Sample Psychology Case Study Annabellel’s Case

Conceptualization of Annabelle’s Case

In this case, Annabelle is a 17-year-old young lady that lives with her 39-year old mum. Her parents separated in their process to resolve their differences from situations in the past that saw them fight and got her physically and psychologically abused. Lately, Annabelle is experiencing loss of value, she does not value herself, and engages in high risky behavior such as using drugs. Also, she has developed high prevalence of anger and furiousness and she cannot control it. In school, she is unable to concentrate due to being bullied in class by other classmates. Due to the non-presence of her dad, she was living with her aunt who died recently (Abel et al., 2016). Her aunt was perhaps her strength as she described her as warm and understanding.

Her mother recommended a therapy session for her to understand the source of her anger and how to control it (Bach, B., & Bernstein, 2019). In her first counseling session, she is able to open up about her tribulations and some of the causes that can be associated with it. As she describes, she feels that no one cares for her, which is a feeling of abandonment and worthlessness. Combined with the bullying at school and the loss of her aunt, she feels her life worthless and out of control. She feels that her mother and father do not take care of the basic love they are supposed to gift their children. Lately, her mother has become aggressive and has stopped her severally from going out with her friends. In that regard, she has no way of relieving herself of stress and discomforts, including her grief for her aunt.

Therefore, the above information describes most of the discomforts and challenges she is facing at the moment. The information is also crucial as it helps the therapist understand her childhood and the formation of her character. One of the fact is that her behavior has developed because of her emotions overtime (Lengel et al., 2016). Additionally, the recent happenings of losing her aunt and the separation of her parents takes a toll on her emotions. In that regard, she faces an emotional problem and a behavioral problem. They can be diagnosed as depression and conduct disorder respectively.

Depression

The patient is at the risk of depression due to the symptoms she displays. Although some of the experiences she is feeling can be symptomized to men, she is experiencing aggressiveness, irritability, and sometimes anxiousness (Urben et al., 2018) . Most of the time she feels empty, sad, and hopeless, which are symptoms of depression. On behavior, she has lost interest in most activities, and has started drinking and using drugs, including engaging in other high-risk activities. In that regard, she can engage in bad behavior that severely affects her performance in school leading to change of grades (Stapersma et al., 2018).

Conduct Disorder

Theoretically, most persons with conduct disorders are judged as bad people. In this case, Annabelle displays a character of a ‘bad kid.’ One of the behavior that she displays based on the symptoms of conduct disorder includes refusal to obey parents and other authorities. Also, she uses drugs and alcohol at her early age (Thapar & van Goozen, 2018). Also, Annabelle is not comfortable with home because it is an environment that she feels unappreciated and unloved. Therefore, there is a high tendency for her to frequently lie, start physical fights, and be aggressive to things and people around them.

While it is legitimate to conceptualize Annabelle’s case, in a theoretical perspective, the theory chosen here will have an impact on the chosen treatment process. In this case, the patient does not understand their problems. Whether it is depression and conduct disorder, the treatment process will begin when the patient accepts and understandings these as their problems. Therefore, the treatment process would involve analyzing the symptoms she displays and those that are intrinsically vivid (Scholten, Lischetzke & Glombiewski, 2020). The patient will be required to elaborate previous episodes of violence or aggressiveness. However, in this case, the healthcare professional recommended that Annabelle to write down an aggressive encounter, which will be discussed in the subsequent sessions.

Evidence-Based Treatment Plans

In the treatment plans, two things must be distinct. The therapist should help the patient identify what short-term goals and long-term goals of their healing journey would be. This helps to shift focus on the most important things (Solomonov et al., 2019). In the first phase, as described by the therapist is to identify the strengths and weaknesses of the patient (Cavanagh et al., 2017). In the treatment plan, three aspects are critical. They include the treatment plan overview, development of long term goals, and development of short-term goals. Each of the long-term goals will have a series of short term goals that should guide the patient to move forward.

