Psychological Case Study: Ms. Smith
PSY 472 - Clinical Psychology
Arizona State University
Part I: Reason for Referral
Ms. Smith was referred to Dr. Liam due to the risk of self-harm. Ms. Smith was found by the
local police wandering around her ex-boyfriend's apartment complex, causing a commotion
among the residents. The residents called the police and reported that Ms. Smith was
screaming, pacing, and sobbing uncontrollably. After the local police found Ms. Smith,
Captain Logan arrived and interviewed her. Ms. Smith reported she recently moved into
town and had a boyfriend named Frank, who broke up with her a couple of hours before the
commotion. Frank said that Ms. Smith was lovely initially but quickly shifted into
demanding, impulsive, and intense. The residents of the apartment complex, the local
police, Captain Logan, and Frank, Ms. Smith's ex's boyfriend, are sources of data that can be
used to determine Ms. Smith's condition.
Part II: Background Summary
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
Ms. Smith is a 32-year-old biracial female with a high school diploma and currently has a
new job as a waitress. Ms. Smith recently moved to town, but she is originally from
Memphis, TN. This is presently her fourth attempt to make a better life in 18 months. She
reported a troubling childhood with substance abuse, physical abuse, negligence, and
poverty. Ms. Smith seems to be alone and without any external support. Her mother stated
that she never sought prenatal care due to financial issues and fear of doctors. Although Ms.
Smith physiologically seems okay, it is unknown if she suffered any prenatal injuries that
may have affected her. Ms. Smith stated that her interests are art, reading, music, and
songwriting. No illegal substance abuse was reported, but she did report slight alcohol
abuse. Ms. Smith acknowledges her mood swings and intensity.
Consequently, she has a restraining order against a past relationship partner that requires
her to keep at least 100 feet away from that person. Ms. Smith, however, was incapable of
assuming the responsibility of that failed relationship. She stated the relationship failed
because the person was married. Ms. Smith reported thought impairment, impulsivity,
hopelessness, suicidal ideations, guilt, and abandonment issues. However, she seemed
erratic, depressed, impulsive, severe self-loathing, and agitated.
Part III: Assessment Data
A tentative diagnosis can be determined by targeting the emotional and cognitive
capabilities. Ms. Smith does not show any signs of learning or mental impairment.
Therefore, the assessment data can be collected through interviews, the patient,
observation, police reports, psychological testing, and primary data sources. A personality
test can be beneficial in Ms. Smith's situation
A Personality Test such as Millon Clinical Multiaxial Inventory Fourth Edition (MCMI-IV) is
best to approach personality disorders. The MCMI-IV is a test constructed to measure the
personality traits found within a person (The Millon clinical multiaxial inventory-IV (MCMI-
IV) 2015). This test comprises 195 items that take approximately 30 minutes to complete
(Psychological Testing Overview, 2019). The test should give an insight specifying Ms.
Smith's personality realm and help determine a diagnosis. In addition to the personality test,
rating scales and self-ratings can provide a good understanding of how Ms. Smith perceives
her situation.
Rating scales are used to rate feelings such as sadness or hopelessness. The patient will
grade themselves using a scale; it can be numerical such as 0-10 or any other scale. The
patient Psychological Case Conceptualization
will grade their feeling using the scales. For example, a question may be, "during the past
two weeks, how often did you feel sad?" The patient then will have to select from 0 being
no days at all or more than five days a week (Korotitsch & Nelson-Gray, 2003). Although
primarily used in children (Psychological Testing Overview, 2019), rating scales will provide
an insight into Ms. Smith's thoughts. This will help determine the severity of Ms. Smith's
situation and whether she is at a dangerous point where she can be a danger for herself or
others.
Part IV: Tentative Diagnosis
Using the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5), Ms.
Smith seems to fit within personality disorders cluster B, specifically borderline personality
disorder. This personality disorder is characterized by erratic mood swings, impulsivity,
negative self-image, erratic temper, hopelessness, identity impairment, fear of
abandonment, and more than anything, unpredictability (Ruben, 2015). Ms. Smith displays
many of these symptoms.
Borderline Personality Disorder (BDP) occurs in 2% of the population (Ruben, 2015). Α
model of personality disorder shows that children who have been separated from parents
or lived with dysfunctional parents, such as drug addicts, are more likely to develop BDP
(Ruben, 2015). Ms. Smith's parents were both heroin addicts. At eight months, her mother
abandoned her and left her with her just out of prison dad. This can explain the attachment
issues and codependency Ms. Smith displays, along with the feelings of hopelessness and
self-loathing. Additionally, to unstable parents, the model shows that randomly punished
children are also more likely to develop BDP (Ruben, 2015). Ms. Smith stated that her
stepmother used to beat her regardless of what she did, whether it was good or bad.
