Benchmark Case Presentation Paper Assignment
Benchmark Case Presentation Paper Assignment
School of Behavioral Sciences, Liberty University
Part 1: Intake Information
LISA CASE STUDY
Identifying Data:
Date of initial assessment 11/20/2025
Benchmark Case Presentation Paper Assignment
Lisa Holder is a 39-year-old married Hispanic female. She is currently a stay-at-home mother, as
she gave birth six months ago. Before that, she worked in finance in a high-demand job, which
she loved.
Presenting Problem
Lisa came in for an assessment because she had been feeling upset and withdrawn from
family and friends. Since her baby was born, she has been unusually tired, feeling down, and
lacking motivation to do anything. She shared that she used to be “the life of the party,” but
now even leaving the house is difficult. Lisa is seeking help because she is afraid, she may not be
able to care for her daughter as she should, given how exhausted and low she feels.
“Before, I was working 12 hours a day and going out all the time, but since I went on maternity
leave, I can’t function. I don’t want to do anything or see anyone. I need help to feel like myself
again.”
Lisa husband tries to help, and they even hired a nanny to give her some alone time, but
she still can’t bring herself to leave her daughter. Lisa reports that she wants to see her friends
and family, yet as soon as they arrive, she gets anxious and can’t wait for them to leave. When
they don’t call or visit, Lisa finds herself blaming the baby, thinking they don’t want to see her
now that she is a mother. “Sometimes I cry because I feel alone, but I also get frustrated when
anyone is around.”
Part II.: Clients Biopsychosocialspiritual Assessment
Biological assessment:
Lisa Holder is a 39-year-old Hispanic female who has been married for six years and has
one child, a 6-month-old daughter. She reports that her sleep schedule has been significantly
disrupted due to her baby not sleeping through the night. As a result, Lisa is awake for most of
the night and sleeps during the day whenever she gets the chance.
Lisa appears to be in generally good physical health. Prior to giving birth, she exercised
daily, but she reports that she is no longer able to maintain a regular exercise routine. She eats
less than she used to and has not gained extra weight, but she feels physically weaker due to
the lack of consistent activity. Currently, her only regular physical activity is walking for about an
hour each day with her baby in the stroller.
She is only taking vitamins at this time. Before her pregnancy, Lisa was prescribed a
mood stabilizer, which she began taking in her twenties to help manage emotional
Benchmark Case Presentation Paper Assignment
dysregulation. She reports that the medication was helpful in supporting her functioning and
preventing her emotions from becoming overwhelming. Lisa has not been taking this
medication since she got pregnant.
Psychological Assessment:
Lisa reports that she previously saw a psychiatric provider on a monthly basis to manage
her medication needs. She also attended therapy for several years in her early twenties, but
discontinued treatment once her medication became effective and her symptoms felt
manageable. She has a history of being diagnosed with an anxiety disorder, and she states that
the medication helped her maintain emotional stability. She eventually stopped taking her
medication because she felt she no longer needed it and had concerns about potential effects
on her pregnancy.
Lisa denies experiencing any major trauma and describes her childhood as generally
normal. However, she noted that her mother engaged in concealed drinking throughout Lisa’s
life. Lisa did not fully recognize this pattern until returning home from college one Christmas,
when she noticed the smell of alcohol on her mother. When she confronted her, her mother
avoided the conversation, and the family chose not to address it further.
Regarding substance use, Lisa reports on occasional alcohol use in the past. During her
high-demand job, she would drink almost daily due to frequent after-work socializing in bar
settings. She also experimented with cocaine a few times but did not enjoy it and did not
continue using it.
Lisa has two younger brothers who live on the West Coast; she maintains weekly contact
with them by phone. Aside from her mother's ongoing concealed drinking, there is no reported
history of mental illness in the family. Lisa describes her parents’ relationship as “fine”—they did
not show affection or playful interactions, but they also did not fight or argue. They appeared
stable but emotionally distant.
Social Assessment
Lisa grew up in a Hispanic neighborhood and reports having positive relationships with
her neighbors. She states that she had many friends during childhood and adolescence, some of
whom she remains close to today. In her twenties, when she began therapy and later started
mood-stabilizing medication, she felt embarrassed and fearful of judgment. She disclosed her
mental health treatment only to two close friends whom she trusted. Her family remains
Benchmark Case Presentation Paper Assignment
unaware of her past mental health treatment, as she believes they would minimize her
experience or treat her differently.
