300 words conceptualization

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The Suicide and Self-harm Risk Assessment

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The Suicide and Self-harm Risk Assessment

The suicide and self-harm risk assessment of Sarah through the SAMHSA SAFE-T framework shows that she is at low to moderate risk for suicide. This is because several risk factors have been detected in step one and include Bipolar, I Disorder, unstable mood, poor compliance with taking her medications, financial difficulties, social isolation, and passive suicide ideation during periods of depression (SAMHSA, 2024). In addition, the presence of symptoms of depression after periods of mania makes her vulnerable to harm. On the other hand, step two shows that there are several protective factors, which include a strong desire to take care of her kids, the support of her sister, secure housing, knowledge about her condition, and cooperation in receiving treatment. In step three, Sarah admits to having no plans or intent regarding suicide at present.

One possible intervention that can be used in accordance with the Suicide Crisis Intervention Model and which can help in managing a suicidal crisis is creating an elaborate safety plan, including warning signs, coping mechanisms, supportive people and resources, etc. Recommending to Sarah to reach out to her sister or a counselor when she feels emotionally unstable can help build a network that will prevent isolation.

From the Mental Status Examination of Sarah, it becomes clear that the patient is neatly groomed, cooperative, oriented, and alert. She is characterized as tired and overwhelmed with constricted but appropriate affect. There are no hallucinations and delusions, as thought processes are logical. Insight of Sarah is fair although the patient takes medications inconsistently. The most relevant information from Sarah's MSE for making a DSM-5-TR diagnosis includes mood instability, poor judgment in manic states, and reduced amounts of sleep with impulsive actions, which indicate Bipolar I Disorder. Culture and context are very relevant when assessing the patient since she can feel shameful about the state and divorce (Lee et al., 2025).

One aspect that involves ethics is ensuring the privacy of Sarah but at the same time her safety from the suicide threats. Another one would be respecting her autonomy while at the same time paying attention to the potential dangers for suicide. In this regard, the ACA (2014) Ethical Standards for counselors’ state that client well-being needs to be balanced against crisis interventions (Hegblom et al., 2025). On multicultural level, counselors need to consider the issues that Sarah faces as a middle-aged divorced female who struggles with parenting and her psychological problems. In the context of Christian worldview, adding spirituality may help enhance her resilience through discussion of hope and purpose.

References

Hegblom, T., Ahmed, Z., Fischer, L., Roelike, L., & Webb, E. (2025). 5.3 Counselor Responsibilities.  Ethical Practice in Co-Occurring Substance Use Disorder and Mental Health Counseling. https://open.lib.umn.edu/ethicalpractice/chapter/5-3-counselor-responsibilities/

Lee, J., Kim, S., & Nam, S. H. (2025). “Living with silence and Shame”: a meta-synthesis of women’s lived experiences of infertility-related stigma.  International Journal of Women's Health, 2699-2713. https://www.tandfonline.com/doi/pdf/10.2147/IJWH.S539531

Substance Abuse and Mental Health Services Administration. (2024). SAFE-T suicide assessment five-step evaluation and triage. https://www.samhsa.gov

Since the start of the term, you have learned about assessments and how to accurately diagnosis clients.  After reading my discussion feedback you know when you diagnose a client you are describing the problem (signs, symptoms, duration, onset, severity, specifiers). You are only reporting the facts. Before we move onto this week, let me share some golden nuggets for your diagnostic work.

I want to remind everyone to maximize your points by using the correct format for abbreviations, citing your references in the text of your posts correctly, or your references are not correct (due to writing format errors or you’re not reading my announcement about references format in Canvas). Implement the American Psychological Association Writing style from the resources I provided at the start of the term and the Liberty University Writing Center.  

· Look to offer the specific criteria in the Diagnostic and Statistical Manual-5-Text Revised (DSM-5 TR) plus case data to support the diagnosis. The resource is in Module 3.

Now let’s begin to understand what is driving the problem. Now we are going to focus on case conceptualization. 

