HCCSSD103 Mental Health Case Study 3 Sample
Assessment Task
Review and analyse two case studies of individuals experiencing mental health issues, then prepare a report that includes a biopsychosocial assessment, treatment options, referral pathways, cultural and population-based considerations for each individual. You will also be required to write a short self-reflection at the completion of the report.
Context
Whether as a community service or counselling professional, a key part of your role will be supporting individuals experiencing mental health issues. Knowing the theory and frameworks is only step one. It is important to be able to apply the theory to working with individuals directly.
These case studies aim to give you a sense of what it would be like to work with individuals experiencing mental health issues and their particular and often complex needs and challenges. As a result, you will be better prepared and more effective when supporting someone or deciding to refer them on. In addition, clinical supervision is a regular and integral activity that counselling and community service professionals often take part in. It draws on active case studies and involves you, your colleagues and your supervisor critically reflecting on and analysing actions taken with an individual and the best support options going forward. These case studies aim to get you into the habit of regular reflection on both your practice and receiving feedback. This reflection will help you to become comfortable with these elements, which, in turn, ensures that those you are supporting will receive the best possible care.
Instructions
1. Refer to the Assessment 3 Case Studies provided in the assessment area on Blackboard.
2. Review the prescribed and suggested readings, videos, templates and your notes on:
? Biopsychosocial assessment
? Diagnostic manuals
? Risk and protective factors
? Treatment modalities
? Cultural and population-based considerations.
3. Structure your report into two parts – one for each case study discussion. Include the following sections for each case study:
a) Complete the biopsychosocial assessment for each case study using a template you found in Module 2 (approximately 200 words per case study)
b) Determine possible diagnoses according to the DSM-5-TR and ICD-11 and give reasons for why you are proposing them (50 words per case study)
c) Determine the predominant risk and protective factors for each individual (approximately 100 words per case study)
d) List possible treatment and support options including programs, treatment modalities and other service referral options. Also identify which tier of mental health services the individual falls into – primary, secondary or tertiary (approximately 150 words per case study)
e) Determine which cultural and population-based considerations you would need to consider for each individual and how you might adjust your approach to be appropriate to their needs (approximately 150 words per case study).
4. Personal reflection (200 words):
a) Respond to the following questions to demonstrate your ability for self-reflection:
i. How different or similar are each of these individual’s experiences and cultural backgrounds to your own?
ii. How might any similarities or differences affect your ability to support these individuals?
iii. Would you refer either of these individuals on? Why or why not?
Please refer to the Assessment Rubric for the assessment criteria.
Solution
Case Study 1:
1. Biopsychosocial Assessment
The individual in this case study is facing complex challenges that warrant a comprehensive biopsychosocial assessment. Biologically, there are signs of substance abuse, initially with alcohol and later escalating to pills, indicating potential dependence and a growing tolerance. The use of substances has escalated to the point of suicidal ideation, with multiple attempts highlighting a severe mental health crisis.
Psychologically, the individual experiences emotional distress following a breakup, contributing to a shift from marijuana use to more harmful substances. There's a significant decline in motivation and self-esteem, evident in the abandonment of once-aspired goals and the current struggle to maintain employment (Gilbert, 2019). Additionally, the individual is grappling with feelings of embarrassment and shame, indicating a strained self-image.
Socially, family dynamics play a role, with a history of normalized alcohol use within the family and strained relationships, particularly with the father's expectations. The individual's isolation from social activities and strained familial connections contribute to a lack of support and exacerbate mental health issues.
2. Possible Diagnosis
The individual likely presents with Substance Use Disorder (SUD, DSM-5-TR - F10-F19) due to escalating alcohol and pill consumption. Major Depressive Disorder (MDD, DSM-5-TR - F32) is indicated by suicidal ideation and low self-esteem. Coexisting Generalized Anxiety Disorder (GAD, DSM-5-TR - F41.1) is possible, given reported anxiety symptoms. ICD-11 diagnoses align with these observations.
3. Predominant risk and protective factors
Predominant risk factors include a family history of normalized alcohol use, strained familial relationships, and parental expectations contributing to a sense of inadequacy. Substance use as an initial coping mechanism following a breakup and subsequent escalation poses a significant risk. Suicidal ideation and attempts highlight acute mental health vulnerability. Isolation and strained social connections compound these risks (Peña-Vargas et al., 2021). Protective factors are limited but include the familial concern expressed by the sister, suggesting some potential for familial support. However, the absence of a robust support network, strained family dynamics, and escalating substance use elevate the overall risk, emphasizing the urgency for intervention and comprehensive mental health support.
