1. Problem Formulation:
Julia a 17 year old who grew up in a stationary living situation in a northeastern suburban town is experiencing problems. She is in her first year of college and is having difficulty relating to others. She has an eating disorder that is affecting her health conditions emotionally and physically. She in not coping with stress with her involvement in track and cross-country because she gained an extra 15 lbs. Her coach asks her to change her diet and watch the junk foods that she consumes. Julia is seeking treatment at this time from pressure from her college. Julia was mandated to attend therapy. Her Dean instructed her to go to the counseling and health center for an evaluation before she could continue practicing with her team. Her current coping skills are not working for her. She is avoidant with her relationships with her roommate, friends and family. She is experiencing insomnia. She is in denial about the extent of her problem. She has started lying to her family and constructing ways not to go home for the holiday. Julia has low self-esteem. My hypothesis is that she has Anorexia Nervosa, insecurity issues, along with severe anxiety disorder. She has pent up emotions that reflect anger turned inward toward self.
2. Treatment Focus:
Julia’s has a history of maladaptive patterns of trying to please her parents and others at the expense of herself. Her internal working model is that she needs to be perfect and be a super achiever. She strived to be a perfectionist taking advanced classes in high school. She engaged in sports because her parents wanted her to do something athletic. She did not join the track program because it was something that she wanted to do. She wanted to find a way t...
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...along with building trust and expressing inner most thoughts from one on one therapy.
6. Impediments to change:
Julia’s personality of being a perfectionist and wanting to constantly please others at the expense of losing herself would be an impediment to change. She may want to please the therapist and not reveal what she is really thinking and feeling. Her denial of the seriousness of her health issues and the dangers that lurk behind her destructive behavior coping style are life threatening. Julia’s pattern of denying help that she so drastically needs may thwart her progress. She longs to be perfect in everything that she attempts and has established eating rituals that are hard to break once habits have been formed. Her robot personality style of living without expressing emotions has created a ruptured sense of self within her internal locus of control.
Patient’s name is Molly Greenwell. She is a single non-Hispanic Caucasian Female. Molly is eighteen year old, with family background orientation of Italian culture. Molly does not work but she feels like she has enough stress surrounded around being a senior with a 4.0 GPA in an all-girls catholic school. She considers herself a shadow on the high school monarchy. This being said she feels like whatever she does, her parents are never happy enough. Having attended Italian school every Saturday, church and religion class every Sunday in the Roman Catholic Church; she feels like she has no friends. The one pleasure she does for herself is participate in a track team. Molly has two older brothers that tell her she is a piece of shit every day and she looks fat. Molly’s parents saying nothing has led to Molly feeling isolated in the family. Molly also has no mental health or dietary issues in her family history.
Sara is a thirty three year old lesbian black female. She reports that she was 5’9” in eighth grade and has always been larger than everyone. She also reports that her grandmother was present in her life and would control her diet with slim fast starting around eighth grade, and her brother lived with her as well. Sara has stated that growing up, she did not feel safe, and that there has been trauma causing her life struggles. Her close friend, Julie, reports that she is aware of Sara’s condition but only because she has brought it up when something apparent relates, but declines to discuss in any further detail. Julie states that it is hard to believe Sara is struggling with such a condition and for so long because
Major current stressors in patient H’s life are normal for a girl of her age; attending college at a prestigious university, a new puppy, and friends. Patient H also is suffering from a variety of mental illnesses (this will be discussed later), and her family majorly stresses her. Patient H is an only child and therefore has had her parents
During Julia’s classes at Le Cordon Bleu, she was faced with many challenges where persistence was key. She had no idea how to cook, and she was thrown into a year long class filled with former army soldiers who thought she was not good enough. Upon entering the classroom, “the GI’s made [her] feel as if [she] invaded their boys’ club” (Child, 63). Feeling left out is a feeling that nobody likes, and unlike most of the other people in her class, she did not have any career plans regarding cooking following her graduation. So, it would have been very easy for her to leave that class and never have to feel that way again. Even the owner of the school, Madame Brassart was against her. Julia believed that she “had placed [her] there as a form of hazing” (Child, 63). She clearly did not like Julia, which was just another reason for her to quit. But, she was persistent, and she became the best chef in her class. From the beginning, Julia had many factors against her, but she did...
Clt meets criteria for the following DSM-V diagnosis: Adjustment Disorder, With mixed anxiety and depressed mood. Clt was a victim of bullying at school in March of 2016 and her depressive symptoms (suicidal ideation, sadness, irritability) and her anxiety symptoms (looking out for danger, hesitation to engage with peers at her new school) arose subsequent to being bullied at school. Clt does not meet full criteria for Acute Stress Disorder due to insufficient symptoms. Therapist used to check in with Cl and elicited information about her week while providing active and supportive listening skills every
The nature of the disorder makes it difficult to treat, since patients are convinced that they suffer from a real and serious medical problem. Indeed, the mere su...
