Running head: CASE STUDY: SAM1
Case Study Sam
Jamie Fard
School of Behavioral Sciences, Liberty University
Author Note
I have no known conflict of interest to disclose.
Correspondence concerning this article should be addressed to Jamie
Fard Email:jfard@liberty.edu
CASE STUDY: SAM2
Abstract
Sam's psychological issues are the focus of this case study. The goal is to determine what
significant issues are bothering her and to identify potential solutions. The diagnostic
impressions are based on the information presented and recommended treatment options.
Fatigue
Mood swings
Hallucinations
Suicidal thoughts
Symptoms
Moods of sadness
CASE STUDY: SAM3
DSM-5 Diagnostic Criteria: Bipolar I
Disorder: Current or Most Recent Episode.
Case Study Sam
Client Concerns
Behaviors
Despair, apathy,
hypersomnia, weariness, loss
of appetite, and inability to
focus
Investing 10 hours every day
in writing a novel
Cut apart from the social
circle
Hearing voices that say, "You
are worthless."
With a sense of hopelessness
and depression, I'm
considering suicide, thinking
"better off if I were dead,"
and looking into painless
death options
Stressors
prolonged mania
Client's Signs/Reported Symptoms:
roommate has threatened
to leave
prolonged mania
depression
I recommend the Mood Disorders Questionnaire (MDQ) for Sam's evaluation. The Mood
Disorders Questionnaire (MDQ) is a self-report tool used to screen for bipolar disorder. MDQ is
a good tool for identifying and monitoring symptoms of bipolar disorder. If the screening comes
back positive, Sam's doctor may decide if she has mania or hypomania and if she needs more
testing and treatment based on how bad her symptoms are (Wang et al., 2020).
Diagnostic Impression
Sam is diagnosed with Depressed: Bipolar I Disorder: Current or Most Recent Episode.
Signs and Symptoms.
Assessment
CASE STUDY: SAM4
Criterion A: A certain time of high, extended,
or agitated mood, as well as unusually and
continuously enhanced activity or energy,
lasting at least a week and present for the
majority of the day, practically every day.
Criterion B: There is a marked deviation
from the individual's typical pattern of
behavior at the time of mood disturbance and
increased energy or activity, as evidenced by
the presence of three or more of the following
symptoms,1: Racing thoughts,2:Decreased
need for sleep,3:Inflated self-esteem,
4:Excessive talking, 5:Increased goal-directed
activity or psychomotor agitation, 6:Over-
involvement in activities with painful
consequences,7:Distractibility (reported or
observed)
Racing thoughts (flight of ideas),
Sam said, "I had experienced the most energy
I've ever had in those ten days; I finished all
my coursework; I cleaned my house; I wrote
a novel; I went out with friends."
The client claims, "I viewed myself as the
most significant novelist ever lived during
those 12 days." The client's roommate adds
that the client believes she is a fantastic
author and promises to remember the
roommate when she becomes famous. During
the first manic episode, the client reported
feeling fantastic and only needing five hours
of sleep. During the second manic episode,
the client said he slept for just one or two
hours per night, but she had plenty of energy.
She remained talkative throughout the 12
days, according to her roommate (12-day
manic period). During his second manic
episode, the client wrote for 10 hours a day,
proving that she was serious about writing
both a book and a movie script. The client did
all her schoolwork during "high" times. The
client showed no interest in English or a
desire to write. Friends of the client have
mentioned
Criterion C: The mood instability impairs Friends have pointed out the difficulties
social or vocational functioning, requires posed by the client's mood fluctuations and
hospitalization to prevent self-harm, or has urged her to get professional aid.
psychotic symptoms.She has been having suicidal thoughts,
contemplating suicide, and researching "pain-
free techniques." Her roommate requested
that she get evaluated after she complained of
hearing voices in her head.
Criterion D: There is no evidence to suggest She was not under the influence of any drugs
that the physiological effects of a drug or any or prescription medications. No medical
other medical condition caused the eventhistory or prescription records were found.
