Case Analysis

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Grand Canyon University *

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625

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Arts Humanities

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Apr 3, 2024

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docx

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5

Uploaded by saldanagabrielle

1 Case Analysis Gabrielle Saldana College of Humanities and Social Sciences, Grand Canyon University SWK-625 Michelle Blair September 13, 2023
2 Susan has experienced significant trauma from a young age and due to the physical, sexual, and verbal abuse she endured from her father, Susan is now presenting with trauma symptoms such as memory loss, difficulty regulating her emotions, flashbacks, and hearing voices. The traumas that Susan went through as a child are considered adverse childhood experiences (ACES) which are defined as "traumatic events that occur before a child reaches the age of 18" (Child Welfare Information Gateway, 2022, p.1). ACES can have a significant impact on an individual's well-being and development and "emerging research has documented the relationships among exposure to traumatic events, impaired neurodevelopmental and immune systems responses and subsequent health risk behaviors resulting in chronic physical or behavioral health disorders" (SAMHSA, 2014, p.2). There are 3 key assessment issues to consider in this case. The questions I would ask would be: Does Susan meet the criteria for a DSM diagnostic? Is she experiencing suicidality? And how is Susan currently coping with the trauma she has experienced? The case study outlines that after various assessments, it was determined that Susan has DID, PTSD, and subclinical levels of depression and anxiety. This then gives us an understanding as to why she is experiencing certain symptoms, but more information is needed to determine how long Susan has been experiencing these symptoms and how severe they are. Susan's safety is the priority and if she is experiencing any thoughts of self-harm or has experienced them in the past, this would need to be documented immediately so that we could create a safety plan to ensure that she is not at risk for harming herself. Her coping skills go hand in hand with suicidality because if Susan has poor coping skills, this might contribute to her beliefs and narratives about herself and what has happened to her. Many environmental factors could contribute to the symptoms Susan is experiencing. Social environmental factors "refer to socioeconomic, racial and ethnic, and relational conditions that may influence a person's ability to cope with stress" (Wellmore, 2021, p.1) and
3 for Susan, lack of self-care, history of abuse, and lack of social support may trigger her symptoms. Not only did Susan experience abuse in her home, but she was also blamed for disrupting the family and essentially causing her parents to divorce. These narratives that her family created about her and everything being her fault also could contribute to her fear of abandonment and desire to be in multiple relationships. Narrative therapy or cognitive behavioral therapy would be appropriate for this client because they both would allow her to work through the narratives and beliefs, she has about herself and what was happened to her. These two forms of therapy would work through why she believes what she does and how that impacts her behaviors. In addition, I would recommend for this client to take a psychoeducational group like Seeking Safety or Beyond Trauma where Susan would be surrounded by peers who understand what she has been through and where she would learn about the effects of PTSD and how to build new coping strategies. I would approach this case utilizing a strength-based approach that builds on Susan's resiliency to help build a service plan. In the article Resilience after Trauma: from surviving to Thriving, six psychosocial factors are identified that promote resiliency, These are "optimism, cognitive flexibility, active coping skills, maintaining a supportive social network, attending to one's physical well-being, and embracing a personal moral compass" (Nugent, et al., 2014, p.1). Although not all these factors are outlined in this case study, I would still argue that Susan has some level of optimism. For example, I would say that Susan continuing with high school and moving on to college is a resiliency factor that shows that she could continue with her education despite the adversity she has faced. Another client strength could be that she is still attempting to build relationships with others and that getting married, shows her commitment to still seeking a connection with another person despite being violated as a child. As mentioned in the factors above, coping skills can also enhance resiliency and strength. Coping skills help a client process their emotions in a healthy way that supports their
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