AMARA CASE STUDY 2
Client’s Concerns
Symptoms Social/Cultural Psychological
Worry Trouble sleeping Hopelessness
Body tensions Verbally aggressive Fear of bad things happening
Irritability Light drinking (she is
cautious of drinking)
Lack of Motivation
Assessment
As a counselor helping Amara, I would want to talk with her about the symptoms she is
presenting with by having some open-ended dialogue. I would also like to utilize the Generalized
Anxiety Disorder 7-item (GAD-7) to see where she lies in terms of a self-assessment. This
screening tool is used to help with diagnosis and determine the severity of the diagnosis.
Diagnostic Impression
Based on the information that Amara and her daughter have provided, I would diagnosis
with Generalized Anxiety Disorder ICD 10 code F41.1. I may consider major depressive disorder
being a secondary diagnosis.
Signs and Symptoms
DSM-5 Diagnostic Criteria:
Generalized Anxiety Disorder (F41.1)
Client’s Signs/Reported Symptoms:
Criterion A: Excessive anxiety and worry Client reports for the past 18 months her
AMARA CASE STUDY 3
occurring more days than not for at least 6n
months
worry has increased to daily for the majority
of the day.
Criterion B: Individual finds it difficult to
control worry.
Client reports that though most of the worry is
hypotheticals she is unable to stop these
“what ifs” from occurring.
Criterion C: Anxiety associated with
restlessness or feeling keyed up or on edge.
Client has communicated that restlessness
occurs two to three days a week at least for
the past 12 months.
Criterion D: Anxiety associated with being
easily fatigued.
Client reports that fatigue is presently over the
past 12 months.
Criterion E: Anxiety associated with muscle
tension.
Client has stated that she has felt increased
tension in her body over the past 24 months,
including headaches 3-4 times a week as well
as shoulder and neck pain.
Criterion F:
Other DSM-5 Conditions Considered
As a secondary diagnosis that was considered is major depression disorder, my guess
would be mild moderate based on the criterion she has so I would use either code F32.0, F33.0,
F32.1, or F33.1. The symptoms that were reported that lead me to this belief were feelings of
restlessness, difficulty concentrating and fatigue.
Developmental Theories and/or Systemic Factors
AMARA CASE STUDY 4
According to Eriksons stages of life Amara is currently in the “Ego vs Integrity” stage of
life. This is the final stage of Eriksons stages of life, during this stage it begins approximately
around the age of 65 (Amara does meet this) and ends at the time of death (McLeod, 2024).
During this time a person usually reflects on all their accomplishments and fulfillments
throughout their life. However, for Amara this is impacting her life in a negative manner.
Multicultural and/or Social Justice Considerations
The client has stated that she is from South Asia and has strong ties to her cultural
identity. While seeking counseling goes against her customs, she, with the help of her daughter,
have decided that she needs more help than what can be provided without counseling and even
medication. Amara is very aware of her symptoms that she has and does not wish for this to
impact her life negatively any more than it already has. It does not appear that Amara is
experiencing symptoms due to discrimination.
Treatment Recommendations
Key Issues for Treatment
Anxiety
Uncontrollable worry
Insomnia
Recommendations for Individual Counseling
Given that the main diagnosis is generalized anxiety disorder, I believe that cognitive
behavioral therapy will be the best route to take in order to help Amara be able to control some
of her anxiety with the help of her medication. According to (Hirsch et al., 2019), cognitive
AMARA CASE STUDY 5
behavioral therapy is the most effective when it comes to treating generalized anxiety disorder.
Knowing that seeking mental health is outside of the customs for South Asians I would
cautiously move forward with helping her change the negative aspects that give her anxieties to
something more positive, changing a thought process or a road map helps to ensure that we can
change the negative and worrisome thoughts to be more helpful and productive thoughts. We
would move slowly through this process so as not to overwhelm Amara. However, because of the
background of Amara’s culture not typically using mental health resources I would want to build
up rapport and trust with her in the first few sessions before moving to make any changes.
Specific Considerations
Amara – Case Study 1: How important of a role does social and cultural background play in
this case? What additional information would you need about her culture? What kinds of values
conflicts might you experience due to the client’s culture? How would you manage your
personal values while working with this client? Integrate the ACA Cross Cultural Competencies
and ASERVIC spiritual competencies here in application to yourself as well.
In this case with Amara, I would say that cultural background plays a vital role in her day
to day life. While from the very beginning she has exposed her cultural and beliefs it will make it
easier to adapt to her needs in mental health. Because Amara exposed her culture from the
beginning it allows for the therapist to do further research into her culture and beliefs in order to
better serve Amara and her needs. Some conflicts that might arise would be the use of western
culture and theories, this is why it will be important to do research and know what will be
acceptable and what will not be acceptable as her even seeking mental health was a huge step
outside of the South African culture. As with any client it is important to set my own personal
beliefs to the side to ensure I do not impose myself upon the client. Because of the differences in
AMARA CASE STUDY 7
References:
American Psychiatric Association Publishing. (2022). In Diagnostic and statistical manual of
mental disorders fifth edition text revision: DSM-5-TR (5th ed.).
Glasofer, D. R. (2023, December 6). How is generalized anxiety disorder diagnosed using the
DSM-5-TR?. Verywell Mind. https://www.verywellmind.com/dsm-5-criteria-for-
generalized-anxiety-disorder-1393147
Hirsch, C. R., Beale, S., Grey, N., & Liness, S. (2019). Approaching cognitive behavior therapy
for generalized anxiety disorder from a cognitive process perspective. Frontiers in
Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00796
Kring, A. M., & Johnson, S. L. (2022). Abnormal psychology: The science and treatment of
psychological disorders (15th ed.). Wiley.
McLeod, S. (2024, January 25). Erikson’s stages of development. Simply Psychology.
https://www.simplypsychology.org/erik-erikson.html
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