Anxiety Disorder Assignment

General Instructions

Select one of the two case studies included to use for the assignment. After selecting a case study, construct a paper including the following information:

•        Identify the diagnosis

•        Use the ICD-10 code for the disorder you choose (alphabetical listing of ICD-10 codes begin on page 929 of the DSM-5-TR)

•        List each criterion from the DSM-5-TR for the disorder you believe the client should be diagnosed with AND provide an example from the case study that supports why you believe that specific criteria was met. (In order for a client to be diagnosed with any disorder, every criterion for that disorder must be met. For example, if you believe a client should be diagnosed with Separation Anxiety Disorder, they must meet criteria for criterion A-D).

•        Based on your diagnosis of the client, identify at least two evidence-based interventions you could use in therapy with this client. You must provide scholarly support for your evidenced-based interventions.

•        Identify at least one commonly used medication to treat the disorder you diagnosed. For each medication identified, you MUST discuss the indications, contraindications, and side effects.

The paper must be a minimum of 5 pages (not including the title page or reference).

•        Paper must include a title page and reference page. Format paper using APA style only. Use Times New Roman font size 12, double spaced

•        Only Microsoft Word documents will be accepted for grading. Any other program used to complete this paper will be returned without a grade.

•        Review the attached grading rubric for this assignment BEFORE you submit the paper for grading.

Case Studies

Case Study 1

John is a 12-year old white male who was referred to your office by his school counselor. He is currently in the 6^th grade at a public school. The summer between his 4^th and 5^th grade year, his family moved. He had always attended a private Christian school that was very small but when he started 5^th grade in his new town, he began going to a public school. His new school is very big and very different from his old school. At his old school he had friends and was well liked but was quiet and kept to himself unless asked to join the group by others. Although he was quiet and somewhat of a loner, John did play baseball and participate in activities in the children’s department at church. 

Shortly after school started last year, John’s parents started to notice a change in his behaviors. They admit they thought the changes were due to him trying to adjust to a new environment and did not make a big deal about the changes. They assumed he would get back to his old self soon. As the year progressed, the changes continued and seemed to worsen rather than improve. They were hopeful when he started middle school this year that things would get better; however, they have not. 

According to John’s parents, John refuses to participate in any type of extracurricular activities. He will not participate in any activities at their new church either. His grades have begun to be impacted as well. When asked why he refuses to play baseball, participate in church activities, or consider any of the other activities at school he tells his parents that he is not good enough to play baseball at this school and that the other kids would laugh at him and make fun of him if he tried-out for the team. He says the kids at church do not like him and do not want him around. 

His parents report that he has begun refusing to go to church and will even fake sick sometimes to avoid going. His grades have been impacted because some of his classes require him to present in front of the class or work out problems on the board in front of the class and he refuses to engage resulting in a zero for the activity. The school counselor got involved when a couple of John’s teachers came to her out of concern. They report seeing other students trying to engage with John but John not responding back. The teachers have witnessed students trying to talk to him or include him in group conversations. When the counselor talked to John, he reported to her that the kids do not like him and he feels like all his classmates are smarter and more experienced than he is. After speaking with his parents and realizing the severity of the changes that occurred over the past 18 months, the counselor suggested John’s parents seek mental health treatment. During the first visit with John and his parents, while gathering basic back ground information,  you learn that John is a healthy young boy with no history of any medical problems and his parents have no concerns of any type of substance use.

Case Study 2

Nancy is a 34-year old African American female who currently works as an administrative assistance. She was referred to your office by her primary care physician.  Nancy has been married for 8 years and has two children, ages 2 and 5. Nancy’s initial compliant is that she is always uptight and anxious. Nancy reports not being able to remember a time when she was not worried about something. Nancy indicates she can remember worrying about silly things even when she was young child. She reports, “I remember worrying about whether or not people in my town got their animals inside every time it was bad weather or being in class and not remembering if I picked up my dirty clothes that morning then worrying the rest of the day about getting in trouble in when I got home. I worried about everything; if the other kids liked me, if I was going to make a good grade on a test, if my shirt was too tight, or my short were too long or too short. It is still that way. I seem to worry about something all the time. The crazy thing is I know what I am worry about is silly but I cannot seem to stop. If I start to worry about something at work, I cannot seem to focus on my work because all I think about is whatever I am worrying about. If something strikes me at night, I can’t sleep because I am worrying about whatever entered my head. When I am worrying, which seems to be all the time, I get tense and I am very snippy with others. I try to get my mind off it but then I only get aggravated even more because I cannot seem to stop thinking about whatever I am worried about.”  Nancy reports that her worrying has significantly impacted he relationship with her husband. She states he gets frustrated with her because she worries about everything and they cannot seem to go anywhere without her worrying about something or enjoy themselves as a family because she is so preoccupied with whatever she is worrying at that moment. Nancy also admits, “my worrying makes me overprotective of my kids and I know that is not good. There are things I know they should be doing but I start to worry about stupid things and I give in to my worries and keep my kids home. For example, the other day my 5-year old was asked to go to the playground with some friends and all I could think about was when was the last time the playground equipment was inspected. That made me worry that he could get hurt on the equipment and instead of telling myself that kids play on that equipment all the time and everything will fine, I gave in to my worries and didn’t let him go. He was so upset with me. Now that the children are getting old enough to know that something is wrong and my relationship with them being impacted, I realized it was time to do something. I went to my doctor for help but after telling him what has been going on, he thought it was best if I came to see you”. You inquire about any history of substance use and she denies any history. She also reports being in good physical health and having no medical conditions. 

Scoring Guidelines

Points available: 100.

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