4. Possible treatment and support options
For this individual, a comprehensive approach involving multiple levels of care is crucial. At the primary level, interventions may include outpatient counseling, support groups, and psychoeducation to address substance use and mental health concerns. Referral to community mental health services, such as local mental health clinics, constitutes primary care. Secondary care involves more intensive treatment, including outpatient programs, counseling with a mental health professional, and potentially medication management by a psychiatrist. In tertiary care, residential treatment programs or inpatient psychiatric care may be necessary, given the severity of suicidal ideation and multiple suicide attempts (Yankovskaya et al., 2017).
5. Cultural and population-based considerations
Cultural and population-based considerations are pivotal in tailoring effective interventions. Considering the family's cultural background, potential stigmas around mental health and substance use may exist, influencing their willingness to engage in treatment. Acknowledging and respecting these cultural nuances is crucial. Moreover, understanding gender-specific aspects is essential; societal expectations, especially from the father, may contribute to the individual's sense of inadequacy, requiring sensitive exploration during therapy. Culturally competent treatment may involve integrating traditional family values into therapeutic approaches. Given the individual's background in gaming and relationships, incorporating technology-based or online therapeutic modalities could enhance engagement (Bond et al., 2020). Recognizing the influence of socioeconomic factors, ensuring accessibility to affordable treatment options or community resources becomes paramount. Collaborating with diverse professionals who can provide culturally competent care is essential for a holistic and inclusive treatment approach that aligns with the individual's unique cultural and demographic context.
Solution
Case Study 2:
1. Biopsychosocial Assessment (200)
The intricate interaction of biological, psychological, and social elements that contribute to Isabel's challenges is evident in her case. Isabel's obsession on calorie monitoring, weight worries, and occasional bingeing are clear indicators that she suffers from disordered eating behavior’s and body image difficulties on a biological level. University Assignment Help, Her self-esteem has probably been severely damaged by the events that happened during her seventh-grade dance shopping. Isabel is psychologically displaying signs of social anxiety, which may have started in early adolescence and been made worse by unpleasant social event experiences. Her dependence on alcohol as a coping mechanism raises the possibility of drug misuse and an escape urge. Her mental monologue, albeit tainted by self-doubt, also conveys a lack of confidence in herself and a yearning for social interaction.
Isabel feels alone socially because of her tense relationship with her father and the lack of a robust support network. Isabel's problems could have been exacerbated by her mother's obsession with looks and her father's departure. Furthermore, she becomes even more alone and finds it difficult to interact with others because she fears being judged by her peers and by society's ideals of beauty.
A comprehensive strategy is needed to address Isabel's difficulties. Therapy for issues related to body image, social anxiety, and possible substance misuse should be part of the interventions. Creating a loving home atmosphere and expanding her network of support systems are essential to her healing. Isabel may overcome her social and academic obstacles with the support of her family, teachers, and mental health specialists working together.
2. Possible Diagnosis (50)
DSM-5-TR and ICD-11 suggest that Social Anxiety Disorder (SAD), Avoidant Personality Disorder (AVPD), and a probable eating disorder, such as Anorexia Nervosa or Bulimia Nervosa, might be the diagnosis based on the case study that was supplied. These options are suggested by the symptoms of anxiety, body image issues, and social isolation.
3. Predominant risk and protective factors (100)
Isabel is exposed to a number of risk factors, such as negative body image brought on by remarks made in childhood, which can result in low self-esteem and disordered eating patterns. Her retreat is exacerbated by social anxiety, which affects her academic attendance. Alcohol abuse is the first substance misuse that turns into a coping technique. Her problems are made worse by her mother's criticism and her father's lack of support (Abd Ellatif, 2020). There aren't many protective factors, and Chelsea occasionally offers assistance. Isabel does better academically because of her perfectionism, but COVID upsets her schedule. Isabel's general well-being might be improved by addressing body image issues, developing supportive connections, and implementing mental health therapies. These actions could also reduce risks and strengthen protective factors.
4. Possible treatment and support options (150)
Isabel is in need of more specialised assistance beyond primary care due to her complicated collection of issues, placing her in the secondary tier of mental health treatment. Individual counselling or psychotherapy are two possible treatment approaches for body image issues, social anxiety, and disordered eating practices. Rethinking unfavorable thought patterns may be possible with cognitive-behavioral therapy (CBT). Her isolation could be addressed by group therapy, which focuses on social skills and self-esteem. Making a referral to a nutritionist who specialises in eating disorders may help you develop a better rapport with food. Her mother could be included in family therapy to enhance support and communication (Maass, 2019). Interventions for substance abuse, including support groups or addiction counselling, have to be taken into account. Teachers' and school counsellors' assistance can be used to overcome academic difficulties. Isabel has complicated requirements; therefore a multidisciplinary team of educators, dietitians, and mental health specialists is essential to her overall wellbeing.