Assuming that the clinician has carried out a comprehensive intake with Annabelle, he would be monitoring her and understanding her long term goals she wishes to achieve. In this case, behavioral theory will be used to identify her characteristics at this step (Bucher, Suzuki & Samuel, 2019). A fast response to this process will prevent Annabelle from experiencing further extreme feelings.

Treatment Plan: Assumption-Based Style

Treatment Plan Overview. Annabelle is motivated to maintain a relationship with her parents despite that she does not understand how to do that. She will also want to love herself more, reduce her aggressiveness, and relate to more people in a positive way. Therefore, the treatment process will focus on these goals.

LONG-TERM GOAL 1: Annabelle will learn to understand the negative and positive consequences caused by her behavior and quantify the behaviors she will use to strengthen her relationship with her mother (Bach & Bernstein, 2019).

 

Short/Mid Term Goals

  1. When Annabelle arrives for the therapy sessions on time, comes regularly, becomes polite and fails to make threats during the discussions, it will be acknowledged as a relationship being built.
  2. The clinician response and engagement expertise will be evaluated whether it has an impact on her posture, smile, and gestures.
  3. In their interaction, Annabelle will be required to practice tuning her immediate behavior to acknowledge the subtle cues she uses in her interaction. The development of these cues will be recorded over time.
  4. Annabelle will want to keep explaining to the clinician the activities and daily engagements that she was engaged in for the day.
  5. As suggested by the clinician on doing what she likes often, Anabelle will explain the positive results of doing that after a first experience from the last session they had.
  6. Annabelle can learn about the power of breathing, relaxation of muscles, as a process of feeling in control of the relationship she has with her environment.
  7. Also, Annabelle will pick a method of controlling their negative behavior and practice it in situations that she finds provoking to over-react (Beauchaine, 2020)

Symptom-Based Style

Treatment Plan Overview. Annabelle sometimes gets aggressive due to her depression and drinking behavior. In this treatment, Annabelle will develop behavioral strategies that will ensure she controls her aggressiveness. She will also learn how to stop using drugs and avoid situations that are regarded as high risk. Although Annabelle may not be willing to take the therapy function recommendations, she at least want to be with her parents, both of them.

 

LONG TERM GOAL

Annabelle will consider taking personal time-out when she becomes verbally or physically aggressive.

Short/Mid Term Goals

  1. Annabelle will use different strategies such as deep breathing to calm herself
  2. Annabelle will use the relaxation method that makes her feel in most control of herself
  3. Annabelle will seek to recall instances where she had confrontations within the sessions to test her ability to control herself
  4. She will become aware of when she becomes angry, and she will implement it at home and in school
  5. Other goals can be developed after noticing the progress she has made.

 

Links of the Treatment Plans to the Case Conceptualization

The therapeutic relations in the treatment plan determines the formulation of the above case. Additionally, the therapeutic relations is seen as an assessment and intervention tool to address the case concepts (Haller, 2018). For instance, the clinician understood Annabelle’s family history and the difficulties that she was facing as a child. In that regard, he could recommend the right processes to alleviate their problems.

The therapist used these links to treat Ann’s fear of self-disclosure. As noticed with most people that require therapy, they have the fear of disclosure. In this case, it was the responsibility of the clinician to create a rapport with Annabelle for her to speak about their feelings. A common finding is that most therapy patients do not understand their problem, and are willing to speak to no one.

From a clinician perspective, it is essential to collect assessment data to develop case and diagnosis formulations. After the formulation is developed, the clinician will used it to develop the appropriate treatment plan based on the patient’s manifestation of mental challenges (Junewicz, A., & Billick, 2020). The treatment plan to be used is one which closely conjure with the formulated findings (Padesky, 2020). After the treatment plan development, it is important to obtain a patient’s consent before proceeding. Furthermore, in the treatment process, it would be effective to maintain a strong collaborative relationship and monitoring of the treatment process.

