Case Vignette: Case Conceptualization for Module 2
Case Conceptualization for Module 2
Case Conceptualization for Module 2 – For module 2, you pick ONE of the following Case Vignette to complete the case conceptualization:
- Chapter 19 has the case vignette of Margarita.
- Chapter 18 has the case vignette of Chester.
- Chapter 16 has the case vignette of Violet.
Instructions
Students will create case conceptualizations for Module 2 to 5. Case conceptualization format and example paper is provided on Blackboard. There are four case conceptualizations for your course. Include, in each of your two paged, short answer summaries, the etiology, diagnosis and designed treatment plan (long term and short-term plan) if working with this individual/family. Also include, what would be some of the challenges you would face as a counselor? You are required to incorporate two peer-reviewed research articles into the summary and will be included in the reference page. The book, newspaper articles, and/or blogs are not considered peer reviewed research articles. The paper does NOT have to be APA style but the references need to be written in APA 7 style.
Chester
CLINICAL HISTORY
Chester is a 42-year-old white male seeking an evaluation at a university-based treatment center. He decided to consult the experts because he had tried so many other treatments in the past with mixed results. He presented with a history of panic attacks dating back to high school. His first attack came during his senior year when he was not accepted to Princeton University. This rejection was a terrible blow to his self-esteem because his father attended Princeton and expected that both Chester and his brother would also attend. His brother was then in his junior year at Princeton and planning to attend law school when finished. After Chester’s first panic attack in high school, he and his parents consulted their family doctor and a cardiologist who found no reason for the attacks and no heart-related issues. Chester was told to reduce his stress and return if the attacks continued. They did not return, and Chester was accepted to Harvard, an acceptable alternative. In his freshman year, Chester experienced another panic attack while he was sleeping. He consulted the university health services, which once again found no medical reason for the attacks. The staff explained to him that the attacks might be a stress-related condition. An appointment was made for him at the university counseling service, but he did not keep the appointment. Chester made it through college by using alcohol to self-medicate. He was able to hide most of his drinking from his family and friends until he graduated and met Judy. He and Judy fell in love and married within six months. His drinking became harder to hide, and Judy confronted him after he fell at a neighbor’s dinner party where he was very drunk and rather loud. Chester confided in Judy about his panic and fears and how he needs the alcohol to function at home and at work. With Judy’s help, he decided to attend AA and seek counseling from a mental health professional. Chester slowly refrained from drinking but felt increasingly more anxious until he had three panic attacks in one week. He was placed on 2.5 mg of alprazolam (Xanax) by a consulting psychiatrist. He found the medication very helpful and was able to learn how to identify, label, and modify his thoughts in counseling with the use of cognitive therapy. He attended therapy weekly for nearly two years but stopped when he and the therapist felt they had progressed far enough. He continued to take the medication and remained symptom free for over 10 years. When he was 32 years old, his primary care physician believed that Chester was over his emotional concerns. His physician felt Chester should stop taking the alprazolam, which now had increased from 0.25 mg/day to over 3 mg/day. He still attended AA meetings from time to time but never touched alcohol again. By the second week of his step down from alprazolam, Chester experienced a panic attack while driving home from work. His medication was increased back to 3 mg/day of alprazolam and has remained at this dose for the past year. He attempted to return to therapy but found the principles of therapy were not helping him much this time around. Chester changed therapists, but the next therapist was less versed than the first, adding to his sense of failure. About a month ago, Chester’s 17-year-old son was accepted to Princeton. Although happy for his son, Chester became very depressed and, while shopping with his wife in a grocery store, he experienced an intense panic attack. He is tired of partially effective approaches and desires a more comprehensive form of treatment. He is aware that he now needs to address the concerns in therapy and deal with his reliance on alprazolam.
