Identifying Relevant Theories and Models
CASE STUDY TREATMENT PLAN
BIOPSYCHOSOCIAL ASSESSMENT FORM
Cultural Background:
Name:
Jasmine
Age:
22
Gender:
female
Race:
White
Ethnicity:
German-American
Religious Issues:
Jasmine reported she was raised in a two-parent household and her family is Catholic.
She reported she grown up Catholic, but she is currently not practicing the beliefs. Although,
she stated, she believes there is a God she doesn't how to reconcile her religious belief with
her thoughts and feelings about her sexuality. Lastly, Jasmine reported about her religious
beliefs is that feelings of guilt is brought on by her faith.
Sexual Orientation:
Bisexual
Relevant Cultural Norms:
As previously stated, Jasmine was raised by both parents to have the traditional Catholic
views. Within Christianity, there various views on sexual orientation and homosexuality. Also,
within a denomination, groups, or individuals they all hold different views, not all parties
necessarily support their church’s view on homosexuality. However, based on the few
information Jasmine reported her parents do not accept her sexual orientation. Viewing
sexuality and gender identity as a phase can delegitimize and prevent access to support,
which isn’t offered because of the misconception that it is not important and that one can grow
out of being LGBT+ ( Toft et al., 2019).
Other Relevant Cultural Norms:
Jasmine reported she spends a lot of time trying discover herself.
Current Symptoms:
Reason for Visit Listed as DSM-5 Symptoms:
After conducting some research, Jasmine is experiencing symptoms of Generalized Anxiety
Disorder. During Jasmine session, she reported due to getting mix reactions after confiding in
some of her heterosexual friends and one of sorority sisters about her sexuality. She is
completely terrify to reveal her sexuality to her parents, siblings, and her best friend as a fear
of being abandon and rejected. The symptoms that Jasmine has been experiencing is
persistent worrying, overthinking plans and solutions to all possible worst-case outcomes, and
experiencing the inability to relax, and set aside her worries. On the other hand, physically,
Jasmine experience excessive sweating, muscle tension, fatigue, trouble sleeping, and feeling
twitchy.
Family Background:
Family of Origin Issues:
Jasmine reported growing up her mother was very controlling and made her do all sorts of
things she was not interested involving in and her father was somewhat dismissive and allow
the mother to control the home. Jasmine reported she later found out in life that her father
allow her mother to house because she was a full-time stay at home mom and made sure the
the family went to church every Sunday.
Family Environment in Childhood/Adolescence:
Jasmine reported her family environment in her childhood and adolescence was very stable.
Jasmine parents never moved from her childhood home because it was a community with
other Catholic families and her parents was well-respected in that community. As previously
stated, Jasmine mother made majority of the rules in the home and all household members
had to abide by her rules and regulations. Jasmine father was breadwinner. Jasmine went to
the same school for 8 years, and the same high school for four years with the same individuals
from both schools.
Marital/Partnership History:
Jasmine reported she was in a total in 5 different relationships her entire life of 22-years, three
heterosexuality and two homosexual relationships. Jasmine reported her last relationship was
with a women and she broke up with her because Jasmine insisted on secrecy.
Children Issues/Concerns:
Currently, Jasmine has no children but she reported in the future she would like to have
children on her own.
Social/Community Background:
Connections to Community Support (Church, AA Group):
Jasmine has communication to home-based church but she not attended since she left for
college. But Jasmine has been very involved in her Sorority and active the community.
Support Network:
Jasmine has a semi- strong support network. She currently lives with three of her Sorority
sister in a townhouse not to far from her college campus. Jasmine is the middle child, but she
is very close with her older brother and younger sister. Jasmine also have friends who are are
part of the LGBT community and heterosexual community.
Hobbies or Volunteer Activities:
In high school Jasmine used to play basketball and tennis. But she was also interested in
other sports in her junior and senior year of high school. Currently, Jasmine favorite hobby is
to read and hang out with her LGBT friends because they are less judgmental. Lastly, Jasmine
reported she works part-time on campus in the dean's office and she really enjoys that job.