Conclusion

Therefore, from the above two conceptualization of Annabelle’s case, the treatment plans suggested may become the basis for their healing and improvement. After development of effective formulation of the case, it is easier to create the treatment plans. The treatment plans have been segmented into both long-term and short/mid-term goals. These goals detail what the patient need to achieve in the long term and in the short term. Perhaps these will help in challenging the issues that Annabelle is facing and ensure she is control of herself. Between the assumption-based and the symptom-based treatment processes, the clinician will determine the process that has the most evidence to guide the process. In this regard, both of the steps (formulation and treatment plans) are dependent on each other considering they both determine the best way to improve the status of a patient.

 

References

Abel, A., Hayes, A. M., Henley, W., & Kuyken, W. (2016). Sudden gains in cognitive–behavior therapy for treatment-resistant depression: Processes of change. Journal of consulting and clinical psychology84(8), 726.

Bach, B., & Bernstein, D. P. (2019). Schema therapy conceptualization of personality functioning and traits in ICD-11 and DSM-5. Current Opinion in Psychiatry32(1), 38-49.

Beauchaine, A. R. (2020). Clinical Depression and The Healing Benefits of Yoga: Yoga as an Effective and Therapeutic Supplemental Tool with Standardized Clinical Depression Treatment Plans. Digitalcommons.snc.edu.

Bucher, M. A., Suzuki, T., & Samuel, D. B. (2019). A meta-analytic review of personality traits and their associations with mental health treatment outcomes. Clinical psychology review70, 51-63.

Cavanagh, M., Quinn, D., Duncan, D., Graham, T., & Balbuena, L. (2017). Oppositional defiant disorder is better conceptualized as a disorder of emotional regulation. Journal of attention disorders21(5), 381-389.

Haller, J. (2018). Preclinical models of conduct disorder–principles and pharmacologic perspectives. Neuroscience & Biobehavioral Reviews91, 112-120.

Junewicz, A., & Billick, S. B. (2020). Conduct Disorder: Biology and Developmental Trajectories. Psychiatric Quarterly91(1), 77-90.

Lengel, G. J., Helle, A. C., DeShong, H. L., Meyer, N. A., & Mullins‐Sweatt, S. N. (2016). Translational applications of personality science for the conceptualization and treatment of psychopathology. Clinical Psychology: Science and Practice23(3), 288-308.

Padesky, C. A. (2020). Collaborative case conceptualization: Client knows best. Cognitive and Behavioral Practice.

Scholten, S., Lischetzke, T., & Glombiewski, J. (2020). Toward Data-based Case Conceptualization: A Functional Analysis Approach with Ecological Momentary Assessment.

Solomonov, N., Bress, J. N., Sirey, J. A., Gunning, F. M., Flückiger, C., Raue, P. J., … & Alexopoulos, G. S. (2019). Engagement in socially and interpersonally rewarding activities as a predictor of outcome in “Engage” behavioral activation therapy for late-life depression. The American Journal of Geriatric Psychiatry27(6), 571-578.

Stapersma, L., van den Brink, G., van der Ende, J., Szigethy, E. M., Beukers, R., Korpershoek, T. A., … & Utens, E. M. (2018). Effectiveness of disease-specific cognitive behavioral therapy on anxiety, depression, and quality of life in youth with inflammatory bowel disease: a randomized controlled trial. Journal of Pediatric Psychology43(9), 967-980.

Thapar, A., & van Goozen, S. (2018). Conduct disorder in ADHD. Oxford textbook of attention deficit hyperactivity disorder, 193-199.

Urben, S., Habersaat, S., Pihet, S., Suter, M., de Ridder, J., & Stéphan, P. (2018). Specific contributions of age of onset, callous-unemotional traits and impulsivity to reactive and proactive aggression in youths with conduct disorders. Psychiatric quarterly89(1), 1-10.