Although Lisa was born in the United States, she identifies strongly with her Hispanic
background. Her mother is Colombian, and her father is American. Lisa describes her mother as
fun, friendly, and well-liked by neighbors. In contrast, she reports that her father has always
been distant and openly prejudiced toward people who are not American, something she finds
“strange considering he married my mom.” Lisa maintains a good relationship with her two
younger brothers, who live on the West Coast and have families of their own. They stay in touch
weekly by phone.
Lisa married in her early thirties to an American man and reports that she is generally
happy in the marriage. She describes her husband as helpful and supportive. However, she
acknowledges that she is not affectionate with him and rarely expresses how she feels, stating,
“He should know how I feel, I shouldn’t have to tell him.” She shares that she has always been
emotionally distant in the relationship, though she loves him in her own way. Since the birth of
their baby, she has become even more distant and often avoids conversation with him.
Lisa holds a master’s degree in finance and describes herself as an average student,
noting that her medication helped her succeed academically. She later secured a well-paid job
and became the primary breadwinner in the household. She did not mind this role, but since
taking maternity leave, her husband has taken overpaying the bills, requiring them to cut back
on expenses, something Lisa finds difficult.
Lisa reports that she loved her job and has the option to return at any time. One of her
main motivations for seeking this assessment is her desire to “get back to her old self” so she
can return to work. She misses the sense of freedom, independence, and security that her job
provided. She expresses financial concerns, stating that her husband’s income alone is not
enough to maintain their previous lifestyle.
Spiritual Assessment:
Lisa reports that her mother is Catholic and actively involved in her church community,
attending Sunday Mass regularly. Her father also attends services with her mother, though Lisa
is unsure how connected he feels to the church itself. Lisa does not currently attend church on
her own, but whenever she visits her parents, she joins them for Mass and enjoys reconnecting
with members of their community. She states that she misses the sense of belonging and
Benchmark Case Presentation Paper Assignment
support she felt there, describing it as a comforting environment where she felt part of
something larger than her immediate family.
Lisa has attempted to attend churches in her current neighborhood but did not experience the
same level of warmth or connection and therefore stopped going. She shared that when her
daughter turns one, she plans to resume looking for a church community. Lisa wants her
daughter to have the same welcoming, supportive environment and sense of community that
she grew up with.
Part III: Mental Status Exam
Lisa Holder is a 39-year-old married Hispanic female who appears to be of average
weight and in generally good physical health. She arrived to the assessment wearing a black
sweater and jeans. She was well-groomed and carried a light lavender scent, which she
explained she uses to keep her clothes fresh.
Lisa presented as pleasant, approachable, and cooperative. She maintained adequate
eye contact and offered frequent polite smiles; however, her affect appeared somewhat flat,
and her facial expressions did not fully match the positive demeanor she attempted to convey.
At times, she sat slightly hunched forward, which gave the impression of self-protection. She
appeared tired and worn down but tried to maintain an upbeat attitude. As the interview
progressed, she seemed to warm up, and her posture gradually became more open and
receptive. Lisa described her mood as tired, useless, and unmotivated. She reported difficulty
managing her emotions and stated that she “can’t get out of this deep hole” and feels like she is
“sinking.” She shared that she used to be someone who did not get upset easily and made an
effort to stay positive, which she feels is no longer the case. Affect was congruent with her
reported mood, somewhat constricted and fatigued, with underlying sadness.
Her speech was clear, coherent, and appropriately paced, with no evidence of slurring or
mumbling. Expressive and receptive language abilities appeared intact. Thought processes were
logical, coherent, and goal directed. There were no indications of delusions, hallucinations, or
other psychotic symptoms. Thought content was appropriate to the conversation. She
demonstrated intact insight and fair judgment, acknowledging her challenges and expressing
motivation to seek help. Lisa was alert and fully oriented to person, place, time, and situation.
Her memory appeared intact, as she was able to recall past events accurately. Intellectual
functioning seemed to be within normal limits based on conversational assessment.
Benchmark Case Presentation Paper Assignment
Lisa was easy to engage and expressed genuine interest in completing the assessment. She
appeared motivated to “get back on track” and return to work. She showed mild frustration
when discussing her mother’s drinking and her current emotional distance from her husband.
Lisa denied suicidal or homicidal ideation. She stated she would never harm herself because she
worries about who would care for her daughter, expressing doubt about her husband’s ability to
parent alone. She displayed no signs of violent or aggressive tendencies. No concerning
behaviors were observed during the interview.
Part IV: Answer Key
DSM-5-TR Diagnostic Criteria: disorder name and
code number
Client’s Signs/Reported Symptoms from case study:
Criterion A: F43.10Posttraumatic Stress Disorder The past six months she been feeling down and
withdrawn from others.
