TOPIC: Mental Health Treatment Plan
Scenario: You are a Clinical Mental Health Counselor working in a Community Mental Health Agency. You are currently seeing Brigitte, an 18-year old adopted Native American female who is accompanied to a therapy session by her mother, Elizabeth, who is European American. Brigitte was a senior at the public high school but has recently stopped attending school. Elizabeth met her husband, who is Israeli, 13 years ago while visiting Israel. After living in Israel for five years, Elizabeth and her husband moved to the United States and adopted Brigitte when she was 11-years old. Elizabeth reported that she filed for divorce from her husband eight months ago after he was caught having an affair. Elizabeth speaks softly and sobs throughout the session as she describes how distraught she is by “my daughter’s behaviors”, which began happening one year ago. According to Elizabeth, Brigitte has been stealing and acting oppositional and defiant towards authority figures. For example, Brigitte continually yells at her adoptive parents, teachers, and her boss at work. After working at a local clothing store for two years, Brigitte was fired from her job six months ago for being combative with her boss. Brigitte also recently got into a physical altercation with a classmate. In addition, Brigitte has been experiencing difficulties falling asleep, reports having nightmares, and appears to be nervous most of the time. Elizabeth describes Bridgette as irritable, “always on edge”, and lethargic for most of the day (or she often sleeps through the day unless she has school or work). Elizabeth is particularly worried that now that Brigitte no longer has a job or school to attend, she will become even less productive. When you ask for Brigitte’s input, she rolls her eyes and sighs, but she also reports that there is “some truth to what my mom says”. Brigitte reports that she dropped out of school recently because her grades had dropped so significantly and she no longer had a desire to go to college. She states that she was an “A” student but over the last year struggled to maintain passing scores. Brigitte reports she has also been isolating herself from friends and fellow classmates. She describes herself as a very social and outgoing person who always maintained many friendships; however, recently she has isolated herself and withdrawn from any social activity. She describes spending most of her evenings at home watching TV. She states she feel hopeless in terms of what her direction her life is going – particularly her career options. Her mother expresses significant concern about her future, particularly getting another job, and states she wants to support Brigitte financially but because of the pending divorce is unable to do so. Brigitte’s mother also mentions not knowing for how long she will be able to pay for sessions as her husband has “nearly stopped” giving her money. She stated, “I have to constantly beg him to help us pay for our food.” Elizabeth also reports that all their belongings, including the company they owned, the home, and the bank accounts, were moved by her husband to his brother’s name. Elizabeth states, “as a result, I have nothing left in this world except our child…The lawyer told me that in all likelihood I won’t get anything…especially since Brigitte is an adult.” Brigitte denies suffering from any medical conditions, or having been hospitalized for any mental health or physiological issues. Brigitte also denies drinking alcohol or engaging in recreational drug use. During the session Brigitte was alert to person, place, and time. Her speech was coherent, although at times there was incongruence between the content of what was spoken and her affect. Bridgette did not endorse any suicidal or homicidal ideation. Directions: Please compose a well-written and organized 6 – 8 page essay in response to the following questions. Use the most current APA Style, write clearly and concisely, cite appropriate and current literature (empirical and/or theoretical), and be sure to demonstrate your multicultural and ethical competence. Assessment: Identify the assessments you would conduct to enhance your understanding of Brigitte’s problems and explain how they would direct your diagnostic formation. Be sure to include at least one career assessment. Diagnosis: Develop a provisional diagnosis– Give a DSM diagnosis. Clarify your diagnostic considerations by indicating why you are considering these possible diagnoses, using specific evidence from the vignette. Theoretical conceptualization: Describe and apply a specific counseling theory that you would use to conceptualize the case example. Include a brief description and primary concepts of the theory. Using your selected theory, provide a theoretically grounded case conceptualization for the client (i.e., explain the client’s background and presenting concerns in the context of the required theoretical framework). Theoretically Grounded Treatment Planning: Using the treatment plan template below, develop a brief therapeutic treatment plan for the client based upon your theoretical conceptualization above (e.g., two measurable goals for treatment and corresponding objectives and interventions). Please make sure the treatment plan is consistent with the theory you identified above. Be sure that the treatment plan addresses career planning and vocational goals, in addition to other primary concerns you have identified. Ethics and Diversity: Identify the ethical and/or legal dilemmas introduced in this vignette. Given the client’s ethnicity and background, explain what factors or cultural considerations you would take into account in rendering diagnoses, case conceptualization, and treatment planning. Your response should provide empirical evidence with appropriate citations to support your choice of assessments, diagnosis, theoretical framework and the treatment plan that you are recommending for use with this client. Make sure you write in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources; display accurate spelling, grammar, and punctuation.