CEFS 521 LIBERTY UNIVERSITY Case Study Assignment Amara 2025.docx

AMARA CASE STUDY 1

AMARA CASE STUDY ASSIGNMENT

Department of Counselor Education and Family Studies, Liberty University- COUC 546

Author Note

I have no known conflict of interest to disclose.

Correspondence concerning this article should be addressed to Student Name

@liberty.edu

Client Concerns

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Headache Alcohol Consumption Challenges at work

Assessment

Amara displayed symptoms similar to Generalized Anxiety Disorder. The Generalized

Anxiety Disorder Assessment (GAD-7) will be used to corroborate these findings. The

Generalized Anxiety Disorder Assessment (GAD-7) consists of seven measurable classifications

(Rosellini et al., 2018). The reported signs and symptoms over the past two weeks will

determine how the questions are applied or asked, as each question has multiple answer

options. According to Rosellini et al. (2018), possible responses would be several days or not at

Amara’s presented symptoms match six of the criteria of Generalized Anxiety Disorder

(GAD). One of the characteristics of this disorder is the inability to control anxiety, which results

in excessive worrying, which is similar to Amara’s presented symptoms. As stated by the

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American Psychiatric Association (2022), the ICD-10 code for Generalized Anxiety Disorder

(GAD) is F41.1.

Substance-Induced Anxiety Disorder, panic disorder, and major depression could also be

the second diagnosis collaborated with the presented symptoms as reported by Amara. The

American Psychiatric Association (2013) named the ICD-10 code for major depression, also

known as clinical depression, as F33.9,. The ICD-10 code for panic disorder, clinically known as

panic disorder/anxiety disorder, is F41.0. However, Substance-Induced Anxiety Disorder would

require an additional assessment relating to the effect of alcohol on Amara’s anxiety.

disruption

Experienced tiredness for a period of 12 months or

more.

Difficulty falling asleep.

Inability to stay asleep after 5-6 hours of being

asleep.

Criterion C: Aching of muscles in the

entire body.

Experiences headaches as much as 3-4 times a week, in

adittion to pain in the neck and shoulder areas of her

body.

Experiences of increased tension lasting 24 months or

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Experiences of lack of control of the worries or anxiety.

Other DSM-5-TR Conditions Considered

Two possible diagnosis options other than major depressive disorder would be Major

Depressive Disorder with anxious distress (F23.9) and major depressive disorder (F33.9). The

reason for this consideration is that the presented symptoms meet the criteria of (F23.9), such

as agitation, anxiety, and her inability to concentrate. However, for her to be accurately

diagnosed (F23.9), she needs to present with five or more symptoms. In this case study, Amara

presented three symptoms. Therefore, she does not fit this diagnosis.

(F33.9) was also considered as a possible diagnosis due to partially presenting symptoms

like challenges. Falling and staying asleep, or lack of motivation in activities that she would

her relationships with her family members, her children, and grandchildren.

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The application of Erik Erikson’s theory of psychosocial development in the Amaras case

could be applicable to the Ego vs Integrity stage. As stated by Shane (2019), during the Ego vs.

Integrity stage, the client evaluates their past accomplishments, present and previous

relationships, and the overall evolvement of their being (Shane, Estelle. 2019). This stage is

considered the eighth stage, which usually occurs from age 65 to their time passing.

During this stage, a stronger bond is formed with family members. The family system

theory posits that during this stage, the client’s behaviors and feelings have an impact on each

other (Erdem & Safi, 2018). In Amara's case, the responsibility of caring for her mother and

children at the same time could cause stress on her behaviors and feelings, which could, in turn,

impact her relationship and place undue stress on her.

In Amara's case, counseling is recommended for her and her family, which could help in

Amara is originally from South Asia. Culturally, family members are tasked with specific

roles and expectations (Kramer, E.J., Kwong, K., Lee, E., Chung, H., 2002). Her cultural identity

and expectations, in addition to the task of caring for her mother and children, could lead to

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pressure and stress on personal relationships due to obligations to her family. Amara could also

be experiencing a lack of encouragement from family due to excessive worrying.

