Week 3 Case Study: Bianca and Juan Week 3 Case: Bianca and Juan (W3LO 3) This assignment focuses on vignette analysis and direct application of course concepts to the persons and situations presented in the vignette for each question. All discussions must take into account the legal and ethical considerations, as well as issues of culture and human diversity that may pertain to the situation presented below.  Cultural information is in both the course text and DSM 5. You may use alternative cultural resources to enhance your work. You are also encouraged to familiarize yourself with and apply the laws and ethics of mental health professionals in your state or country. Use the reading assignments thoroughly in an integrative discussion. Remember to reference all work cited or quoted by the text author. You should be doing this often in your responses You are encouraged to use the DSM-5 Level I Assessment Measures which can be found in your DSM-5 book or visiting the following website: https://www.psychiatry.org/psychiatrists/practice/... Please keep your responses focused on what is presented in the vignette. Do not add information but use your creativity to support what you see in the vignette as written.  Avoid elaborations and assumptions. This assignment MUST be typed, double-spaced, in APA style, and must be written at graduate-level English. Case: Juan and Bianca are a middle-aged couple of Latino descent. The couple has two children, both away at college. Juan and Bianca were referred by their priest for counseling, due to Bianca’s history of depression and suicidal ideation. Bianca tells you, “life has always been a struggle for me. I was raised by my grandmother who tried to protect me, but I was molested many times as a little girl. I’ve often wanted to end my life, but my religious beliefs don’t allow me to”.  Bianca does report periods of joy and happiness in her life, especially regarding her children. She admits that during the last 5 years, she has had a few periods where she has actually felt euphoric, energized and elated with life. These times are brief and infrequent and, “I return to that suffocating place of despair.” She describes her husband as, “a good man. I don’t know why he has stayed with me all these years.”  Juan is very supportive of his wife, but his worry about her has resulted in exhaustion, missing work and obsessively checking that all the kitchen knives are accounted for. He tells you that, “sometimes Bianca cries out in her sleep and I don’t know how to help her.  I worry that she will do something to end her life during one of these night terrors. Even though she’s never tried, what if it happens and I’m not able to stop her.” Directions: Consider Mood, Anxiety, OCD, and Trauma Related Disorders 1.  Taking into account the genetic, neurobiological, sociocultural, familial and environmental factors of assessment and diagnosis, what are your diagnostic thoughts for Bianca? What about Juan? Use the DSM-5 criteria to formulate your diagnostic impressions for Bianca and Juan, supporting what you see in the vignette that supports your diagnostic impressions. 2.  Using the psychotherapeutic and pharmacological interventions discussed in the text, describe an initial treatment plan for Bianca and Juan. Remember to treat the persons in the vignette, and not the diagnosis. Also remember to consider culture and legal/ethical issues. 3.  Given the diagnosis you have made, describe your medication treatment strategies. Discuss not only initial choices of medications but also your next-step strategy and why you’ve chosen it. (In doing so, be sure to provide a rationale for your choices.) What questions should be addressed about the class of medications that is chosen (e.g., mood stabilizers)?

DQ 1. As one noted psychologist would state to his clients, "What's your objection to having all of your feelings?" Did you find that you were censoring your gut-level feelings towards clients upon review of the client progress notes? What types of emotion did you think you might have held back, and why? DQ 2. Has supervisory time spent in review of your session documentation been helpful, uncomfortable, or a combination of both? Please elaborate. Journal - write a paper of approximately 250 words reflecting upon the week's learning experiences at the agency in which you are completing your practicum. Summarize the task areas you performed