CASE STUDY: PHIL 1
Case Study: Phil
School of Behavioral Sciences, Liberty University
Author Note
CASE STUDY: PHIL 2
Case Study: Phil
Assessments
Symptoms Behaviors Stressors
Sadness Anger outburst Phil’s parents’ separation and
divorce
Anger Crying Phil’s father being remarried.
Lack of interest in hanging
with friends
Argumentative
Aggressive towards others Struggling academically
Diagnostic Impression
Upon assessing Phil’s symptoms behaviors and stressors, it seems that Phil has
Adjustment Disorder with Mixed Disturbance of Emotions and Conduct 309.4 (F43.25). The
assessment I would use in this case would be The International Adjustment Disorder
Questionnaire (IADQ). This questionnaire contains 19 questions that focuses on the features of
adjustment disorder. It is a self-report measure with validity in diagnosing adjustment disorder
(Shevlin et. Al, 2019).
Signs and Symptoms
DSM-5 Diagnostic Criteria: disorder name
and code number: Adjustment Disorder with
mixed disturbance of emotion and conduct
Client’s Signs/Reported Symptoms:
A. The development of emotional or
behavioral symptoms in response to an
identifiable stressor(s) occurring within 3
months of the onset of the stressor(s)
Once his father was remarried, Phil has had a
consistent feeling of sadness for the four
months.
B. These symptoms or behaviors are
clinically significant, as evidenced by one or
both of the following:
B1. Marked distress that is out of proportion
to the severity or intensity of the stressor,
taking into account the external context and
the cultural factors that might influence
symptom severity and presentation
Due to his dad remarrying, Phil has been very
argumentative, displaying aggressive
behaviors in school and has lost interest in
friends and sports.
CASE STUDY: PHIL 3
B2. Significant impairment in social,
occupational, or other important areas of
functioning
Phil has expressed a lack of interest in
hanging out with friends due because of the
onset of this stressor.
C. The stress-related disturbance does not
meet the criteria for another mental disorder
and is not merely an exacerbation of a
preexisting mental disorder.
Phil has no prior mental health disorder and
his symptoms does not meet full criteria for
any other diagnosis.
Other DSM-5 Conditions Considered
Acute Stress Disorder 308.3 (F43.0) was considered for Phil, but his symptoms have
lasted longer than the time frame for it be considered this disorder.
Post Traumatic Disorder 309.81 (F43.10) was also considered for Phil but he did not have
enough related symptoms to meet full diagnostic criteria.
Developmental Theories and/or Systemic Factors
The most important factor in this scenario that is affecting Phil’s behavior and outbursts
is this major change in his family system. Phil has experienced multiple changes in his family in
the last two years. His parents went from being separated to being divorced. Then Phil’s father
gets remarried while Phil keeps hope alive that his parents will get back together. These events
have affected his current functioning and behavior because he is coping with losing his mother
and father as a unit in one home. This is not what he wanted for his parents and now it seems he
is acting out due to his ongoing feelings of sadness.
Multicultural and/or Social Justice Considerations
Phil’s current stage of development falls under Early Adolescence. During this phase, the
emotional development can be fragile and be affected by situations such as not having both
parents in this household. This can lead to the adolescent not being a focus or concentrate in
school (Wong et. Al, 2015). Phil’s emotional development is struggling due to his parents’
CASE STUDY: PHIL 4
separation and divorce following his dad getting remarried. These events have caused him to
struggle academically in school as well as act out emotionally.
Treatment Recommendations
Key Issues for Treatment
Mood Swings
Phil’s grief with parents divorcing
Recommendations for Individual Counseling
The first recommendation for counseling would be incorporating some Mindfulness
techniques. Mindfulness techniques are used to help an individual be aware of themselves and
what they are feeling in the moment. Mindfulness techniques has been proven to be effective in
adolescence when it comes to managing emotional well-being and promoting self-regulation
(Fergulio et. Al, 2022). I would specifically introduce Phil to grounding techniques. Grounding
techniques can help someone be calm and be in the present moment with themselves.
Another recommendation for individual counseling is to incorporate Cognitive Behavior
Training (CBT) techniques into Phil’s counseling. CBT has been proven to be effective in
treating children who are dealing with grief like Phil. CBT-grief and Supportive counseling is a
form of counseling used for students who may be dealing with grief. CBT-grief and supportive
counseling is used to improve coping skills through talk therapy and activities such as playing
and writing letters (Boelen et. Al, 2021).
Specific Considerations
Phil’s age affects his diagnosis since the symptoms don’t seem to be too atypical for
someone in his stage of development. His symptoms are like what some people may call “teen
angst”, where he shows signs of anxiety and rebellion. When it comes to the family system, I
CASE STUDY: PHIL 5
think Family Therapy sessions should happen when Phil is ready. Phil had a good relationship
with both his parents prior to the separation and divorce so I do believe it is possible for him to
get back to a space where he has good relationships with both his mother and father as well as
his sisters.
CASE STUDY: PHIL 6
References
Boelen, P. A., Lenferink, L. I. M., & Spuij, M. (2021). CBT for prolonged grief in children and
adolescents: A randomized clinical trial. , (4), 294–304.American Journal of Psychiatry 178
https://doi.org/10.1176/appi.ajp.2020.20050548
Feruglio, S., Pascut, S., Matiz, A., Paschetto, A., & Crescentini, C. (2022). Effects of mind-body
interventions on adolescents’ cooperativeness and emotional symptoms. Behavioral
Sciences 12, (2), 33. https://doi.org/10.3390/bs12020033
Shevlin, M., Hyland, P., Ben Ezra, M., Karatzias, T., Cloitre, M., Vallières, F., Bachem, R., & ‐
Maercker, A. (2019). Measuring ICD 11 adjustment disorder: The development and initial ‐
validation of the International Adjustment Disorder Questionnaire. Acta Psychiatrica
Scandinavica 141, (3), 265–274. https://doi.org/10.1111/acps.13126
Wong, D. W. (2015). Counseling Individuals Through The Lifespan. SAGE.