Personal Background:
Developmental History:
Jasmine reported in middle school she realize she liked both men and women, so she began
doing researching and gain more knowledge about her sexuality.
Disability:
Jasmine has not reported a disability.
Educational:
Jasmine has earned a high school diploma four years ago and is currently enrolled in college
study environmental science.
Military:
Jasmine has no military experience.
History of Trauma:
Jasmine has no history of trauma.
Employment Status:
Jasmine currently works part-time on campus in the dean's office.
Legal Status:
Jasmine reported she is a citizen of the United States.
Financial Status:
Jasmine reported she currently depend on her parents financially until she gets a stable job in
her field of studies.
Other Circumstances, Such as Transportation, Housing, et cetera:
Jasmine and three of her sorority sister are renting a home off-campus. Jasmine reported she
currently has a car that her parents brought her after high school.
Medical Background:
Medical History:
Jasmine reported she has no medical history,
Use of Medication:
Jasmine is currently not prescribed on any medications.
Current Medications:
Jasmine is currently not prescribed on any medications.
Substance Use Background:
Jasmine reported before going to college she was not a drug user of any sort. But when she
got to college that when she started to experiment with alcohol and marijuana. Currently she
has been regularly using marijuana and alcohol to cope with her symptoms of anxiety.
Mental Health Background:
Previous Psychological Issues (Depression, Anxiety, et cetera):
Growing up Jasmine reported she never has any psychological issues. However, she is
currently seeking counseling services because she want to get to know herself better and be
brave enough to let her loved ones know about her sexuality without abandoning and
disowning her.
Previous Counseling, Hospitalizations:
Jasmine has not previous been in counseling or hospitalize.
Family Fistory of Mental/Psychological Issues:
Jasmine family has no history of mental/psychological issues.
Ethical/Legal Background:
According to section A.1.a. of the American Counseling Association (ACA) Code of Ethnics,
the counselor primary responsibility is to respect the dignity and promote the welfare of clients
(ACA, 2014). The ACA Code of Ethics also states in section A.4.b that counselors should be
aware of and avoid imposing their personal behaviors, attitudes, beliefs, and values. Lastly, in
section C.5 of the ACA Code of Ethic states, that counselors should not condone or participate
in discrimination against other views or current clients, employees, research participants, etc
based on their sexual orientation, marital/partnership status, immigration status, age, culture,
race, ethnicity, spirituality/religion, and etc.
Consultations/Referrals Needed:
Currently, this is no need for a referral or consultation. Jasmine is currently involve with
therapy session weekly.
Strategies to Address Presenting Problems:
1:
One out the two strategies to address the presenting problems is assist Jasmine with finding
programs, and other support groups that target the LGBT community who are having trouble
with acceptance and their sexuality. Jasmine stated she is afraid of that her close friends and
friend will abandon her because of her sexuality. Jasmine is really worry that she will not have
a strong support network with her family which can lead to other harm such as suicidal
thoughts, substance abuse, mental disorders, etc.
2:
The second strategy to address the presenting problems is to assist Jasmine to get an insight
and gain knowledges on her symptoms. The Acceptance and Commitment Therapy (ACT) is
an present and problem-focused talk therapy. The main goal of ACT is to reduce the struggle
to control anxious thoughts , uncomfortable sensations, and increase involvement in
meaningful events that are align with chosen life values.
Sexuality Research to Support Strategies:
1:
According to Savin-Williams and Dube (2015), stated parents often react in a less than ideal
fashion after learning their child sexual orientation. The writers proposed a developmental
sequence of stages that parents face upon first learning their child’s sexual orientation.
2:
Acceptance and Commitment Therapy is one of the recent mindfulness-based behaviour
therapies shown to be effective with a diverse range of clinical conditions (Harris, 2017).
ACT assumes that the psychological processes of a normal human mind are often destructive
and create psychological suffering. Symptom reduction is not a goal of ACT because ongoing
attempts to get rid of Generalized Anxiety Disorder symptoms can create other clinical
disorders in the first place.
