George's Case

CP-CC OF PENNY 1

Case Conceptualization (CP-CC) of Penny

John Doe

School of Behavioral Sciences, Liberty University

Author Note

I have no known conflict of interest to disclose.

Correspondence concerning this article should be addressed to John Doe.

Email: [email protected]

Case Conceptualization (CP-CC) of Penny

Case Conceptualization

STEP 1: Identify and List Client Concerns and Any Other Problem Areas

Feeling sad Fatigue Avolition Hypersomnia Parental divorce Joint custody Elevated PROMIS Emotional Distress- Depression Score	Low self-worth Low grade performance Drop in attendance Worry about sister Fear of visiting a friend High parental conflict Elevated BDI-II score Parental conflict	Worry about parents Feels lonely Withdrawal from friends Potential discrimination A friend in a car accident Infidelity Feels “helpless”

STEP 2: Organize Concerns Into Logical Thematic Groupings Descriptive-Diagnostic Theme Used F32.1 Major depressive disorder – feeling sad, fatigue, avolition, hypersomnia, low self-worth, avoidance, helpless, false guilt Z63.5 Disruption of family by separation or divorce – parental divorce 2 months ago, high conflict, affair, joint custody Z60.5 Target of (perceived) adverse discrimination and persecution (provisional) – “Black kids can’t get a break”

STEP 3: Theoretical Inferences: Attach thematic groupings to Inferred Areas of Difficulty Maladaptive thoughts (CBT) Maladaptive thinking in the following areas: the false guilt of parent’s divorce – “I caused my parent’s divorce,” perceived fear of visiting a hospitalized friend, and poor view of self as “helpless” Maladaptive behavior (CBT) Maladaptive behaviors in the following areas: Withdrawing from relationships (isolation), avoiding locations (hospital, school), sleeping more, and not engaging in enjoyable activities.

STEP 4: Narrowed Inferences and Deeper Difficulties Deepest Negative Distortion (CBT): I am “helpless”

Case Conceptualization Narrative

Using a CBT lens (Beck Institute, n.d.; Murdock, 2017), Penny’s core maladaptive belief is helplessness which is driving her maladaptive thoughts and behaviors resulting in some of her current problems. Penny has expressed sadness, which can be healthy, but sadness, crying, avoidance as well as other maladaptive activities are driven by cognitive and prediction errors of reality. These cognitive errors or automatic thoughts (“It’s all my fault”) are driven by faulty core beliefs or interpretations of the world based on Penny’s belief she is the one who is the source of her parent's conflict and divorce and helplessness to change her circumstances. This may be the rationale for the avoidance of her friend and the hospital as well; she is powerless so why try. Penny attempts to evade triggering her core belief of helplessness by using avoidance behaviors such as shunning parents, hospital, school, and engaging in hypersomnia; the client is using her compensatory behaviors based on her conditional assumptions e.g., if I avoid, then I am in control and I will not feel helpless.

References

Beck, J. (n.d.). Essentials of CBT: The Beck approach. Course Manual. Beck Institute.

Murdock, H. L. (2017). Theories of counseling and psychotherapy: A case approach (4th ed.). Pearson.