Discussion
MEDICAL HISTORY:
Sigmund states he currently takes Synthroid for a thyroid problem and this helps him keep his weight down.
FAMILY ISSUES AND DYNAMICS:
Sigmund was first married at age twenty one years old. He reports not loving his first wife but liked the stability of her family and asked her to marry him. They spent one year together. He physically abused her from the beginning of their marriage. Mrs. Sigmund the first had an affair that ended the marriage. Mrs. Sigmund reports Sigmund had spoken to her several times about getting involved with other men for sexual pleasure with his knowledge and she states she just followed through with his wishes. They had no children.
Six months after his first divorce Sigmund married again. He reports not loving his second wife but thought it was better to be married. The second Mrs. Sigmund had one child from a previous marriage who Sigmund adopted. They had two other children.
The first ten years of their marriage Sigmund reports physically abusing his wife. He reports hitting the oldest child once. He stopped the physical abuse when Mrs. Sigmund asked for a divorce the first time. Sigmund reports he always wants people around him. He believed his wife was becoming more distant from him over the past several years which he could not take. Their fighting increased, although he would not become physical with her now.
MENTAL STATUS EXAM:
Sigmund presents as a neatly dressed male who appears younger than his stated age. His hair is a bit disheveled. His nails are neatly groomed. Facial expressions are appropriate to thought content. Motor activity is appropriate. Thoughts are logical and organized. There is no evidence of hallucinations. Sigmund admits to a history of suicidal ideation, gestures and attempts. His mood is depressed. During the interview Sigmund talked fast. Sigmund is oriented to time, place and person. His intelligence appears above average.