Question

Case Study – Jane

Someone sitting behind Jane had dropped a book on the floor and it set her off.  jane backed in a corner in the waiting area of a mental health clinic and started screaming. Her pupils were widely dilated and perspiration stood out on her forehead. She was panting heavily. Jane pointed her finger at a Chinese man who stood petrified in the waiting room. “Get this rapist out of here” she screamed. She made a fist and started running towards the man.

The therapist came and took Jane firmly into a private office. They sat there in silence for a few minutes, while Jane breathing gradually returned to normal and the therapist reviewed her chart.

Jane was thirty-five (35) years old, but when she was twenty (20) years old she had volunteered to join the Red Cross during a war in Vietnam. While in a tent the hospital came under fire and many of the medical personnel were killed. Jane was taken captive for a month and was gang raped by some Oriental men.

She never talked about her ordeal, even during anger management class for war survivors who were suffering from Post- Traumatic Stress Disorder. Whenever she was asked to share her story she would get in a rage. Jane had blocked out that part of her life and in order to cope she avoided movies depicting war or rape. After returning home she started drinking and was drunk most times. Whenever she was sober she took drugs and became promiscuous in order to facilitate her habit. Despite her best efforts Jane would have nightmares and she would awaken at nights screaming several times a week. Sudden noises would startle her into a panic attack.

After being in jail for the last six months, Jane had been clean and sober. A condition for her release from jail was to seek medical help. The therapist reminded Jane that she had to share her feeling about the past. She responded that she didn’t have any feelings as they had all dried up. Jane commented that the future did not look bright: “got not job, no husband, no kids. I just wasn’t meant to have a life.” She got up to leave and said; “it’s no use I can’t talk about it”.

A. Using the following format below, develop a Case Formulation and Treatment Plan the case study.

1. Identifying Information                                              
2. Problem List                                                               
3. Diagnosis:                                                                              

Axis 1

Axis 11

Axis 11

Axis 1V

Axis V

4. Working Hypothesis                         

Schemata:                               

Self

Others

World

Future

            Summary of the Working Hypothesis

            Strengths and Assets                                                               

5. Treatment Plan                                                                                 

Goals                                       

Interventions                           

2. Identify the losses that Jane has faced and explain (using examples) the grief process that she is experiencing using one of the grief and bereavement models.

Answer 1

The patient Name; Jane

Age: 35 years old

Gender: Female

Axis I: Jane had suffered from Post- Traumatic Stress Disorder.

Axis II: She is exhibiting avoidant personality disorder.

Axis III: Beside PTSD there was no other medical condition that was established. She has stopped watching shows that depict war or rape; she had become alcoholic and taking drugs regularly to stop remembering the incident she went through in Vietnam.

AXIS IV: When Jane was twenty (20) years old she had volunteered to join the Red Cross during a war in Vietnam. The tent in which she was staying was burnt and she was taken captive and gang-raped over a month.

AXIS V: Her behavior is influenced by delusions, impairment in communication, feeling helpless, and showing an inability to function in almost all areas.

Working Hypothesis

Schemata:

Self: She had volunteered to join the Red Cross during the war in Vietnam when she was 20 years old it looks like she was enthusiastic and ready to do social work.

Others: When she was in Vietnam she had a tragic incident that has changed her completely. She was silenced about the incident and used to get angry whenever asked about it.

World: Her perception towards the world must have changed with that incident.

Future: Jane sees her future as dark because she does not have a job, no husband, and no kids.

Summary of the working Hypothesis; It says that Jane has suffered from mental trauma due to the incident she went through in Vietnam; She is avoiding that memory by shutting all the activities that resemble rape and war. She is become an alcoholic and takes drugs. She was in jail. She is haunted by the memory and have a nightmare and gets a panic attack.

Strength and Assets: The strength of the case is that Jane had become sober after staying six months in jail. For all this time she was not opening or discussing the incident of Vietnam, but suddenly after looking at a Chinese man she opened her mouth and called him her rapist.

It gave a concussion that she is suffering from anxiety and the thought of rape has remained in her unconscious mind and looking at the Chinese man who resembles a Vietnamese in facial features her fear has surfaced.

Treatment plan:

Goal: The goal of the treatment is to bring her out of the nightmare and have a normal life.

Intervention: In her case, the cognitive behavioral therapy will be useful, it gives a good chance for the people to interact with other people who had gone through the same events, if it is conducted in the group she would be open to more ideas and the ways to cope with it.

As she suffers from nightmares and panic attack antidepressant medication would help her soothe down and read her mind.