Abby is a 20-year-old female college student experiencing ongoing anxiety and worry without a specific cause for these feelings. She has been restless, tense, and her symptoms are affecting her functioning. She sought help at the university’s counseling center, where Dr. Smith established rapport, discussed confidentiality, and assigned homework to log negative thoughts. Based on this scenario, answer the following questions concisely.
Paper For Above instruction
The scenario presented involves a young woman, Abby, exhibiting symptoms consistent with Generalized Anxiety Disorder (GAD), as characterized by excessive and persistent worry and physical symptoms such as muscle tension and restlessness over at least three months. Her presentation aligns with diagnostic criteria outlined in the DSM-5, which include pervasive anxiety not attributable to other disorders or medical conditions (American Psychiatric Association, 2013). The weekly homework of recording negative thoughts mirrors cognitive-behavioral therapy (CBT) strategies, emphasizing cognitive restructuring to address maladaptive thought patterns (Beck, 2011). This approach is rooted in the cognitive-behavioral model, which focuses on identifying and modifying distorted thinking to alleviate symptoms.
If Dr. Smith recommended medications solely, this would correspond with a biological or medical model, emphasizing pharmacotherapy to correct neurochemical imbalances (Shaw et al., 2009). When medications are combined with therapy, it reflects an integrated biopsychosocial model, acknowledging the interplay of biological, psychological, and social factors (Engel, 1977). The use of free association by Dr. Smith would align with psychodynamic therapy, which explores unconscious processes and early life experiences (Freud, 1917). Similarly, unconditional positive regard, a cornerstone of client-centered therapy developed by Rogers (1951), emphasizes providing unconditional support and acceptance to facilitate growth and change.
If the symptoms described later—such as traumatic flashbacks, avoidance of driving, and beliefs about being a horrible driver—persist for over a month, a diagnosis of Post-Traumatic Stress Disorder (PTSD) might be appropriate, as per DSM-5 criteria (American Psychiatric Association, 2013). Conversely, persistent depressive symptoms—feeling sad most of the day, appetite changes, sleep disturbances, and impaired functioning over two weeks—would suggest Major Depressive Disorder (MDD). Elevated mood,
increased energy, and impulsivity over at least a week points toward a Manic Episode, characteristic of Bipolar I disorder, especially if episodes have been recurrent and include periods of depression (Goodwin & Jamison, 2007). A long-standing suspiciousness and distrust, beginning in childhood, could indicate Paranoid Personality Disorder (American Psychiatric Association, 2013).
Regarding substance use, Abby’s escalating alcohol consumption leading to withdrawal, hospitalization, and life-threatening symptoms signifies Alcohol Use Disorder (AUD). The DSM-5 specifies criteria such as impaired control, social impairment, risky use, and pharmacological dependence, including withdrawal symptoms like delirium tremens (American Psychiatric Association, 2013). The behavior of talking to herself, hearing voices, and neglecting hygiene over the past month suggests Schizophrenia, characterized by psychosis, hallucinations, delusions, and disorganized behavior (Tsuang et al., 2011).
If Abby were five years old experiencing nightmares, separation fears, refusal to leave home, and physical complaints, Separation Anxiety Disorder would be a fitting diagnosis, marked by excessive fear of separation and persistent refusal to be apart from caregivers (American Psychiatric Association, 2013). For a 67-year-old with a significant decline in cognitive functions, the appropriate diagnosis would be Major Neurocognitive Disorder, formerly termed dementia, notable for memory impairment, attention deficits, and interference with independence (American Psychiatric Association, 2013). Finally, Dr. Smith discussing the limits of confidentiality and obtaining informed consent serve to protect the patient’s autonomy and rights, essential components of ethical mental health practice (American Counseling Association, 2014).
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Beck, A. T. (2011). Cognitive therapy: Basics and beyond. Guilford Press.
Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129-136.
Freud, S. (1917). Introductory lectures on psychoanalysis. W. W. Norton & Company.
Goodwin, F. K., & Jamison, K. R. (2007). Manic-depressive illness: Bipolar disorders and recurrent depression. Oxford University Press.
Rogers, C. R. (1951). Client-centered therapy: Its current practice, implications, and theory. Houghton
Mifflin.
Shaw, S., et al. (2009). Pharmacological treatment of anxiety disorders. The Journal of Clinical Psychiatry, 70(1), 44-50.
Tsuang, M. T., et al. (2011). Schizophrenia: Epidemiology, genetics, and neurobiology. JAMA Psychiatry, 68(5), 515-516.
American Counseling Association. (2014). Code of ethics and standards of practice.