D. Negative alterations in cognitions and mood
associated with the traumatic event(s), beginning or
worsening after the traumatic event(s) occurred, as
evidenced by two (or more) of the following:
Persistent negative emotional state (e.g., fear,
horror, anger, guilt, or shame). 5.Markedly
diminished interest or participation in significant
activities.
6. Feelings of detachment or estrangement from
others.7.Persistent inability to experience positive
emotions (e.g., inability to experience happiness,
satisfaction, or loving feelings).
Since her baby was born, Lisa has had a hard time
doing anything, including leaving the house or
seeing her friends.
Criterion B: F43.21 With depressed mood Lisa reported she been having low mood and feel
hopelessness.
Depressive symptoms (e.g., low mood, tearfulness,
or feelings of hopelessness) are predominant.
Criterion C: F43.23 With mixed anxiety and
depressed mood
She feels overwhelmed when people visit, but
depressed when they don’t..
A combination of depressed mood and anxiety
symptoms is predominant.
Criterion D: F94.1 Reactive Attachment Disorder
Benchmark Case Presentation Paper Assignment
B. A persistent social and emotional disturbance
characterized by at least two of the following: 1.
Minimal social and emotional responsiveness to
others. 2. Limited positive effects. 3. Episodes of
unexplained irritability, sadness.
Lisa feels withdrawn from others, has little to no
enjoyment, and experiences unexplained sadness
and irritability around friends and family.
Part V: Treatment Consideration
Two Counseling Approaches:
The primary clinical concern in Lisa’s case is her postpartum depression (PPD), as most of her
difficulties began after the birth of her baby. One effective counseling approach for addressing
PPD is Cognitive Behavioral Therapy (CBT). Clinical practice guidelines consistently recommend
evidence-based psychotherapies such as CBT as first-line treatments for individuals experiencing
postpartum depression (Lieshout et al., 2023).
A second appropriate counseling approach is Interpersonal Psychotherapy (IPT). This modality
can help Lisa rebuild her social connections, strengthen her relationship with her husband, and
address the interpersonal challenges that have emerged since becoming a mother. Lisa also
expressed missing the sense of community she had growing up, which IPT could help her
explore and reestablish. Research indicates that IPT can effectively improve depressive
symptoms and interpersonal functioning in women with postpartum depression. PPD is defined
in the DSM-5-TR as the onset of depressive symptoms—such as low mood, anhedonia, sleep
and weight changes, fatigue, guilt, impaired concentration, or suicidal ideation—within 4 to 24
weeks postpartum (Suryawanshi & Pajai, 2022; Wang et al., 2023).
Medication Consideration:
I would recommend taking anti-depressant medication again as Lisa’s benefited from it in the
past. She may experience significant relief from antidepressant medication as part of a
combined treatment plan. A growing body of literature suggests that postpartum depression is
a subtype of major depressive disorder that responds similarly to antidepressants (Fitelson et
al., 2010).
Based on current research, Zuranolone appears to be one of the safest and most effective
pharmacological options for Lisa. Zuranolone represents a different therapeutic approach by
selectively modulating the GABAA receptors. Unlike traditional antidepressants that may act
through multiple neurotransmitter systems and have a delayed onset of action, zuranolone's
mechanism of action is more direct and may offer a faster therapeutic effect (Nashwan et al.,
2024).
Benchmark Case Presentation Paper Assignment
However, several factors must be considered and should be addressed collaboratively with Lisa
and a prescribing provider to determine the safest and most effective course of treatment.
Spiritual Integration Consideration:
As Lisa shared how much her faith and church community mean to her, and how deeply she
misses having a place where she feels connected. I would intentionally incorporate her
spirituality into her counseling. This focus would likely benefit her and may support a more
meaningful and effective healing process.
References:
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental
disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Publishing.
Fitelson, E., Kim, S., Baker, A. S., & Leight, K. (2010). Treatment of postpartum
depression: Clinical, psychological and pharmacological options. International Journal of
Women’s Health, 3, 1–14. https://pmc.ncbi.nlm.nih.gov/articles/PMC3039003/
Nashwan, A. J., Rehan, S. T., Imran, L., Abbas, S. G., & Khan, S. F. (2024). Exploring the
clinical potentials of zuranolone in managing postpartum depression: A new therapeutic
horizon. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 132, 110983
https://www.sciencedirect.com/science/article/pii/S0278584624000514
Wang, X., Qiu, Q., Shen, Z., Yang, S., & Shen, X. (2023). A systematic review of
interpersonal psychotherapy for postpartum depression. Journal of Affective Disorders, 333,
Article 122520.
https://www.sciencedirect.com/science/article/pii/S0165032723009187?via%3Dihub
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