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Clinical Assessment - Carrissa

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on 18 July 2016

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Transcript of Clinical Assessment - Carrissa

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Clinical Assesment
CARRISSA
The Iceberg
Tip of
What people see.
The
story.
whole
What lies
beneath
PRESENTING ISSUES AT INTAKE:
Depression
Anxiety
Substance Use
Trauma,
Loss &
Insecure
Attachment
Abused by her Primary Caregiver
Raped as a Teen
Grandfather committed suicide
Father went to prison
Shame around the public scandal
Mother distinct and uninvolved
Provisional
DSM 5 Diagnosis
311 (F32.9) Unspecified Depressive Disorder with anxious distress, Moderate
303.90 (F10.20) Alcohol Use Disorder, Moderate
305.60 (F14.10) Cocaine Use Disorder, Mild
305.40 (F13.10) Sedative, Hypnotic, or Anxiolytic Use Disorder, Mild
Differential Diagnosis:
291.89 (F10.24) Substance/ Medication-Induced Depressive Disorder, Moderate
296.32 (F33.1) Major Depressive Disorder with anxious distress, Moderate
309.81 (F43.10) Postraumatic Stress Disorder
What about
Culture?
Latino Culture
Authoritarian Style of Parenting
Latino Family Model
Generational Hierarchy
Treatment Model:
Individual Therapy using Bowlby's
Attachment Theory
The security of a child's attachment depends on the reliability and responsiveness of the parent to the child.

Abusive
Primary Caregivers
Distance/
Uninvolved



The End...
Treatment Goals:
Goal 1:
Acquire the neccesary skills to maintain long-term sobriety
Goal 2:
Alleviate depressed mood and return to previous level of effective functioning
Goal 3:
Resolve the core conflict that is the source of the anxiety
Goal 4:
Resolve past trauma/grief related issues leading to less depresion, greater self esteem, security and confidence
Full transcript