Case conceptualization is salient to aid you with accurately creating treatment plans.  Diagnostic impressions and case conceptualization are salient because you will need this for your professional practice courses and when you enter the profession.  Some learners are enrolled in 692 (Practicum).  This week’s discussion is going to assist you with your clinical presentations in supervision and with your course work.  You will use your selected counseling theory (this is the counseling theory you like the best, the one you feel makes sense- you MAY ONLY select one) to develop clinical themes, theoretical themes, and etiology . Read the module three posts from me because I provided detail on the difference between your theoretical orientation belonging to you and using theory as a therapy. This will be critical for this week. 

Read Before You Begin. You are selecting a counseling theory not a therapy. For example, Dialectic and Behavioral Therapy is not a theory. Cognitive Behavioral Therapy is the application of Cognitive Behavioral Theory.

For you written assignment  Case Presentation – Assessment & Diagnosis (CPAD) read all the course instruction and be sure to:

· Expand the approved AI client using  independent clinical reasoning ( no further AI use)

· Conduct a comprehensive  assessment and diagnostic justification review the literature on psychometric assessments for the diagnostic impression (you can use the assessment in the Diagnostic and Statistical Manual as well). The Mental Measurements Yearbook has a list of assessments for you to review for this section of your CPAD assignment. Please review the resource in our LU Library. I was introduced to this resource in my Master’s program and it was a blessing for my studies, thesis, and dissertation; enjoy!

· Mental Measurement Yearbook. Liberty University Online Library.  https://go.openathens.net/redirector/liberty.edu?url=https%3A%2F%2Fsearch.ebscohost.com%2Flogin.aspx%3Fauthtype%3Dshib%26custid%3Dliberty%26profile%3Dehost%26defaultdb%3DmmtLinks to an external site.

· Video on Using the Mental Measurement Yearbook.  Mental Measurements Yearbook: Introduction - Liberty University

I enjoyed doing this work and now it is time for the fun to begin!

Learning Outcomes

Upon successful completion of this module, you will be able to:

· Recognize the conceptualization process.

· Develop a case conceptualization inverted triangle and case conceptualization narrative. Note- We will use the Sperry & Sperry (2020) Case Conceptualization Model for our discussion.

· Recognize the Christian adaptation of their secular theory.

INSTRUCTIONS

Discussion Thread: Sperry and Sperry Case Conceptualization Model

This week we will learn a second case conceptualization process offered by Sperry and Sperry (2022). A case conceptualization is defined by Sperry and Sperry (2022) “Case conceptualization is a method and clinical strategy for obtaining and organizing information about a client, understanding and explaining the client’s situation and maladaptive patterns, guiding and focusing treatment, anticipating challenges and roadblocks, and preparing for successful termination.”

Through the discussion this week, you will begin to prepare the information you need to write about the narrative of the upcoming  Case Presentation: Assessment & Diagnosis (CPAD) Assignment and  Case Presentation: Case Conceptualization (CPCC) Assignment. First, please watch the video for this week’s module titled: Sperry and Sperry Case Conceptualization Model Overview. After you watch the video, using the  8 Ps of the Sperry and Sperry model, consider information you would gather in an assessment for your approved case study client (approved in  Quiz: Case Presentation: Selecting Your Client Using AI (Microsoft Copilot)), and identify the information for each of the 8 Ps in the case. You may also read the article by Sperry P’s required for more clarity regarding the P’s required to write the case conceptualization.

In this first thread, you will write the information for  each of the 8 Ps from your client. Please use the template below. Do not write in narrative form since this is the information you will use to write the narrative in the  Case Presentation: Case Conceptualization (CPCC) Assignment. This is to help you organize the information you need to write the narrative in the coming week. 

Create a counseling client for a 45year-old Caucasian female diagnosed with bipolar 1 disorder.

