COU 610 Week Nine 9 one Correct 1

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Psychology

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Jan 9, 2024

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Running head: COMPHREHENSIVE CASE CONCEPTULIZATION 1 Lashunda Stateson Final Project:1 Comprehension Case Conceptualization Southern New Hampshire University COU-610 Assessment & Evaluation in Counseling Dr. Zachary Pietrantoni

COMPHREHENSIVE CASE CONCEPTULIZATION 2 I. Presenting Concerns A. Describe the problem/issue/challenge the client reports they want help with. Amelia Yee Jones is a 42-year-old multi-racial lesbian female who states she is not feeling like herself. She states that she struggles with her mood, is nervous, lacks motivation, and has no interest in life. She always feels tired and does not have much energy, which is starting to affect her job as a Licensed Professional Counselor. Her wife, Juanita, states that she has observed Amelia staring off into space and can have a difficult time trying to snap Juanita out of doing so. Amelia and Juanita both state that these symptoms have been going on for 22 years and are progressively worsening. Amelia did suffer a loss within the past year, as she lost her dog eight months ago. She has had medical setbacks such as being born early, delayed language development, being involved in a car accident at the age of three where both legs were broken, rehabilitation took one and a half years, and being diagnosed with Dyslexia. In addition, starting at 14 years of age, she started using Marijuana until age 23 and was bullied physically, mentally, and emotionally from 2nd through 11th grade. The client desires to feel better about herself, feel motivated, and manage her emotions so she will not get overwhelmed. B. Explain the problem/issue/challenge affecting the client. 1. Behavioral symptoms: Amelia is experiencing several behavioral symptoms such as being angry or aggressive. She has been irritable, missed days at work, has had obsessions or compulsions, and has had a substance abuse problem in the past. 2. Cognitive symptoms: Amelia is experiencing cognitive symptoms such as abnormal thoughts, cognitive impairment, dissociative symptoms, disruption of thoughts, orientation memory, paranoia, poor concentration, and severe mood swings.

COMPHREHENSIVE CASE CONCEPTULIZATION 3 3. Emotional symptoms: Amelia is experiencing emotional symptoms such as depression, feeling worthless, grief, guilt, and hopelessness. 4. Physiological symptoms: Amelia is experiencing physiological symptoms such as anxiety, disturbance in appetite, disturbance in sleep, lack of energy, panic attacks and tearfulness. C. What does the client typically experience and demonstrate when the presenting problem/issue/challenge is activated? Amelia states she cannot do many things, such as get out of bed. She also states she struggles to stay motivated, is often nervous, cannot control her mood, and has little interest in life. In addition, she has very little energy and is always tired, which is starting to affect her work performance and life. Amelia’s DSM-5 Level 1 Cross-Cutting assessment, results report that she feels nervous, anxious, or frightened nearly every day. She also has aches and pains that she cannot explain. She has had problems sleeping and is having difficulty knowing who she is and what she wants out of life. (American Psychiatric Association, 2013) D. What are the results of the quantitative assessments? There are many quantitative assessments performed on Amelia, such as anger, anxiety, depression, repetitive thoughts and behaviors, sleep disturbance, and somatic symptoms, to name a few. These tests were performed to evaluate her symptoms, and many of her tests showed results of moderate to severe symptoms. For example, the WHODAS (World Health Organization Disability Assessment Schedule) was administered to the client. This assessment indicates that her general disability score is 3.25, which is equivalent to extreme disability (World Health Organization, 2012). However, the score will have been taken into context because, according to Watson & Flames (2015), test scores “should be interpreted in collaboration with other assessments such as interviews, observations, and other instruments you