TREATMENT PLAN
Instruments/Screens to Facilitate Diagnosis
Instruments and Screens:
There are multiple instruments that could be in facilitating a diagnosis of the Generalized
Anxiety Disorder. One of the instrument to diagnose Generalized Anxiety Disorder is the
Generalized Anxiety Disorder 7-item (GAD-7) s scale. According to Brown & Rutter (2017),
The Generalized Anxiety Order Scale-7 (GAD-7) is a 7-item, self-rated scale developed by
Spitzer and colleagues in 2006 as a screening tool and severity indicator for GAD. This
instrument is easily scored and initially created to increase recognition of GAD in primary care
setting.
Another instrument that could be beneficial in developing a diagnosis would be The Hamilton
Anxiety Rating Scale (HAM-A). This scale is widely used interview measure designed to
assess anxiety. According to Hamilton (1959), the HAM-A Scale consists of 14-items, each
defined by series of symptoms, and measures both somatic anxiety (physical complaints
related to anxiety) and psychic anxiety (mental agitation and psychological distress).
HAMILTON M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32(1):50-
5. doi: 10.1111/j.2044-8341.1959.tb00467.x. PMID: 13638508.
Rutter, L. A., & Brown, T. A. (2017). Psychometric Properties of the Generalized Anxiety
Disorder Scale-7 (GAD-7) in Outpatients with Anxiety and Mood Disorders. Journal of
psychopathology and behavioral assessment, 39(1), 140–146.
https://doi.org/10.1007/s10862-016-9571-9
DSM-5 Diagnosis
DSM-5 Diagnosis:
According to American Psychiatric Association (APA), 2014), the DSM V Diagnosis for
Jasmine will be the Generalized Anxiety Disorder 300.02 (F41.1). Generalized Anxiety
Disorder (GAD) is characterized by excessive worry about various of different things.
Excessive anxiety and worry occurs more days than not for at 6 months. The individual finds it
difficult to control the worry. The anxiety and worry are associated with three or more of the
following six symptoms which are restlessness, being easily fatigued, irritability, muscle
tension, sleep disturbance, and difficulty concentrating.
American Psychiatric Association (2014). Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author.
Differential Diagnosis
Differential Diagnosis:
There are several different types of disorders that can occur at the same time as an individual
that has been diagnosed with GED. Feeling of anxiety and excessive worry can lead to
depression and even suicidal thoughts if the the symptoms go untreated. Jasmine's anxiety is
an result of her excessive concern of revealing her sexuality to her immediate family and
friends. Jasmine strongly feel that she will be rejected and abandoned by her family.
Ethical/Legal Consideration of the Diagnosis
Ethical/Legal Consideration of the Diagnosis:
There are multiple legal and ethical considerations that counselors must acknowledge
regarding a proper diagnosis for Jasmine. According to the section A.2.C, counselors should
be able to communicate in various ways that are both culturally appropriate and
developmental (ACA, 2014). In section A.1.c, counselors and their client should work jointly in
devising counseling plans that offer reasonable promise of success and is consistent with the
developmental level, abilities, temperament, and the circumstances of the clients.
ACA Code of Ethics. (2014). Retrieved from https://www.counseling.org/Resources/aca-code-
of-ethics.pdf
Short-Term Goals to Address the Diagnosis
Short-Term Goals to Address the Diagnosis:
One short term goal to address Jasmine's diagnosis of Generalized Anxiety Disorder is to
have Jasmine work with a therapist/counselor to help expose and extinguish irrational beliefs
and conclusion that contributes to anxiety that should occur at least once a week.
Another short-term goal to address the diagnose is have Jasmine participate in a support
group program where she can speak to other individuals experiencing the same event as her.
While participating in the support group Jasmine will have the opportunity to share and hear
personal experiences, feelings, coping strategies about have to deal with her experiences of
being open about her Bisexual.
