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SOCW 6090 Week 10 Discussion Assignment

SOCW 6090 Week 10 Discussion AssignmentSOCW 6090 Week 10 Discussion Assignment Final ProjectThe sign of an effective clinician is the ability to identify the criteria that distinguish the diagnosis from any other possibility (otherwise known as a differential diagnosis). An ambiguous clinical diagnosis can lead to a faulty course of treatment and hurt the client more than it helps. Using the DSM-5 and all of the skills you have acquired to date, you assess a client.This is a culmination of learning from all the weeks covered so far.SOCW 6090 Week 10 Discussion AssignmentTo prepare: Use a differential diagnosis process and analysis of the Mental Status E in the case provided by your instructor to determine if the case meets the criteria for a clinical diagnosis. A PLAGIARISM-FREE PAPER HEREBy Day 7Submit a 4- to 5 pgs in which you: (PLEASE ANSWER EVERY BULLET POINT)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).Explain the full diagnosis, matching the symptoms of the case to the criteria for any diagnoses used.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.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.Explain your recommendations for initial resources and treatment. Use scholarly resources to support your evidence-based treatment recommendations.Explain how you took cultural factors and diversity into account when making the assessment and recommending interventions.SOCW 6090 Week 10 Discussion AssignmentIdentify client strengths, and explain how you would utilize strengths throughout treatment.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.CASE of BOBINTAKE DATE: November 2021DEMOGRAPHIC DATA:This is a voluntary intake for this 24 year old Jamaican male. Bob has had several psychiatric hospitalizations in the past. Bob has been married for 5 years. His wife, Rayona was born and raised in the United States. He has one son 5 years old and one daughter, 3 years old. Bob has had difficulty in jobs and has not been at any job longer than one year. Bob immigrated to the United States with his parents when he was 6 years old.SOCW 6090 Week 10 Discussion Assignment CHIEF COMPLAINT:“My wife is complaining about my behavior. I do not see what the issue is”. HISTORY OF ILLNESS:Bob reports first seeking psychiatric treatment when he was sixteen years old. He was prescribed anti-depressants, but does not remember what kind. Since they helped his mood he remained on anti-depressants for four years. At twenty years old he attempted suicide after his wife threatened to leave him. He was hospitalized in a psychiatric unit for thirty days. At that time Bob was put on Depakote, with continued success for three years. He stopped taking the Depakote 1 years ago.SOCW 6090 Week 10 Discussion AssignmentIn September 2021 Bob returned to his psychiatrist because he was becoming depressed again, feeling sad, fearful and suicidal. He was given Trintellex. During the next few weeks Bob felt on top of the world. He then would have angry outbursts. His wife asked him to leave the home. He then took an overdose of Klonopin.More recently Rayona was getting concerned about their financial state because Bob would constantly be buying big items that they could not afford. They would have arguments about this all the time. Bob was rarely sleeping because he was up shopping at night on the Internet. This had no effect on his ability to work. SUBSTANCE USE HISTORY:At twenty one Bob began drinking. His use of alcohol continued increasingly until about 6 months ago. He reports never planning on drinking as much as he did but once he started he was compelled to drink until he passed out. He stopped drinking after attending outpatient treatment for 16 weeks. He began drinking in September 2021 again, Bob indicates, to cope with the marital difficulties.SOCW 6090 Week 10 Discussion Assignment PSYCHOSOCIAL HISTORY:Bob reports growing up as uneventful. His mother separated from his father on several occasions. His mother made all the decisions and his father played a more passive role.Bob is the only child from his parents’ union. He has an older brother from his mother’s previous marriage. Bob does not have any contact with his brother. Bob was initially considered an underachiever in the early years of school. He had trouble being in fights with other kids because they used to make fun of his wrinkled clothes.Bob has no legal history. He worked in the family business through high school and college. He became a project coordinator at his next job. He stayed there six months years. MEDICAL HISTORY:Bob states he had the usual childhood vaccinations and no major illnesses as a child. He currently is physically fit and healthy. FAMILY ISSUES AND DYNAMICS:Bob reports that he is happy in his marriage and does not know why his wife has so much trouble with