Other DSM-5 Conditions Considered
The alternating manic and depressed phases suggest a diagnosis of Bipolar I Disorder.
Since the mania, she does not fulfill the criteria for Bipolar II. The schizoaffective disorder was
Key Issues for Treatment
·Suicidal Ideation
CASE STUDY: SAM5
ruled out because she did not meet Criterion A. Schizophrenia disorders should be cleared before
a Bipolar diagnosis is made in adolescents and young adults (Fu-I et al., 2020).
Developmental Theories and/or Systemic Factors
Sam, at age 25, is taking on the challenging task of completing a master's degree program. Since
Sam is the eldest of her siblings, I cannot help but think about Alfred Adler's birth order
hypothesis. If she accepted her responsibility as the eldest child, she might be more ambitious
and responsible. If she does not, she may be an anxious, insecure girl. Even though I know the
data does not support Adler's theory, it is the one that keeps popping into my head.
A negative factor is withdrawing from one's social circle. Sam's parents divorced while she was
an adolescent, and they both eventually remarried. It has been two years since she moved to a
nearby state, far away from his folks. However, the fact that her mother and sister suffer from
undiagnosed depression is perhaps the most significant influence. Given that neither parent is
receiving treatment for their depression and Sam has no idea whether her depressive episodes are
linked to her bipolar condition, it is feasible that Sam's risk of being diagnosed with the disease
is increased by a factor of ten (American Psychiatric Association, 2013).
Multicultural and/or Social Justice Considerations
According to Elmadani, A. (2020), "Therapists play a crucial role in advancing social justice in
the counseling field by working on behalf of minorities and disadvantaged groups to have a
voice, get benefits, and access resources" (Change et al., 2014). Unfortunately, Sam's current
difficulties appear unrelated to any of these factors.
Treatment Recommendations
CASE STUDY: SAM6
·Mania with Psychotic Features
·Depression
Recommendations for Individual Counseling
Clients diagnosed with Bipolar Disorder have shown improvement in their symptoms via the use
of cognitive-behavioral therapy (CBT), which has also proven effective in preventing relapses of
depression episodes. Clients with Bipolar Disorder who also get mood-stabilizing medication
have a greater chance of seeing positive outcomes from CBT (Scott et al., 2022).
Family-focused therapy (FFT) uses attachment-based methods, which have alleviated symptoms
and lessened cycles of mania and depression (Wittenborn et al., 2021).
Clients with Bipolar Disorder can benefit from Mindfulness-Based Cognitive Therapy (MBCT).
Increased mindfulness of one's thoughts, actions, bodily sensations, and emotions has been
linked to positive behavioral changes in MBCT patients (Hanssen et al.,2021). Including the
client's religious beliefs and practices in the treatment plan is possible when implementing
MBCT. One can include contemplative prayer and other spiritual practices in any mindfulness
treatment.
Methods rely on common medications used to treat bipolar disorder, including mood stabilizers
and antidepressants, yet twenty-five percent of patients on medication experience a relapse
within the first year (Marzani & Neff, 2021).
Specific Considerations
When dealing with a client in crisis, shifting your attention from assessment to treatment
planning is essential to ensure the client's safety. This includes learning where the client typically
hangs out, what they are likely doing, how detailed their plans are, and with whom they will be.
Then, make a call to find out what to do next for the customer. Helping a customer feel safe and
CASE STUDY: SAM7
secure during a crisis can be accomplished by offering reassurance, assistance, and/or credit.
When a client is in crisis, time is of the essence, and this is especially true when the client has
unidentifiable triggers, as is the situation with Sam. Before this, she had discussed suicide
ideation and planning. Even if she is entirely down in the dumps, she might be able to pull
together a strategy in less than ten minutes.
Last Na
CASE STUDY: SAM8
References
Me, F. M. (Year). Article Title. Journal Title, Pages From - To.
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CASE STUDY: SAM9
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