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Assignment: Clinical Assessment Mr. and Mrs. Lawson brought their 4-year-old adopted daughter, Clara, to see Dr. Mason, a psychiatrist. Clara was polite in greeting Dr. Mason, but did not smile and kept her gaze down as she took a seat. Mr. and Mrs. Lawson sat next to Clara and began explaining their concerns. They described Clara as a quiet child who has recently begun throwing temper tantrums, during which she is inconsolable. Her sleep and eating patterns have changed, and she no longer wants to go to preschool. ? Create a brief response to each of the following questions: What other information would you like to learn during the interview with the family? What questions would you ask? I would want to learn as much about Clara as possible first. I would go into her birth parents and just how long was it before they gave her up for adoption? Maybe for some reason or another she was taken out of the home and the parents parental rights were taken. I would want to know why? I would want to know how many other adopted families have she been exposed to? What were the circumstances of each? I would want to then know more about the Clara before the temper tantrums started.
How were her eating habits and moods? How was she at preschool before the actual tantrums. When did the adopted parents notice the change in Clara? I would then get to know Mr. And Mrs. Lawson. I would ask the couple just how is their relationship? Do they argue, fuss or fight around the child? What are their work schedules? How much time do they spend with Clara? The answers might help to reveal the causes and probable course of her present dysfunction and suggest what kinds of strategies would be most likely to help her.
Treatment could then be tailored to Clara’s needs and particular pattern of abnormal functioning. * In addition to the clinical interview, what other clinical assessment tools should you consider? Why? In addition to the clinical interview the first additional tool that I would use is the intelligence test. I would want to see just how Clara’s learning is going in preschool. This could have a lot to do with why she is suddenly acting out and not wanting to go back. The next thing that I would try in addition to these two that I mentioned previously is the Clinical observation method of treatment.
In one technique, called naturalistic observation, clinicians observe clients in their everyday environments. In another, analog observation, they observe them in an artificial setting, such as a clinical office or laboratory. Much can be learned from this method of treatment. * Although you need more information to begin treatment, what factors might you take into consideration in designing an effective intervention for this family? I would take into account that Clara could be experiencing this depressive type of behavior because Mr. nd/or Mrs. Lawson could be experiencing it and it could very well be rubbing off on the child. I would look into the home situation first. I feel that their may be some problems in the home that are affecting the child. In question 1 I did not go into it, but the question to the parents as to why they had to adopt is an issue here. Maybe they are dealing with issues dealing with the fact of them not being able to have children or another child of their own. Also a home study is in order to see just how they interact. How are their social skills?
So my beginning of treatment would be basically looking for the diversity of influences on the development of behavior that Clara is experiencing. * If you were preparing to diagnose Clara, you would refer to the DSM-IV classification system to evaluate her condition on five separate axes. What type of information would go into each axis? You are not asked to enter a diagnosis, only describe the kind of information that would be entered in each axis. Axis I: It appears that Clara is experiencing both anxiety disorders and Mood disorders.
It was reported by her parents that she throws temper tantrums, during which she is inconsolable. This could be caused from periods of panic (panic disorder). Then the scenario describes the little girl as quiet and looking downward, but polite to the Dr. This could very much fit into the mood disorder category. People with mood disorders feel extremely sad or elated for long periods of time. These disorders include major depressive disorder and bipolar disorders (in which episodes of mania alternate with episodes of depression).
Axis II: With this axis I would look and see whether Clara fits into one of the two categories, mental retardation or personality disorders. From looking at the scenario only it is not enough to say that the child is mentally retarded, but she might be experiencing one of the types of personal disorders such as dependent personality disorder. People with dependent personality disorder are persistently dependent on others, clinging, obedient, and very afraid of separation. Axis III: Ask for information concerning relevant medical conditions from which the person is currently suffering.
Axis IV: Ask about special psychosocial or environmental problems the person is facing, such as school or housing problems. This is where I would take into consideration that they have said that Clara is a quiet child who has recently begun throwing temper tantrums, during which she is inconsolable. Her sleep and eating patterns have changed, and she no longer wants to go to preschool. Axis V: This axis requires me as the diagnostician to make a global assessment of functioning (GAF), that is, to rate the person’s psychological, social, and occupational functioning overall.
And because she seemed fairly dysfunctional at the time of diagnosis, Clara’s GAF would probably be around 55 on Axis V, indicating a moderate level of dysfunction. * Do you think that diagnosing Clara would be beneficial or harmful? Explain why. With the information given I feel that diagnosing Clara at this point would be very harmful. The case is too widespread with possibilities in order to just make a diagnosis. The child has so many obstacles from the abandonment issues from being adopted to severe depression.
I would have to find the very root of the problem before diagnosing the child. And in this case in question we are hearing a source of information such as a parent’s report about a child, and nothing from the child. Beyond the potential for misdiagnosis, the very act of classifying people can lead to unintended results. We also can influence the behavior to be whatever we have diagnosed it to be or label a person wrong where as we make it hard for them to obtain jobs and etc. in today’s society.