him. He believes his wife has become more distant from him over the past several years which he doesn’t like. Their fighting has increased. Bob reports his wife is frustrated with his lack of energy and fatigue which has, recently, been impacting their social life and activities with the children.SOCW 6090 Week 10 Discussion Assignment MENTAL STATUS EXAM:Bob presents as a neatly dressed male who appears younger than his stated age. Facial expressions are appropriate to thought content. Motor activity is appropriate. Thoughts are logical and organized. There is no evidence of hallucinations or delusions. Bob admits to a history of suicidal ideation, gestures and attempts. His mood is depressed. During the interview Bob talked fast. Bob is oriented to time, place and person. His intelligence appears above average.CASE PRESENTATION – F INTAKE DATE: May 2014 IDENTIFYING/DEMOGRAPHIC DATA:This is a voluntary admission for this 32 year old Black male. This is F’s first psychiatric hospitalization. F has been married for 13 years and has been separated from his wife for the past three months. He has currently been with his sister. His family residence is in Miami, Fl., where his wife, two daughters and son reside. F has had a 12th grade education plus education to complete an LPN program. In the past, F worked for seven years as an LPN. For the past three years F has been employed at a local print shop. Religious affiliation is agnostic.SOCW 6090 Week 10 Discussion Assignment CHIEF COMPLAINT/PRESENTING PROBLEM:“I need to learn to deal with losing my wife and children.” HISTORY OF PRESENT ILLNESS:This admission was precipitated by F’s increased depression with passive suicidal ideation in the past three months prior to admission. He identifies a major stressor of his wife and three children leaving him three months prior to admission. F has had a past history of alcohol binges and these binges are intensified when there is a need for coping mechanisms in times of stress. F was starting vacation from work just prior to admission and recognized that if he did not come to the hospital for treatment of depression and alcoholism, he would expect to have a serious alcohol binge. F reports that in the past three months since separating from his wife, he has experienced sad mood, fearfulness, and passive suicidal ideation. He denies specific suicidal plan. Wife reports that during these past three months prior to admission, F made a verbal suicidal threat.SOCW 6090 Week 10 Discussion AssignmentF reports he has been increasingly withdrawn/non-communicative. His motivation has decreased and he finds himself “sitting around and not interested in doing chores at home”. He reports decreased concentration at work and increased distractibility. F has experienced increased irritability, decreased self esteem, and feelings of guilt/self blame. There is no change in appetite, but F reports an intentional weight loss of 20 pounds since 5 months ago with dieting. F states for many years he doesn’t sleep, having a past history of working double shifts when requested. F reports his normal sleep pattern for many years has been generally three hours of unbroken sleep. F reports past history of euphoria, although wife reports to intake worker observing periods when F’s mood is elevated, and then in the next few hours, F appears out of control with poor impulse control, increased arguing, temper tantrums and alleged shoving and pushing her and the children. He then feels tired and ends up sleeping more than his average pattern.  Wife reports he has not been violent with her since they have been separated.F denies suicidal ideation at the present time while on the evaluation unit. PAST PSYCHIATRIC HISTORY:F was seen on an outpatient basis by Dr. S, for a period of two months prior to admission. He was being seen for individual counseling because of the marital problems and depression. Dr. S recently referred F for inpatient rehabilitation. SUBSTANCE USE HISTORY:F reports a history of some alcohol binges in the past. He began drinking beer in 1999.  When he turned 21 years old, F reports that until two years prior to admission, his pattern of drinking was to get drunk with his social group approximately twice per month. He denies a history of blackouts. He admits to the alcohol binges and heavy use of cocaine (snorting and freebasing on weekends) for a period of three months in 2010. F has received a charge of driving while intoxicated in 3/02 and had lost his driver’s license for six months. Since his marital breakup, F reports using alcohol as a coping mechanism for stress (reporting that he will only drink on weekends now).SOCW 6090 Week 10 Discussion Assignment  PAST MEDICAL HISTORY:F reports having been involved in a motor vehicle accident with loss of consciousness in 1991. He states he has no memory of the accident. In 1993, F sustained a head injury when he hit his head on a coffee table. F had a past history of fractured toes with pins being inserted in the third and fourth digits in his right foot after an accident in which he crushed his foot at work. F denies a past history of seizures.F has had a weight loss of approximately 20 pounds secondary to dieting since 1/99. F smokes approximately two packs of cigarettes per day. F is allergic to Codeine. FAMILY MEDICAL AND PSYCHIATRIC HISTORY:Father and grandfather have a history of cardiovascular disease.     