Reference no: EM134038689

Assignment:

The Case of Julia.

Julia is an 8-year-old female who lives with her mother, father, and 5-year-old brother. Julia presented with her mother and brother for her initial visit due to concerns that had become more pronounced as her school career progressed. Julia's father travels frequently for work and was not able to attend counseling sessions. Julia is in the second grade at a public elementary school in a suburban neighborhood.

Julia presented in a pleasant and talkative mood. Julia was very animated, exploring the room, touching, picking up objects, and often interrupting her mom by putting the objects in her face. Julia did not sit down for the duration of the initial session and moved from task to task without engaging in any one activity for more than a few minutes. Julia had to be reminded multiple times not to climb on the couch. Julia frequently intruded on her brother's play by grabbing objects from him and whined to her mom when he did not cooperate with her intrusion by saying that he would not "share." At times, Julia would intrude on her brother's play by giving him directions on what to do and how to play.

During the initial session, her mom reported that Julia has al- ways demonstrated difficulty following directions and completing various tasks at home. Her mom specifically reported that cleaning her room has become a constant battle because Julia will remain in her room for hours, often "playing" when she should be cleaning.

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CASEBOOK FOR DSM-5®

Mom reports that she is often frustrated because Julia does not listen to her even when she is speaking directly to her. Her mom admits that Julia knows how to clean her room and can do so with constant supervision and specific instructions-what to do when-but states that they (parents) refuse to "overfunction" for their daughter who is "old enough" to complete independent chores. Her mom states that if Julia was more organized she would not have such a big mess to tackle in her room. Her mom also states that Julia often becomes overly emotional with "things that really aren't a big deal." For ex- ample, she can become tearful when she is not going to a place she likes to eat or when her brother plays with something that is hers and she is afraid that he will break it. Her mom described a situation in which Julia was upset because she could not wear a shirt that she had outgrown, and it took her 20 minutes to calm down and stop crying.

Her mom reports that Julia has been constantly "on the go" since she could walk. Julia rarely sits still and constantly has something to say. Her mom explained that they stopped going out to restaurants when Julia was a toddler because she could not sit still and would disrupt the entire restaurant. Her mom reports constantly having to tell Julia to "sit like a lady" and that she gave up on dresses long ago because Julia is constantly climbing on objects or sprawling around on the floor. Julia's mom explains having difficulty getting anything done when Julia was little because her daughter would not remain engaged in any activity long enough.

Her mom reports that there have been additional problems as Julia has gotten older and the demands of school have increased. Based on teacher reports, Julia has difficulty remaining in her seat and following the directions of the classroom as well as specific directions from her teachers. Julia has difficulty completing her seatwork, often playing with items in her desk and attempting to engage other students or simply staring off into space. Her mom reports that getting Julia to complete her homework is a nightly struggle that takes hours to finish. Despite finishing her homework, Julia often loses homework points because she frequently fails to follow her morning routine at school and forgets to turn it in. Julia's teacher reports that she has to constantly remind Julia to raise her hand if she wants to answer a question or needs to get the teacher's attention. Another area of concern for the school is Julia's difficulty with walking and/or waiting in line-she often gets

CASE EIGHTEEN JULIA

Out of line to talk to peers and has difficulty keeping her hands to herself. Julia also displays some intrusive behaviors with peers, often interrupting games and taking others' belongings without asking. Her mom believes that these intrusive and impulsive behaviors have made it difficult for Julia to make and maintain friendships. Her mom reports that Julia has the habit of being too honest by saying whatever comes to her mind without considering others' feelings. Despite the various concerns in the school setting, Julia's teachers report that when she pays attention she avoids careless mistakes and generally knows the material. All parties involved agree that Julia is a bright girl.

Julia reports that her parents are always yelling at her and that she is always getting in trouble. Julia maintains that she wants to do well in school but reports that the teachers hate her and make her work more difficult on purpose. Julia expressed sadness and frustration at not having any close friends and reported that she tries to play with the girls at recess but that they always run away from her.

Based on the case above, please answer the questions below.

Students will write a case formulation (provisional diagnostic impression) using information provided in a written case study that will be provided by the instructor. The case formulation should follow the following format:

Section I. Diagnosis

A. Signs and Symptoms

• What are the client's significant symptoms with regard to having a mental disorder?
• When did the symptoms begin?
• For how long have the client problem been evident?
• Have they changed over the course of the problem?
• If so, in what way have they changed?

B. Case Considerations and Differential Diagnosis (your thought process in thinking through what diagnosis, if any, is most appropriate).

• What other disorders does his symptoms overlap?
• For what reason(s) would you rule other diagnoses out?

For example, though the client's symptoms of XYZ could be features of both Disorder X and Disorder Y, they do not present with the symptoms ABC which are indicative of Disorder Y, etc....

C. Provisional Diagnosis

Given the above information and considerations, what diagnosis have you arrived at?

Include specifiers, severity levels, and if associated with another medical condition.

D. Rationale for Diagnosis

NOTE: The questions and hints after each section are suggestions and may not cover all details that may be important to present.

Section II. Risk and Resilience

A. Onset of the Disorder

• Risk Influences
• Resilience Influences

B. Course of the Disorder

• Risk Influences
• Resilience Influences

NOTE: The textbook presents this section as a chart and bullet points. For this assignment, I want you to write it in paragraph (narrative) form.

In the answers, please include the readings from the following Text books American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental

Disorders (5 th ed., text revision), DSM5-TR. Washington, DC: American Psychiatric Association.

Corcoran, J. & Walsh, J. (2019). Mental health in Social Work: A Casebook in Diagnosis and Strengths-based Assessment (3rd Ed.). New Jersey: Pearson Education.