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Psychotherapy is the treatment of choice (Frank, 2016).Other differentials include major depressive disorder, bipolar disorder, and post-traumaticstress disorder. Each of the symptoms that can occur in adjustment disorder can also occur in major depressive disorder. The difference is the timing and the occurrence of a stressor (Lyness,
COMPREHENSIVE CLIENT FAMILY ASSESSMENT72018). If WL continues to experience these symptoms for the next month, that will put the stressor of the death of her mother at 6 months prior. At that point, a diagnosis of major depressive disorder, mood disorder, or dysthymic disorder would be considered, as at the 6-month mark, the diagnosis of adjustment disorder will no longer be appropriate. Case FormulationWL is a 65-year-old Caucasian female living with her husband of 47 years their house in a rural area of town. She is seeking help to learn how to cope with her sadness and grief after the death of her mother, for whom she was the primary caregiver, 5 months ago. Besides grieving theloss of her mother, she is experiencing somewhat of an “empty nest syndrome”, as she expresses the feeling that she “no longer has a purpose” since her daughter and her grandsons no longer need her anymore. She has never been to therapy before, but she has been taking Zoloft for about10 years which is being prescribed by her PCP. She began taking it 10 years ago due to excessiveworry about her daughter’s wellbeing which is now long resolved. Even though the client feels like it is not working, she stays on it to avoid side effects of discontinuation symptoms. Treatment PlanThe plan is to begin individual psychotherapy sessions weekly using a strengths-based approach while utilizing cognitive behavioral therapy techniques. Discussed the possibility of herstarting to attend a weekly “Grief Group” that is offered by Forward Counseling, as a new grief group cohort will be starting in January. She also agreed to make an appointment to see her PCP to discuss her medication and possibly begin a slow taper off Zoloft once she becomes established in therapy. Once the client becomes established in regular therapy, the topic of volunteering or getting a small, very part-time job will be discussed, as this might help address her need for a sense of purpose.
COMPREHENSIVE CLIENT FAMILY ASSESSMENT8GGFGGMGGFGGMGGFGGMGGFGGM88986278UNKUNK = UNKNOWNUNKUNKUNKGFGFGMGM55389010272FATHERETOHabuse88MOTHERWorrier/anxiousDied 7 months agoW.L.65DAUGHTER35Only childDX: MajorDepression1210GRANDSONSMALEFEMALE= close / conflictual= close relationshipCLIENT
COMPREHENSIVE CLIENT FAMILY ASSESSMENT9ReferencesAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Retrieved from Walden Library DatabasesFrank, J. B. (2016). Adjustment disorder workup. Retrieved from Guo, Y., Wang, S., & Johnson, V. (2012). Clinical assessment in the counseling process: a teaching model. Retrieved from Lyness, J. M. (2018). Unipolar minor depression in adults: epidemiology, clinical presentation, and diagnosis. Retrieved from