F reports that while growing up his parents maintained a satisfactory relationship. Father reportedly worked nights and slept during the day. F did not have much contact with his father but now enjoys a close relationship with his father. He states he has always had his parents support.During F’s school years, he reports he was an underachiever in elementary school. He denies having had a history of discipline problems or hyperactivity. He states he did well in high school and earned grades of A’s and B’s. F played football in HS. In his senior year of high school, F began using marijuana and alcohol during the spring term. After completing high school, F earned his license as a practical nurse. He states he graduated at the top of his class from nursing school.SOCW 6090 Week 10 Discussion AssignmentF worked as and LPN for approximately seven years. For the past three years he has been employed as a machine operator for a local printer.F was married for 13 years and has recently been separated for the past three months. F and his wife have three children including a daughter, age 12, a daughter, age 8, and a son age 7. F states he feels very invested as a parent and feels close to his children.Leisure time activities F has enjoyed in the past include playing softball, skiing, reading, playing poker, and watching football.  His wife has complained that he is doing less of that now since he is drinking more.  F states he has several close friends. CURRENT FAMILY ISSUES AND DYNAMICS (OPTIONAL):Wife reports that F’s difficulties began to get worse a few months ago when she decided to move out of the house due to F’s increasing erratic behavior. She moved into her parents’ house and F is living with his sister. Wife states that F has been suffering from mood swings where he is “very up” and feeling great, firm in his direction and then within the next few hours, he is often out of control, arguing, throwing temper tantrums, pushing and shoving, and becoming verbally abusive.Wife states that F has been drinking for several years in the amount of a 12 pack of beer per day plus shots of hard liquor. Although F reported he has been using cocaine on and off for about two years, wife states she does not think that F is presently using cocaine. At one point, after threats from his wife, F told her that he had gone to a clinic for outpatient rehabilitation, but she did not believe him.Wife describes F as “extremely depressed” now and says F states, “life is over…I wish I was dead…don’t send the kids over to visit because I don’t want them to find my dead body…everything I tough turns to garbage. Wife adds that F suffers from poor self esteem, lack of sleep and an extremely boastful attitude. On the positive side he is a good father, compassionate, creative, and could be an outstanding person.Wife reports F always had a bad relationship with his mother. F is close to his father who is reported to have an alcohol problem and was allegedly loud and intimidating.F is currently employed by his wife’s father. F states he has financial problems now due to paying for counseling and child support.SOCW 6090 Week 10 Discussion Assignment MENTAL STATUS EXAM:(Include the nine areas to the best of your ability)F presents as a casually dressed male who appears his stated age of 32. Posture is relaxed. Facial expressions are appropriate to thought content. Motor activity is appropriate. Speech is clear and there are no speech impediments noted. Thoughts are logical and organized. There is no evidence of delusions or hallucinations. F denies any hallucinations. F admits to a recent history of passive suicidal ideation without a plan, but denies suicidal or homicidal ideation at the present time. F admits to a history of decreased need for sleep but denies euphoric episodes. His wife has observed a history of notable mood swings. No manic-like symptoms are observed at the time of this examination.On formal mental status examination, F is found to be oriented to three spheres. Fund of knowledge is appropriate to educational level. Recent and remote memory appear intact. F was able to calculate serial 7’s. In response to three wishes, F replied “I wish that my marriage would work out and that my kids would be happy and that someone would give me a million dollars. SOCW 6090 Week 10 Discussion Assignment

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