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The Case Study: Barbara

Complete an assessment (including level of risk), diagnosis and treatment plan for a client with a co-occurring disorder. Write about the ethical, legal and socio-cultural considerations associated with treatment.

Co-occurring Disorders and Treatments

A Case Study

Final Project

In a 7 page page scholarly research paper: Title page, abstract page, 7 body of pages, Reference page

Complete an assessment of the client
Determine the client’s diagnosis
Determine the level of risk for the client
Develop a treatment plan for the client
Address the epidemiological implications associated with treating this client
Address the legal, socio-cultural and ethical considerations associated with treating this client

The Case Study: Barbara

Barbara is a 33-year-old, single counselor. Although she has not had a history of major psychiatric symptoms, she did mention several episodes of “nervousness” each time in response to major life transitions. The first episode was in high school when her family moved from New York to California. It was a very difficult adjustment for her. She missed her friends and for 3 or 4 months felt extremely “nervous”. She said that during that time she felt afraid to leave the house, although she did make herself attend school. She also said that when her parents left the house for an evening out she became increasingly anxious until they arrived back home. After a while, her anxiety seemed to “go away”. The second episode occurred when she left for college. She attended a school in Florida. She again felt extremely anxious and developed excruciating stomach pains, although even with multiple appointments to see a doctor, no explanation could be found. After several months, Barbara’s stomach pains disappeared and she graduated after four years from college. She returned to California and found a job and apartment very close to her parent’s home.

Four weeks ago, Barbara’s father suffered a heart attack. He was in critical condition for two days, but continued to recover and is currently doing well. However, two days after her father’s heart attack, Barbara drove herself to the emergency room certain that her symptoms of shortness of breath and chest pain signaled that she too was having a heart attack. The doctor diagnosed anxiety and prescribed a limited prescription of diazepam. Barbara’s symptoms disappeared. However, one week later, with no precipitating event, Barbara again suffered shortness of breath and chest pain while visiting her parents. Her mother suggested that she lie down and brought her a glass of wine to “relax her”. Barbara and her mother discussed the stresses in Barbara’s job and that a glass of wine at the end of the day would be “just what the doctor ordered”. The glass of wine (or on particularly stressful days several glasses of wine) seemed to help. However, one month later Barbara began suffering stomach pains, shortness of breath and chest pains. Over the next three weeks, she was increasingly unable to work (because of the pain) and unfortunately, her doctor who ran a battery of tests was not able to identify any reasons for her symptoms.