Practicum Assessing Client Families PTSD Chapter

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ASSESSING CLIENT FAMILIESAssignment: Practicum – Assessing Client FamiliesDemographic information: Client Y is a 33 year old African-American woman. Client Y has been married to X for the last 7 years. X is a 39 year old Hispanic male. They have two children together – a 3-year-old boy and a 5-year old girl. Client Y is an interior designer while X works as a sales agent in the real estate industry.Presenting problem: Client Y has for the past 4 months been experiencing distressful dreams in which case the recurrent theme has been violence. She also claims that she experiences extreme psychological distress whenever she does something that has the possibility of annoying her husband. Specifically, she points out that she is often afraid of associating with members of the opposite sex and claims that whenever a male client reaches out to make enquiries about a certain aspect of the business, she is overcome by “unexplainable fear” and “shakes uncontrollably.” In some instances, the psychological distress she experiences when engaging members of the opposite sex is so intense that she has to halt any further association with an existing or potential client. She points out that this is negatively impacting her business. She also observes that over the last few months, she has lost interest in most of the things that she used to enjoy doing such as trying out new recipes. Now, she just cooks “the very same meals day in, day out.” She also observes that she no longer loves her husband like she did when she first met him. Indeed, she is of the opinion that “all that love has been replaced by fear…” It is also important to note that the client observes that she often has trouble falling asleep and has realized that she gets angry at her co-workers more frequently than was the case before.History or present illness: Client Y observes that she has been experiencing the symptoms highlighted over the last 4 months.Past psychiatric history: Denies any diagnosed mental health issue.Medical history: HypertensionSubstance use history: Client Y points out that she has never used any drugs of mind altering substances.Developmental history: The relevant milestones (from birth to present time) appear to have been met.Family psychiatric history: No close family member has been diagnosed with a mental health issue.Psychosocial history:Financial Assessment: Client does not have immediate pressing financial needs. Her family could be described as financially stable.Family History: Client comes from a single-mother family. She never met her father. Client’s mother is still alive. She is the first-born in a family of six.Educational History: Client is a college graduate.Spiritual Assessment: Client is not deeply religious. However, she identifies as Roman Catholic.History of abuse and/or trauma:Client Y never had any physical confrontation with her husband – until 5 months ago. They had sorted their issues amicably and were “on the same page most of the time.” However, on the material day, X found out that Client Y’s previous boyfriend had spent two nights at their home when he was away on a business trip. It was at this point that all hell broke loose and X appeared to have “gone berserk.

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” Client Y claims she had never seen him that angry. As a matter of fact, she points out that he instantly morphed into a person she did not really know. He accused her of…

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…injury and threatened death. She was directly involved.2. Under criterion B, Client Y has had dreams whose content relates to the event she described.3. Under criterion C, Client Y avoids upsetting her husband as she fears his anger could morph into violence. She also avoids close interactions with members of the opposite sex.4. Under Criterion C, the client blames herself for the event and has since lost interest in one particular activity she previously took delight in.5. Under criterion E, it was clear during assessment that the client has difficulty concentrating. Further, she reports difficulty sleeping.6. Under criterion F, the client has been having the symptoms for the last 4 months.7. Under criterion G, the client has suffered significant distress as a consequence of the said symptoms.8. Under criterion H, the client denies drug or substance abuse, and also denies any diagnosed mental health issue.Treatment plan:The goal of treatment in this case will be to ensure that Client Y is able to reclaim control over her life and develop skills to address her symptoms. Thus, the main treatment option that will be embraced on this front is psychotherapy. It is important to note that according to Wilson and Keane (2004), “effective psychotherapies tend to emphasize a few key components, including education about symptoms, teaching skills to help identify the triggers of symptoms, and skills to manage the symptoms” (p. 77). In the present scenario, the specific technique that will be deployed is cognitive behavioral therapy – specifically cognitive restructuring, which as Zayfert and Becker (2006) observe could come in handy in attempts to enable patents make sense of memories that are deemed bad. However, X will also be roped in….....

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