3:2: RA: Vignette Analysis: Design Interventions
An important part of the skills you will develop in this course is the ability to design appropriate interventions, and that includes designing an assessment strategy appropriate to the particular client treated. In this assignment, you will create an assessment strategy based on the information provided in the vignette. This assignment is to be completed individually.
As a Forensic Case Manager, Laurel is sent to you to conduct an intake in order to start the assessment process. During that appointment, she relays to you the information mentioned in the vignette. Using the information found in the vignette, provide a preliminary diagnosis of the client according to The Diagnostic and Statistical Manual of Mental Disorder (DSM) criteria.
Create a 2- to 3-page paper describing the assessment tools you will use. In your paper, include the following:
A description of the steps you will take to build rapport with Laurel and help her feel comfortable in confiding in you. Consider the work of Carl Rogers Person Centered Theory; the work of Insoo Kim Berg Solution-Focused Brief Theory (SFBT); and Crisis Theory to help inform your rapport building with Laurel.
A description of what methods you will use to continue with the assessment process, knowing this may take three to four visits. Be specific if you are considering using any instruments or questionnaires. Explain the rationale for using each method and indicate what information you expect to find by using them.
Given the information you know at this point, what would be your provisional diagnosis of Laurel?
Look at a diagnosis for this exercise.
You may consider rule-outs. Any diagnosis you give should have an explanation of the criteria or symptoms supporting your choice.
study the vignette.
When Laurel was a freshman in college, she was one day walking back from her part-time job in town to the dorm where she lived. It was dusk when she reached the outskirts of a quiet neighborhood and started to cut across a large field that lay between town and campus. Suddenly, a man in a stocking mask jumped from a hedge that bordered the field. He grabbed her arm, pushed her down, and shoved the barrel of a gun into her mouth as he raped her. She thought she was going to die. But just as quickly as he had appeared, he disappeared. His only words were, “If you tell anybody about this, I’ll really get you.”
Somehow, Laurel made it back to the dorm, and her roommate drove her immediately to a hospital emergency room. After she was examined and treated, she spoke briefly to a psychiatrist who suggested she talk to someone at the college counseling center. She was also questioned by police, who investigated the incident but were never able to develop a lead.
The next day, Laurel felt strange, as if the experience had been a bad dream. She found herself jumping out of her skin at the slightest noise. Over the next few weeks, she had trouble falling asleep and woke from nightmares she could not clearly remember. But she did not go to the counseling center; she did not want to talk about the rape. It was as if talking about it might make it more real. She also felt vaguely guilty—she should not have taken the shortcut home.
Over the next few weeks, Laurel’s life changed. Prior to the rape, she had started a relationship with a fellow student. Afterwards, she abruptly stopped seeing him or socializing much with anybody. She had difficulty concentrating on her schoolwork. Her grades, which had been consistently high before the rape, fell sharply. At the end of the semester, she dropped out of college where she had been doing preprofessional coursework. Only after working two years in a dead-end job did she finally decide to try again and enroll in a business course that trained her to do secretarial work.
Five years later, following the breakup of a serious relationship, Laurel sought therapy for “depression.” She also complained of dissatisfaction with her job. She was beginning to see her problems with men as a result of her own ambivalence. Every time she got close to someone, she said, she began to panic and did something to force distance. Laurel considered her childhood normal and reasonably happy. Her parents seemed to have a good marriage, as did her siblings. She had concluded that something must be wrong with her.
USE THIS TEMPLATE
Module #: Assignment #
[Use this template to complete your assignment.]
Case Vignette: Assessment
Answer the following questions thoroughly:
1. You are the therapist Laurel chose to work with, and you give Laurel an appointment to conduct an intake in order to start the assessment process. During that appointment, she relays the information mentioned in the vignette to you.
a. Describe the steps you will take to make Laurel feel comfortable with telling her story to you.
b. Describe what methods you will use to continue with the assessment process, knowing this may take three to four visits. Be specific if you are considering using any instruments or questionnaires. Explain the rationale for using each method, and indicate what information you expect to find by using them.
c. Given the information you know at this point, what would be your provisional diagnosis of Laurel?
i. Use DSM criteria (including appropriate diagnosis code number). We are just looking at Axis I diagnosis for this exercise.
ii. You may consider rule-outs. Any diagnosis you give should have an explanation of the criteria/symptoms supporting your choice.