Moreover, BDP is a disorder related to the personality trait of neuroticism (Crego & Widiger,
2022). Neuroticism is characterized by emotional instability, impulsivity, self-destruction,
rageful, and many other characteristics. Ms. Smith showed emotional instability when found
walking around sobbing uncontrollably, also during her interview; she was often tangential.
Impulsivity is seen in Ms. Smith's case when she acts without thinking in rageful acts and
immediately regrets it, such as when she sent Frank all those text messages and regrated
doing it.
Ms. Smith displays erratic and self-destructive behavior most of the time. For example,
besides her suicidal ideations, Ms. Smith states she had unprotected sex with various men
before meeting Frank. Unprotected sex is a form of self-destruction since she doesn't know
if her sexual partners carry any sexually transmitted diseases. Her behavior is erratic since
she is entirely unpredictable and can explode in violence at any time. Ms. Smith mentions
during her interview that if she felt rejected or judged, she would have violent moments and
could hurt someone. Also, she was found uncontrollably sobbing and yelling for no apparent
reason after Frank broke up with her. These are examples of erratic behavior; her behavior
is not consistent and prone to changes.
Part V: Treatment Recommendations
Ms. Smith would benefit from humanistic-existential approaches such as person-centered
counseling and cognitive behavioral therapy. Humanistic psychology aims to become aware
of the self and understand how it can change (Neukrug, 2015). People with borderline
personality disorder react well to positive reinforcement (Ruben, 2015). "In most cases,
reinforcement-centered feedback approaches can even streamline errorless learning to
optimize the speed and mastery of nearly any complex verbal or nonverbal set of skills"
(Ruben, 2015).
Person-centered counseling satisfies the need for positive regard. In Ms. Smith's case, she
has never received that genuinely; therefore, it can be very beneficial to undergo this type
of therapy. Additionally, person-centered counseling can help improve her self-esteem by
teaching her the organismic valuing processing (Neukrug, 2015).
Cognitive-behavioral therapy (CBT) includes operant and classical conditioning and
experimental psychology (Newman, 2017). CBT teaches patients coping skills and is more
flexible with their thoughts. This helps reduce the times the patient goes into despair
(Newman, 2017). Ms. Smith needs to learn coping skills to cope with her mother's
abandonment and the abuse she endured from her family. This healing process and moving
on can help reduce Ms. Smith's erratic behaviors and BDP episodes.
Part VI: Considerations
The hospital referred Ms. Smith due to the immediate risk of self-harm. Ms. Smith is alone
in a new city with no support. Ms. Smith's mother abandoned her, and her father is absent.
Both parents were drug addicts, and it is unknown if the mother stopped consuming drugs
during pregnancy and had no prenatal care due to severe poverty. There is no evidence of a
relationship with any of her half-siblings. Ms. Smith seeks to be better, after all
Ms. Smith is a biracial woman that grew up in severe poverty and abuse. She was
malnourished and neglected by her father and a stepmother that beat her. Ms. Smith
attempted to play band, and there was no family support; on the contrary, her ideas were
turned down. Ms. Smith attributed the severe poverty and abuse to the consumption of
illegal substances by both her father and stepmother.
Ms. Smith was cooperative during her interview, although in some moments of
defensiveness and erratic behavior, she cooperated by answering the questions. However,
there can be issues with the data acquisition since Ms. Smith's emotional instability can
cause bias. Additionally, her mental status at the moment of the commotion may have
interfered with her answers.
Part VII: Conclusion
Ms. Smith, a 32-year-old biracial woman, was referred for evaluation due to immediate self-
harm risk. After evaluating Ms. Smith's background, there was evidence about multiple
dysfunctional factors such as parental abandonment, parental abuse, neglect, substance
abuse, and severe poverty. After collecting and assessing the data, Ms. Smith displays
cluster B personality disorder characteristics, borderline personality disorder.
To aid Ms. Smith's neurotic tendencies, I recommended existential-humanistic therapy
approaches such as cognitive-behavioral therapy and patient-centered therapy. This therapy
style will help Ms. Smith's need for positive reinforcement acceptance and will provide Ms.
Smith the tools to learn healthy coping skills to improve her quality of life.
