Question Description

Donald is a54-year-old paper mill employee. He has adult children and 7grandchildren with his wife of 30 years. Donald began to experienceproblems with worrying during his first few years of marriage. Hewould worry excessively about finances, his job security andperformance, fixing up the house, his children and their futures, andhis parents’ health. Since that time he has also worrieduncontrollably about the car breaking down, his grandchildren beingharmed, saving enough for retirement, his own health, and his wife’shealth.

Donald’s worry has interfered with hisability to enjoy his life, including holidays and special occasions,as he always feels tense, restless, and on guard. He has also turneddown multiple promotions at work due to excessive worry that hecouldn’t handle the increased stress, responsibilities, and beingaround others. He often worries about whether his coworkers like him.In addition, Donald worries that he will not be able to keep up withthe new technology being used at his job. His worrying also preventedhim from exploring other jobs outside of the mill due to worry hewould fail and end up losing the family home. His back and neckconstantly ache from the tension. His worrying has also led tolong-term problems falling asleep. He has become dependent onover-the-counter sleeping pills and is still easily fatigued mostdays.

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Friends and family complain that Donaldis always on the go and never sits still, but this is the only way heknows how to block the worries from his mind. Sometimes heexperiences upsetting images about his grandchildren being injured orharmed when worrying about them. Twice in the past, these images havebeen accompanied by feelings associated with a heart attack includingsweating palms, dizziness, heart palpitations, and shortness ofbreath. Each time he went to the emergency room, he was releasedafter tests were run confirming that he was not going to have a heartattack.

Around times of stressful life events(e.g., during his daughter’s divorce) Donald tends to experience anincrease in his worrying frequency and intensity, but his reaction isalways stronger than other people’s. After a bad period of worry heoften feels depressed for weeks afterwards, including having nopleasure or interest in his usual activities. Donald feels envious ofthe enjoyment and relaxation other people seem to get from life andhe often feels hopeless when it comes to managing his worry. He justdoes not understand why he is not able to relax the way others are.He is very concerned that he may develop health problems due to hisexcessive worrying and he sometimes wonders whether his worryingactually increases the odds of bad things happening to him.

CaseStudy Template

Follow the example below as you complete your Case Study assignment.You will have 3 major areas to your case study response: (1) keyissues, (2) diagnostic impressions, and (3) treatmentrecommendations. This assignment does need an APA-formatted titlepage, and you are required to cite the sources for the treatmentrecommendations and include a reference page. It should be 3–4pages for content. The case study assignment is an opportunity foryou to think through a clinical case, identify and prioritize keyissues involved, consider and clarify relevant diagnostic issues, andformulate treatment recommendations that are most likely to behelpful to the client.

1. Key Issues

   1. List in order of importance the key issues you believe are involvedin the case study, as if you were the client’s counselor. Providea rationale for the order in which you prioritized issues. What arethe most important features to you, and why?

   2. Link your rationale to what you believe outcomes of treatmentshould be for this client. How will your order of prioritycontribute to a successful outcome for the client?

1. DiagnosticImpressions

   1. Based on the information provided in the case study, use thecurrent version of the DSM to accurately diagnose the type(s) ofdisorder(s) involved. Refer to specific diagnostic criteria whenpresenting your impressions. What category could this be in? Whatdisorder in that category does this appear to be and why? Providerationale for diagnosis, giving consideration to differentialdiagnostic considerations. In other words, what disorders in thiscategory or other closely related categories were considered? Whycould this not be any of those disorders?

   2. Be sure to consider other disorders in addition to the maindisorder. Is there more than one diagnosis? Provide rationale fordiagnosing any additional disorders.

1. TreatmentRecommendations (cite sources in this section)

   1. List your recommendations (e.g., 1., 2., 3., etc.) so that you canclearly delineate what you believe will be of most help to yourclient. Consider recommendations that will be motivating to yourclient and reflective of a collaborative approach.

   2. Be sure to consider the biopsychosociospiritual aspects of thecase. Make sure your recommendations are relevant to the case, ableto be implemented by the client, and have some basis of supportfrom professional literature—include academic sources here (2–3).

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