Assignment
Catherine is a 38-year-old married Mexican-American female with no children who lives in a rural county. She was court-ordered to attend an outpatient mental health clinic for individual and group anger management services. Two months ago, her husband charged her with assault after she stabbed him in the shoulder with a steak knife during an argument at a local restaurant. Catherine is also awaiting incarceration for an arrest in which she was recklessly driving a vehicle without a license. She has in fact been jailed on five occasions for offenses ranging from disturbing the peace to assault. The social worker met with Catherine on four occasions over five weeks. Catherine is separated from her husband but is open to possibly reuniting with him after she receives professional help.
Catherine is in generally good physical health and reports that she is in regular contact with her family physician. She broke her arm two years ago in a saloon fight, however, and has diminished strength in that arm. She also reports having ankle pain due to possible arthritis, which moderately decreases her mobility. Still, Catherine has kept a full-time job at the post office for the last 15 years, working primarily as a mail sorter and occasionally as a deliverer. Catherine reports that she has had irritable and "up and down" moods for most of her adult life. She describes extended periods of time when she becomes "hyperactive" and easily annoyed by people around her. Catherine says she has "incredible energy" at those times and "gets a lot done." At those times she likes delivering the mail, working out at the local recreation center, eating out in restaurants, and going to bars. She rests primarily with "short naps" during her energy bursts. Catherine drinks alcohol (only beer) regularly and makes no apologies for it. "It's fun. Who says girls can't hold their liquor like the guys?" Upon further questioning, she admits that she drinks only "enough to get drunk" when she is in a "high-energy" phase. Otherwise she limits herself to a few beers on the weekends.
Catherine admits that she "wears herself out" after about a month of this hyperactivity, becoming "shaky" and "disoriented" from the lack of sleep. When in a manic episode, she is apt to lose her temper and argue with "almost anyone" who gets in the way of her activities. She gets into physical fights frequently, often with strangers, but sees this as acceptable behavior. "I was raised to take care of myself. No one is going to push me around." Despite her erratic behaviors, Catherine is "accepted for who I am" in her small community. The culture of her Mexican-American family of origin features high levels of emotional expressiveness and Catherine is comfortable behaving this way. She is usually released from jail a few days after her arrests to the custody of her husband, with the charges dropped
With each case, the small group will provide:
a) DSM 5-TR diagnosis
b) Brief rationale and differential diagnosis (for the diagnosis(es) chosen)
c) If this client was assigned to your caseload, which strength (choose one) would you build upon and how would you do accomplish this? Be specific.
d) What 1 treatment goal would you establish to address the most pressing problem? Make sure the goal meets the MAPS (measurable, attainable, positive, & specific) guidelines.
e) What specific practice intervention(s) would you consider to be the most appropriate for your client for a previously identified goal? Why?