5. Cultural and population-based considerations (150)
Isabel believes that when customising support, cultural and population-based factors are essential. Acknowledging the beauty standards that are common in her society would be part of a culturally sensitive approach, given the possible sociocultural implications on self-esteem and body image (Alexander, 2020). It is important to comprehend her hesitation to seek treatment because mental health is stigmatized in her culture. Effective communication may be hampered by language issues, necessitating the use of translators or multilingual mental health specialists. Considering her age, respect for personal liberty is crucial while developing a therapy plan.
It's also critical to be aware of potential cultural influences on family interactions. Her perspective can be influenced by her father's departure and possible expectations from her family. Including a range of voices in therapeutic materials helps improve relatability. Culturally appropriate social activities can help Isabel with her social anxiety and increase involvement.
Personal Reflection (200)
The complex interactions between biological, psychological, and social aspects that shape each person's issues are striking to me when I consider the thorough bio psychosocial examinations and potential diagnoses described in the two case studies. A comprehensive treatment plan is required in the first example due to the seriousness of the substance misuse, suicidal thoughts, and damaged family ties. The various risk factors, such as increasing drug abuse and accepted alcohol consumption in families, highlight how complicated mental health problems may be.
Regarding Isabel's situation, I find it really moving how her body image and self-esteem have been affected by society expectations of beauty, which has resulted in social anxiety and compulsive eating. The population-based and cultural factors highlight the necessity for a nuanced strategy that respects her cultural background and acknowledges any potential stigmas. To ensure that Isabel's treatment plan fits her particular demographic situation, it takes both professional knowledge and cultural competency. In both situations, I understand that mental health specialists play a critical role in negotiating these intricacies and offering specialised solutions. Effective mental health treatment is holistic in nature, as evidenced by the significance of interdisciplinary teamwork, cultural sensitivity, and treating multiple aspects of well-being.
References
Abd Ellatif, H. (2020). Causal model of relationships between alexithymia, dependent personality disorder, avoidant personality disorder, and depression among university students. Faculty of Education Journal Alexandria University, 30(3), 285-321. https://jealex.journals.ekb.eg/article_152659_5f1c85c2a33311c60f85018ee438f403.pdf?lang=en
Alexander, G., (2020). SCHEMA THERAPY FOR ANOREXIA NERVOSA: AN INTENSIVE SYSTEMATIC INDIVIDUAL CASE STUDY. https://commons.ru.ac.za/vital/access/services/Download/vital:45724/SOURCE1
Bond, L., Carroll, R., Mulryan, N., O'dwyer, M., O'Connell, J., Monaghan, R., ... & McCarron, M. (2020). Biopsychosocial factors associated with depression and anxiety in older adults with intellectual disability: results of the wave 3 intellectual disability supplement to the Irish longitudinal study on ageing. Journal of intellectual disability research, 64(5), 368-380. https://onlinelibrary.wiley.com/doi/abs/10.1111/jir.12724
Gilbert, P. (2019). Psychotherapy for the 21st century: An integrative, evolutionary, contextual, biopsychosocial approach. Psychology and Psychotherapy: Theory, Research and Practice, 92(2), 164-189. https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1111/papt.12226
Maass, V. S. (2019). Personality disorders: Elements, history, examples, and research. Bloomsbury Publishing USA. https://books.google.com/books?hl=en&lr=&id=NkrEEAAAQBAJ&oi=fnd&pg=PP1&dq=biopsychosocial+approach+for+Social+Anxiety+Disorder+(SAD),+Avoidant+Personality+Disorder+(AVPD)&ots=k-Ft3oDDBB&sig=huGRVNf7JPWdyMZipP6HWhkVipE
Nielsen, K. E. (2008). Social anxiety and close relationships (Doctoral dissertation, University of Calgary, Division of Applied Psychology). https://prism.ucalgary.ca/bitstreams/76435c67-15a3-415a-9b17-277b6383109d/download
Peña-Vargas, C., Armaiz-Peña, G., & Castro-Figueroa, E. (2021). A biopsychosocial approach to grief, depression, and the role of emotional regulation. Behavioral Sciences, 11(8), 110. https://www.mdpi.com/2076-328X/11/8/110
Yankovskaya, A. E., Kornetov, A. N., Il’inskikh, N. N., & Obukhovskaya, V. B. (2017). An expansion of intelligent systems complex for express-diagnostics and prevention of organizational stress, depression, and deviant behavior on the basis of the biopsychosocial approach. Pattern Recognition and Image Analysis, 27, 783-788. https://link.springer.com/article/10.1134/S1054661817040204
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