Assignment

Sandra, a 43-year-old female, Italian American, is seeking therapy because she recently started having panic attacks. After a period of working adjunct at several universities; Sandra was approached by a prestigious university last year this is also around the time her son Michael, 11 graduated from elementary school. Sandra had her first panic attack 4 months ago while at the theatre with her partner Candice. She reports feeling suddenly overwhelmed and had to leave in the middle of the performance. Since then she has had an attack every 2 -4 weeks. (While Sandra suggest that there are not identifiable triggers you note that the attacks seem to center around her reflection of the various transitions that she in the family are going through). Sandra’s partner Candice is an accountant, and reports that life has been going well for Sandra: she was recently promoted to rank of full professor at a prestigious university and their child Michael is doing well in school and will start middle school in the coming months. Sandra reports no particular stress at the moment and is unsure why she is having these attacks. Her only prior history of mental disorders was anorexia as a teen as a way of coping with being sexually abused by an uncle while growing up.

Client Introduction:

· Sandra 43 y/o female, Italian American, Professor of Dance

· Candice: 40 y/o female, Hispanic American, Accountant, met Sandra 15 years ago while out with friends

· Michael: 11 y/o male, loves spending time with his mothers, doing well in school looking forward to going to middle school

Presenting Concerns:

· Sandra: Reports not knowing why she is having panic attaches, reports that life is otherwise “fine”. She is excited about her new position this was a personal goal for her.

· Candice: Believes that Sandra’s panic is related to her desires for perfectionism; “she wants everything to go well at this job and is concerned about implementing structure in the home so that things are not thrown off by her new position”. Also, Candice reports that Sandra is stressed by Michael’s transition into middle school. “He and Sandra are very close and in her adjunct position she was able to spend a lot of time with him; now he is seeking autonomy and is not desiring connection to his parents in the same way”. Additionally, she feels that Sandra recognizes that her new job will limit the time she is able to spend with her and Michael.

· Michael: Is happy about going to middle school, feels that Sandra “always wants things to be perfect” and is overly concerned about him

Extended Family

· Sandra’s friend believes Sandra is having an early mid-life crisis with Michael getting older and meeting her last personal goal: tenure

Background Information:

· Trauma History:

· Sandra reports being sexually abused by her uncle as a child growing up. While her parents enrolled her in treatment for the eating disorder, they did not believe that she was abused.

· Substance Use:

· There are no substance use issues

TEMPLATE USE JUST TO GUIDE OR GIVE IDEA

· Unit of Treatment: Who will be included in therapy?

· Goals for Treatment: What are your goals for treatment given the model's primary objectives?

· Presenting Problem: What is the primary conflict that the family/couple/individual is hoping to address?

· Circular Hypothesis (Case Conceptualization):

·  Problem Analysis: What are the behaviors, emotions, and thoughts that contribute to the problem?

· Assessment of Baseline Functioning: What is the frequency, duration, and severity, of the problem behaviors

· Mutually Reinforcing Behaviors: What are the behaviors that are exhibited by each member of the system that reinforces the problem with the system

· ABC Theory: What are the  A ctivating Events,  B eliefs (meaning created around the event),  C onsequence (emotion or behavior)

· Core Beliefs/Family Schema

· Couple Cognitions (if applicable)

· Additional Points of Conceptualization: Outline legal and ethical considerations, issues of safety or crisis, client strengths, spirituality, physical illness, and/or diversity. That may impact your work with this family.

· Interventions and Treatment: Outline treatment goals and devise a treatment plan using specific strategies and techniques. Describe the treatment plan and strategies in detail and explain your reasons for choosing the strategies used and why these will help reach therapy goal(s).