Running head: FINAL PROJECT 1
SOWK 6090 Week 10 Assignment
Racquel Walsh
Walden University
FINAL PROJECT 2
Provide the full DSM-5 diagnosis. Remember, a full diagnosis should include the name of the
disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may
need clinical attention).
F32.2 Major Depressive Disorder, severe
F10.10 Alcohol Use Disorder, mild
F15.20 Other Unspecified Stimulant Use Disorder
Z56.9 Other problems related to employment
Z62.810 Personal history (past history) of physical abuse in childhood
Z62.898 Child affected by parental relationship distress
Z63.0 Relationship distress with spouse or intimate partner
Z91.410 Personal history (past history) of spouse or partner violence, Physical
Explain the full diagnosis, matching the symptoms of the case to the criteria for any
diagnoses used.
F32.2 Major Depressive Disorder, severe
Saul returned to his psychiatrist because he was becoming depressed again, feeling sad, fearful,
and suicidal, and was given Trintellex which is used to treat Major Depressive Disorder. Saul’s
psychiatrist did not think that the Trintellex was working well so Saul was prescribed Rexulti
which is also used to treat Major Depressive disorder. Saul would constantly buy big items that his
family could not afford causing his wife to become concerned with their financial state. Saul was
rarely getting any sleep due to staying up shopping at night. None of this had any impact on Saul’s
ability to work.
F10.10 Alcohol Use Disorder, mild
Saul began drinking in his late teens. Saul’s use of alcohol continued increasingly into his early
thirties. Saul reported that he never planned on drinking as much as he did but once he started he
would drink until he passed out. Saul stopped drinking after he attended inpatient treatment for 30
days and began drinking again in December of 2019. Saul reported his drinking helped him to cope
with the difficulties in his marriage. Saul’s use and behavior continued up to his most current
presentation for this intake
F15.20 Other Unspecified Stimulant Use Disorder
Saul reported ingesting methamphetamines. Saul was a regular user and reported loving the way it
made him stay thin. Saul has not used any methamphetamine since he left rehab.
Z56.9 Other problems related to employment
Saul has had difficulty in jobs and has not been at any job longer than two years
Z62.810 Personal history (past history) of physical abuse in childhood
Saul reported having a very tumultuous childhood. Saul’s mother would beat him and often lock
him out of the house whenever she was angry.
FINAL PROJECT 3
Z62.898 Child affected by parental relationship distress
Saul separated from his father on several occasions and sometimes would throw Saul out of the
house with his father. Both of his parents would often have physical fights and Saul would try to
break up the fights.
Z63.0 Relationship distress with spouse or intimate partner
Saul reports physically abusing his wife, but stopped physically abusing her when she asked for a
divorce the first time. Saul reported believing that his wife is becoming more distant from him over
the past several years which was something he could not take. Saul reported that their fighting
increased although he would not become physical with her.
Z91.410 Personal history (past history) of spouse or partner violence, Physical
Saul reported being physically abusive towards his wife.
Identify 2–3 of the close differentials that you considered for the case and have ruled out.
Concisely explain why these conditions were considered but eliminated.
Two close differentials that I considered for the case and ruled out were. Bipolar I Disorder and
Bipolar II Disorder. In regards to Bipolar I disorder Saul met the criteria for hypomanic and major
depressive episode, but I did not feel as though he meet the diagnostic criteria for manic episodes,
and according to the DSM-V, at least one-lifetime manic episode is required for a diagnosis of
Bipolar I. Bipolar II disorder was ruled out because although some of the symptoms listed for the
hypomanic episode can be related to some of Saul’s behaviors reported in the case study the
duration for how long he experienced those symptoms were clear.
Some of the behaviors/symptoms reported that influenced my consideration of giving a diagnosis
of Bipolar I or Bipolar II Disorder were Saul reporting having periods over a course of three
months in which he reported feeling on top of the world which last for ten days, then he would
have angry outbursts, Saul rarely sleeping staying up all night shopping buy things he and his wife
cannot afford and his angry outburst. Individuals with Bipolar I or Bipolar II disorder are known
for having “mood swings” going from extreme highs, then to extreme lows as well as engaging in
activities such as unrestrained buying sprees, and decreased need for sleep.