... from communicating by being silent and talk negatively and which can be difficult for everyone. Another, issue was that Mrs Smith did get emotional and cried at times; therefore, the author and the mentor had to stop the assessment for a while until Mrs Smith was no longer distressed. This is also supported by (Sanders 2011, pg. 501) who suggested that communicating with a depressed patient can be quite difficult. This is exactly what the author experienced when assessing Mrs Smith. Since Mrs Smith had been living with depression she was taking medications such as antidepressants which made her feel better and suppressed the symptoms from getting worse. Therefore, she was considered to be at low risk of self harming since the symptoms were suppressed by the medication but a follow up and mental health team checkups were arranged for her when she gets discharged.
The physician will question the patient about any stressors she may be contending with at home or work prior to her entering the hospital. The physician will order lab tests and speak with the patient to understand the psychological factors; a referral will be made for making a final diagnosis. After the physician reviews both lab tests and the psychological factors, a referral will be made for the patient to see a clinician. The referral will focus on obtaining support and stabilization. The clinical assessment will gather information using written forms as a first step, including releases to speak with family members. The second step would be to invite the family along with the client in an effort to obtain a better understanding of existing medical conditions along with any past mental disorders. Abuse as a child or abuse as an adult will be determined. The clinician will evaluate if the client is portraying any signs due to alcoholism or a drug addictions. An example of one question her clin...
Additionally, AN has the highest level of mortality among the psychiatric diseases and the continuing result of this morbidity is immensely detrimental for the person with the disorder along with their close family and friends (EDC, 2014). Eating disorders are factual, multifaceted, destructive, and overwhelming conditions that ultimately have serious consequences for the individual’s health, productivity, and their relationships (NEDA, 2014). The grave effects imposed on the families battling anorexia nervosa presents an essential need for successful treatment to aid in defeating the individual’s illness, receiving proper health care, and to have an overall improved life. This paper will analyze a case study involving an anorexic family and will determine what would be the best therapeutic intervention to reconstruct thi...
Formulation of Problem/Needs: The client 's presenting problems are caused by her mother’s emotional verbal abuse. In spite of all, her emotional problems Ana maintains a positive outlook towards her future. Ana demonstrates self-determination as she clearly expresses her current issues. She struggles with overeating because she feels unloved and worthless. Ana is seeking services to overcome the resentment she feels towards her mother. She is requesting help to manage her coping skills and reduce her feelings of depression. According to Ana these feelings started at a young age. Ana’s current challenges are learning to cope with her mother’s verbal abuse. Anna will arrange monthly meetings with her social worker to talk about what methods she’s used to coping with her depression. Ana agrees that she needs to find positive away to communicate with her mother. Ana also stays that she wants to learn to be selfish and break free from the traditional stereotypical life of East LA. Ana would like to begin addressing the following
Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities
Growing up, I was given the freedom to choose who I wanted to be, to decide what I wanted to do. I grew up with many different opportunities and chances to try out new things. A simple life I led as a child, sheltered and loved by all, but I was oblivious to reality, lost in my own “perfect” world. Yet as I grew up and began to surpass the age of imaginary worlds, the idea of “perfection” had begun to fade and reality began to settle in. Like a splash of cold water, I went from a childish mindset to an adult’s. Child hood play was a thing of the past and responsibility became the norm.
...meet. This woman continues to struggle daily to even believe that she can receive her GED even though she would very much like to. Through this example you can see that what this individual thinks about herself affects every other aspect of her life. Even though she would like to go back to school she does not feel like she is capable. Sadly, these thoughts even transfer to her children. Her oldest daughter has no hopes of going to college but just wants to make it through high school. Thoughts affect behaviors and feelings continually with this family. Her daughter consistently runs away because she feels unloved. During one visitation her daughter stated to me that she wanted to get pregnant just so she could have someone to love her unconditionally. Rarely, do individuals see all the positives they have in their life but instead they focus on the few negatives.
People are influenced by everything from jobs, music, fashion, certain people, even to different cultures. Chefs never seemed like the group of people one would expect to have an impact on the world, but they do. They change the way people see food and show that it is far more than just a way to stay alive it is sort of like a new way of life to say. There was one woman who changed the scene entirely, by graduating from the Parisian cooking school Le Cordon Bleu, publishing 19 books, airing 13 television shows, and having 8 DVD releases. Julia Child has been an inspiration for many cooks but has also influenced society as a whole while changing the way people thought about food and at the same time, revolutionizing the professional cooking industry for women.
I think humanistic therapy would be a useful approach to use with Julia, however, it has some limitation and should be combined with psychodynamic therapy approach. Humanistic therapy would increase Julia’s self-worth and also reduce the level of incongruence between her ideal and real self. However, humanistic therapy focuses on a here and now approach. It stated in the scenario that when Julia was a child her mother would belittle her whenever something bothered her causing her to do everything herself and never complain. Part of psychodynamic therapy explains that our past, specifically our experiences during childhood significantly influences our present behavior. Julia might not be consciously aware that her experiences with her mother as a child might be manifesting in her present relationships and behavior. Psychodynamic therapy might help her come to this