Long-Term Goals to Address the Diagnosis
Long-Term Goals to Address the Diagnosis:
There are multiple long-term goals to address the Jasmine's diagnosis of Generalized Anxiety
Disorder. One long-term long is to help Jasmine reduce her overall level, frequency, and
intensity of anxiety so that her daily functioning is not impaired.
Another Jasmine's long-term goal is to reveal her sexuality to her family during attending her
counseling sessions and support group sessions. Jasmine reported she is afraid to tell her
family ,friends, and sorority sisters about her sexuality because of afraid of abandonment and
disowned. Therefore, the main goal of this long-term goal is to help Jasmine build her
confidence and support system.
Strategies to Promote Optimal Sexual Functioning
1:
One strategy to promote Jasmine's optimal sexual functioning is to have her keep a journal to
express thoughts and feelings relating to her anxiety and sexuality. This will help Jasmine
learn the relationship between her feeling of fear and moods when she thinks about revealing
her sexuality to her loved ones. Journaling helps control Jasmines anxiety symptoms and
improve her mood by tracking any symptoms day-to-day so that she can recognize triggers
and learn better methods to control them. In addition, it provides an opportunity for Jasmine to
have positive self-talk and identify her negative thoughts and behaviors.
2:
According to Bandelow. et, (2017), Anxiety disorder should be treated with pharmacotherapy,
psychological therapy, or a combination of both. But another strategies to promote Jasmine's
optiomal sexual functioning is continue to encourage her to attend support groups and reach
out to different individuals maybe through social media who she can relate to and learn
different coping strategies.
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues
in clinical neuroscience, 19(2), 93–107. https://doi.org/10.31887/DCNS.2017.19.2/bbandelow
3:
Imaginal Exposure Therapy is a type of therapy that client is asked to imagine feared images
or situations that can assist the individual with overcoming their fear. According to Bryant
(2013), stated prolonged imaginal exposure (IE) would lead to greater symptom reduction than
providing IE alone for participants with posttraumatic stress disorder (PTSD). This type of
therapy session will help Jasmine come over her fear about telling her family, friends, and
sorority sisters about her sexuality.
Bryant, R. A., Moulds, M. L., Guthrie, R. M., Dang, S. T., & Nixon, R. D. V. (2013). Imaginal
exposure alone and imaginal exposure with cognitive restructuring in treatment of
posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 71(4), 706–712.
https://doi.org/10.1037/0022-006X.71.4.706
Evidence-Based Treatment Interventions to Support Strategies
1:
In today's society many individuals at a younger age is coming out as lesbian, gay, bisexual,
and transgender and public support for the LGBT community issues has dramatically
increased, which lead to compromising mental health (Russell & Fish, 2016). Attempting tp
reveal your sexuality to close friends and family can trigger with your mental health if you allow
it to overwhelm you. Therefore journaling is a strategy that many therapist recommend
because it helps individuals meet their goals and improve their quality of life. However, this
can look different for each individual and the outcome can also vary widely. But it is a positive
method to conduct self-talk.
Russell, S. T., & Fish, J. N. (2016). Mental Health in Lesbian, Gay, Bisexual, and Transgender
(LGBT) Youth. Annual review of clinical psychology, 12, 465–487.
https://doi.org/10.1146/annurev-clinpsy-021815-093153
2:
There are many benefits of encouraging the LGBT community to attend support groups.
According to Dietz & Dettlaff (2008), there are many individuals are enrolled in colleges and
universities during the time they explore their sexual orientation. Although, most individuals in
the LGBT community find ways of achieving positive and health identities as adults, many
struggle with the experience of loneliness and isolation. Some major benefits from support
group membership is meeting and being with other individuals like themselves; having
mentors relationships with other individuals in the LGBT community, and learning about issues
related to homosexuality, all that have impact on identity formation. Jasmine fits under this
description perfectly that is why it is important to encourage to attend support groups.