Identify the assessments you recommend to validate treatment. Explain the rationale behind
choosing the assessment instruments to support, clarify, or track treatment progress for the
diagnosis.
Assessments that I would recommend to validate treatment would be either the Hamilton
Depression Rating Scale or Beck’s Depression Inventory. The Hamilton Depression Rating Scale
assesses for the severity of and/or changes in the individual’s depressive symptoms. The Hamilton
Depression Rating Scale can be used to track Saul’s depressive symptoms which can provide more
insight as to the severity of Saul’s depressive symptoms and rather or not they worsening or getting
better. Beck’s Depression Inventory is a 21 item self-reporting inventory
FINAL PROJECT 4
that can measure various characteristics, attitudes, and symptoms associated with depression.
Beck’s Depression Inventory can be used to support the diagnosis of Major Depressive Disorder
by seeing if the client’s responses on the inventory correlate with behaviors, attitudes, and
symptoms associated with Major Depressive Disorder.
Explain your recommendations for initial resources and treatment. Use scholarly resources
to support your evidence-based treatment recommendations.
“We found that Jews were at a significantly higher risk for major depression, but this was true for
males only” (Levav, Kahn, Golding et al 1997). Recommendations for initial resources and
treatment would be recommending that the client receives treatment within the Jewish community.
I would make this recommendation because “religion is only one component of one’s
identification as a Jew” (Levav, Kahn, Golding et al 1997). Saul seeking and receiving treatment
from a Jewish professional could make him more open to treatment as well as fully participating in
the treatment and following all the way through with the treatment and following any
recommendations made by the professional providing the treatment. If Saul seeks treatment from a
Jewish professional it is possible that he could feel more connected to that professional and feel as
though that the professional providing treatment to him understands him on a level than a
professional who is not Jewish would.
Explain how you took cultural factors and diversity into account when making the
assessment and recommending interventions.
Consideration and acknowledgment were given to the fact that Saul is a 53-year-old Jewish male.
When making assessment and interventions recommendations I will be sure to make certain that I
am culturally competent in regards to how individuals of the Jewish community view mental
health/mental illnesses and what their views are on treatment. I would also want to make sure
rather or not if Saul’s cultural background has any influence on any of his behaviors or his the
relationship he had with his mother or the relationship that he witnessed between his mother and
father had any influence on the relationship that he currently has with his wife as well as how he
treats her. If the cultural differences are too grave, I would make the recommendation that Saul
seeks treatment from a Jewish mental health professional so that Saul could better relate to the
professional which in turn could make him more suspectable to treatment. If Saul agrees with the
recommendation, I would then make the referral.
Identify client strengths, and explain how you would utilize strengths throughout treatment.
The strengths that Saul has are how transparent and honest he is regarding certain behaviors,
feelings, past/current drug/alcohol use, relationship with his wife and child, and past mental health
history. I would utilize this strength throughout treatment to retain more information from Saul
which could provide me with more insight on other past and current experiences, thoughts,
FINAL PROJECT 5
and feelings that could be contributing to his current mental state and certain behaviors that he is
displaying.
Identify specific knowledge or skills you would need to obtain to effectively treat this client,
and provide a plan on how you will do so.
Specific knowledge and skills I would need to obtain to effectively treat this client would be
making sure that I am culturally competent. In order to make sure that I am culturally competent
and not hold any expectations that the client will educate me on their culture, instead, I will educate
myself on the client’s culture. I would then see in what ways how may have the client’s culture
influence their current mental health status and past mental health history then use that information
to select the best treatment method
FINAL PROJECT 6
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5
th
ed.).
Levav I, Kohn R, Golding J, & Weissman M: Vulnerability of Jews to Affective Disorders.
American Journal of Psychiatry 1997; 154:941-947