Client Profile: “Sarah M.” (Fictional Counseling Client)

Age: 45 Ethnicity: Caucasian Diagnosis: Bipolar I Disorder (most recent episode: manic, moderate severity)

Identifying Information

· Name: Sarah M. (pseudonym)

· Age: 45

· Gender: Female

· Marital Status: Divorced

· Children: Two (ages 14 and 17)

· Employment: Administrative assistant at a medical office; currently on leave

· Living Situation: Lives with her two children in a rented townhouse

Presenting Problem

Sarah presents to counseling reporting mood instability, difficulty maintaining sleep, increased irritability, and “feeling like my mind is racing all the time.” She states she recently experienced a manic episode lasting approximately 10 days, during which she slept 2–3 hours per night, spent over $3,000 impulsively, and started multiple unfinished projects.

She reports feeling “embarrassed and exhausted” after the episode and is now experiencing mild depressive symptoms, including low motivation and guilt.

History of Present Illness

· First diagnosed with bipolar I disorder at age 29 after hospitalization for mania

· Experiences 1–2 manic episodes per year, often triggered by stress or sleep disruption

· Reports inconsistent medication adherence in the past

· Has been stable for the past 18 months until the recent episode

· Denies current suicidal ideation but reports passive thoughts during depressive phases

Psychiatric & Medical History

· Psychiatric:

· Bipolar I disorder

· Generalized anxiety symptoms (not formally diagnosed)

· One psychiatric hospitalization at age 29

· Medical:

· Hypothyroidism (treated)

· Chronic migraines

· Medications:

· Lithium (recently restarted)

· Levothyroxine

· PRN medication for migraines

Family History

· Mother: Depression

· Maternal uncle: Bipolar disorder

· Father: Alcohol use disorder

Substance Use

· Drinks wine socially (1–2 glasses/week)

· Denies illicit drug use

· No history of substance misuse

Social & Occupational Functioning

· Reports supportive relationship with her sister

· Limited social engagement due to embarrassment after manic episodes

· Work performance has declined due to mood instability and missed days

· Financial stress due to impulsive spending during mania

Mental Status Examination

· Appearance: Well-groomed, appears stated age

· Behavior: Cooperative, slightly restless

· Mood: “Tired and overwhelmed”

· Affect: Constricted but appropriate

· Speech: Normal rate and tone

· Thought Process: Linear, logical

· Thought Content: No delusions or hallucinations

· Insight: Fair—acknowledges diagnosis but struggles with medication adherence

· Judgment: Intact but impaired during manic episodes

· Cognition: Alert and oriented ×4

Strengths

· Insight into her condition

· Strong motivation to stabilize for her children

· Supportive family member (sister)

· Stable housing

· History of successful functioning when mood is stable

Treatment Goals

ShortTerm Goals

· Improve medication adherence

· Establish consistent sleep routine

· Reduce anxiety and irritability

· Identify early warning signs of mania

LongTerm Goals

· Maintain mood stability for 12+ months

· Strengthen coping skills for stress

· Improve financial boundaries and planning

· Rebuild confidence and social engagement

Proposed Treatment Plan

· Cognitive Behavioral Therapy for mood regulation

· Psychoeducation about bipolar disorder and relapse prevention

· Medication management with psychiatrist

· Sleep hygiene plan to reduce relapse risk

· Relapse prevention plan including triggers and early warning signs

· Financial boundaries work to address impulsive spending

Would you like next steps?

I can create:

· A full treatment plan

· A progress note (DAP, SOAP, or BIRP)

· A relapse prevention worksheet

· A sessionone script for the counselor

Which direction do you want to go next: Full treatment plan • SOAP note • Relapse prevention plan

1) I didn’t run into any problems using AI

2) I would give AI a grade of an “A” because it gives all evaluations, history and treatment plan.

3) I would include if she is currently under the care of physicians and therapist. Her profile states that she is inconsistent with taking her medication. It may simple be that she’s not seeing her care team on a consistent basis.

4) Yes, I will use this client.