Tracy J. Dietz & Alan Dettlaff (2008) The Impact of Membership in a Support Group for Gay,
Lesbian, and Bisexual Students, Journal of College Student Psychotherapy, 12:1, 57-72, DOI:
10.1300/J035v12n01_06
3:
The main benefit of imaginal exposure therapy is help individuals overcome their fear. IE
Therapy assist with reducing symptoms of distress related traumatic events in the safety of the
therapy setting. According to Bryant., et al, 2013, stated there are many benefits which
improve mental stability, improved functioning, recognizing one's in power to overcome
challenges, increased ability to tolerate fear.
Bryant, R. A., Moulds, M. L., Guthrie, R. M., Dang, S. T., & Nixon, R. D. V. (2013). Imaginal
exposure alone and imaginal exposure with cognitive restructuring in treatment of
posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 71(4), 706–712.
https://doi.org/10.1037/0022-006X.71.4.706
Treatment Plan Interventions Annotated Bibliography
Based on your diagnostic impression, develop an annotated bibliography of resources describing suggested interventions for the client. You should describe each source in your own words, not simply use the provided abstract. You will utilize a minimum of five current articles from peer-reviewed journals in the counseling or related professions from the Capella Library. Cite and reference the resources using APA 6th edition guidelines. You may utilize your textbook, but it does not count as one of your five scholarly resources. You are also encouraged to utilize more than five resources if they aid in developing a comprehensive treatment plan.
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues
in clinical neuroscience, 19(2), 93–107. https://doi.org/10.31887/DCNS.2017.19.2/bbandelow
In this article discuss the different methods on how anxiety disorder should be treated.
Psychological therapy and pharmacotherapy is the main treatment. The treatment
recommendations was given in this article based on the guidelines, meta-analyses, and
systematic reviews of randomized controlled studies.
Bryant, R. A., Moulds, M. L., Guthrie, R. M., Dang, S. T., & Nixon, R. D. V. (2013). Imaginal
exposure alone and imaginal exposure with cognitive restructuring in treatment of
posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 71(4), 706–712.
https://doi.org/10.1037/0022-006X.71.4.706
In this article it discussed, an study that investigated cognitive restructuring prolonged imaginal
exposure that can lead to greater symptom reduction than providing IE alone for participants
with PTSD. The treatment included 8 weekly sessions. In addition, they explained the benefits
of Imaginal Exposure Therapy. This type of therapy can assist Jasmine overcome her fear of
revealing her sexuality.
Savin-Williams, R., & Dubé, E. (2015). Parental Reactions to Their Child's Disclosure of a
Gay/Lesbian Identity. Family Relations, 47(1), 7-13. doi:10.2307/584845
In this article it discussed, an study that examined parents reactions to their child identity
development and psychological adjustment following their child revealing their sexuality.
Interviews on parental reactions were administered to 53 parents, and questionnaires on
identity and adjustment were administered to their 53 youth LGBT members. This article was
used as evidence- based how some parents react to their child their revealing their sexuality.
Rutter, L. A., & Brown, T. A. (2017). Psychometric Properties of the Generalized Anxiety
Disorder Scale-7 (GAD-7) in Outpatients with Anxiety and Mood Disorders. Journal of
psychopathology and behavioral assessment, 39(1), 140–146.
https://doi.org/10.1007/s10862-016-9571-9
This article discuss, the psychometric properties of the Generalized Anxiety Disorder Scale-7
with outpatients who suffer with mood and anxiety disorders. This article explained GAD is
classified in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-
5).
Toft, A., Franklin, A., & Langley, E. (2020). ‘You’re not sure that you are gay yet’: The
perpetuation of the ‘phase’ in the lives of young disabled LGBT + people. Sexualities,
23(4), 516–529. https://doi.org/10.1177/1363460719842135
This article explores the lives of disabled LGBT + young people from their perspective, using
their experiences and stories to explore their identities and examine how this links to the
misconception of their sexuality and gender as a phase. he article calls for a more nuanced
understanding of sexuality and gender in the lives of disabled LGBT + young people, which
will help to reduce inequality and exclusion.