COMPHREHENSIVE CASE CONCEPTULIZATION 4 may have administered.” Once additional data is gathered and evaluated, she may or may not have an extreme disability. E. What is the relationship between the data from qualitative and quantitative assessments? The relationship between the quantitative and qualitative assessments is that they were both administered to further evaluate the client’s symptoms. The qualitative data reported additional information, such as the client’s demographic information and known triggers. The quantitative data then numerically placed her symptoms into perspective, which is how we achieved her scores. F. Considerations related to assessments. 1. Justify why the assessments used are appropriate and applicable to this client. According to Watson & Flamez (2015), “Evaluating multiple sources of information gives you a clearer picture of the client and the issues being experienced.” Because of such, the various assessments are appropriate and applicable to the client because she has a range of symptoms that must be explored. Watson & Flamez (2015) also state, “In the diagnostic formulation phase, the focus is on gathering as much information as possible about the client to accurately understand his or her presenting issues.” The client has been having symptoms for over two decades and wants to get to the root of the problems. She also desires to know if the problem is because of depression, anxiety, or her past trauma, and she is interested in learning how all of her symptoms and issues are connected. With this information, clinicians should keep in mind that “Many times the issues that lead a client to seek counseling are not their true problems. Rather, they often are seen as manifestations of larger, more complex problems in the client’s life.” Watson & Flamez (2015)

COMPHREHENSIVE CASE CONCEPTULIZATION 5 2. What are the reliability and validity considerations in using each assessment with this client? With each assessment, they will only be reliable based if the client understands the questions. For example, according to the client's file, she was diagnosed with Dyslexia, which could be why she struggles with English, reading, and spelling. The assessments might are only be reliable if the client understood understands the questions. In addition, there may be cultural bias with the questions, and clinicians should consider if special accommodation was provided for the client. However, based ( Because the results consistently) on the results, the client consistently received results of moderate to severe, so with a preliminary review of the results , the assessments are valid but not reliable . Watson & Flamez (2015) states, "Validity speaks to the truthfulness of the data." In this diagnostic phase, and because of the unknown variables, such as if the appropriate accommodations were provided, the clinician could determine that the assessments have a low validity score to not cause unintentional harm to the client. 3. What are the limitations associated with using each assessment with this client? Watson & Flamez (2015) state, “Counselors recognize the effects of age, color, culture, disability, ethnic group, gender, race, language preference, religion, spirituality, sexual orientation, and socioeconomic status on test administration and interpretation.” With this information, clinicians should recognize that the client has limitations as she has a diagnosis of Dyslexia, has difficulties with English, spelling, and reading, is a lesbian, and is multicultural. 4. What are the ethical considerations necessary when using these assessments with this client?

COMPHREHENSIVE CASE CONCEPTULIZATION 6 The American Counseling Association (ACA) Code of Ethics must be followed when assessing the client. To begin with, Section E provides the ethical standards for evaluation, assessment, and interpretation and the clinician's responsibility for administrating and interpreting assessments. To begin with, the 2014 ACA Code E.1.A. provides the purpose for assessments which is a tool to gather information from the client. (American Counseling Association, 2014) ACA Code E.2.b. Clinicians are responsible for selecting the appropriate assessment, using the proper scoring method, and interpreting the assessment(s). ACA Code E.5.b. provides the responsibility that must be taken with different cultures. II. Current Triggers A. Describe the triggers (people places things, and sensory experiences) that activate the behavioral, cognitive, emotional, and physiological patterns that result in the client’s presenting problem/issue/challenge. The client has had problems in her past, such as being bullied in school by an ex- boyfriend and her father. When her mother and medical professionals evaluate her symptoms and do not consider who she is as a whole person by embracing her entire identity, this triggers the client. Also, the due dates for her work projects, family events, holidays, and being alone at home after work are also triggering for her. In addition, she is not being supported by her mother because her mom does not believe in counseling. Also, her mom seemingly disregards her method of receiving help through counseling and being told by her mother to speak with a priest, although she is not Catholic anymore. Her siblings stated that her lifestyle as a lesbian is what is causing her problems, and her partner said her job is the problem triggering the client. B. Discuss the following considerations related to the assessments used:

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