Although Amara may try to conceal it, she is unable to hide her frequent worrying from

her family and friends. Amara exhibits awareness of her symptoms, as reflected in her

mentioning that her mother experienced the same symptoms and also mentioned that it

became worse as she grew older. Culturally, counseling is not a norm in her culture; as she

mentioned, due to the stigma attached to mental illness, Amar mentioned that her mother

never utilized counseling; therefore, she is unaware of the benefits of counseling. The stigma

surrounding mental health was reinforced by (Kagawa-Singer & Blackhall, 2001), stating that

there is a lot of stigma surrounding mental health and treatment in South Asian communities.

Amara identified as Hindu, stating that her religious and spiritual orientation is critical to

her. Amara's spiritual and religious beliefs could also influence seeking treatment, symptom

mindfulness and yoga. Considering her cultural orientation and background, a holistic treatment

that incorporates yoga will be beneficial in helping to reduce stress, and it’s acceptable in her

One recommendation that can be effective in Amara's case is the use of Cognitive

Behavioral Therapy (CBT). This treatment recommendation will be helpful in managing

generalized anxiety disorder and other anxiety disorders (Evans, 2016). Several studies have

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explored the use and benefits of CBT on clients with generalized anxiety disorder. CBT could be

effective in helping Amara reframe her mind to create a positive mind and change negative

thoughts and compulsions into positive ones.

Another technique that could be useful, which also supports her cultural belief and

orientation of Hinduism, is the use of mindfulness, psychotherapy, or meditation. These

techniques will be effective because of Amara's religious beliefs. These techniques could be

incorporated into therapy sessions as requested by Amara. Mindfulness will help Amara focus

on the present. Also, it will help the client to examine herself both internally and externally.

Mindfulness technique encourages self-reflection (Sharma et al., 2012).

At this time, this writer would recommend this client for medication evaluation.

However, no medications will be prescribed because the client is currently taking serotonin

reuptake inhibitor (SSRI) and Paxil (Paroxetine). The client reported that she started taking this

medication a couple of weeks ago, and she reports she is still currently monitoring the effects of

the medication to determine if the dosage needs to be increased or not. Paxil (Paroxetine) can

also be used to treat disorders such as OCD or major depressive disorder.

during the onset of the counseling session. This information provided an opportunity for the

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counselor to consider the appropriate treatment technique using a culturally responsive and

ethically grounded lens. It is important to recognize and respect a client’s worldview, whether

spiritual or otherwise, as it will help to promote an inclusive and empowering therapeutic

setting (Sue et al., 2019). The counselor has a responsibility to understand how beliefs influence

the client’s daily life, values, and decision-making process when the client introduces their faith

and cultural traditions during counseling sessions.

Hook et al. (2020) recommend that counselors take responsibility for understanding the

cultural expressions of suffering, seeking assistance behaviors, and coping strategies. A

counselor with mere awareness of cultural competence is not enough; however, it is

recommended that a counselor engage in ongoing self-reflection, continuous education, and the

application of culturally responsive techniques. In Amara’s case, especially with an Asian

background, it has been reported that people opt for family-based solutions due to the stigma

attached to mental health, which poses a barrier to seeking mental health services (Kim et al.,

2020). It is crucial that counselors acknowledge and address these cultural dynamics, providing

more respectful and effective care.

lead to the client sharing valued and sensitive information (Fisher-Borne et al., 2015).

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Another important consideration will be developing rapport with the client during the

intake session, as this is important for collecting culturally sensitive information. Creating a safe

and secure space, in addition to utilizing active listening skills, can help the counselor ask

culturally relevant questions that promote a therapeutic alliance. This information could also

help to inform the treatment plan in a way that aligns with the client’s values (Gallardo, 2021).

In conclusion, culturally competent counseling requires strict adherence to

recommended ethical practices, awareness of the client’s cultural beliefs and orientation, and

client-centered care. Acknowledging the benefits of cultural and spiritual values could

significantly impact how the client engages in sessions and ultimately influence treatment

outcomes.