For this assignment, you will develop and present your analysis. Your analysis will include early
thoughts on diagnosis, an accounting of the key symptoms presented, an acknowledgment of the
client’s strengths and areas for growth, and potential treatment goals for the client. You will
conclude the intake analysis by discussing areas to explore with the client at the next visit.
Client: Carl
Carl is a 37-year-old male who, during his intake visit, communicates he is experiencing a
variety of life stressors. As you take notes, the following list is recorded:
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change in weight, an increase of 25 pounds
trouble sleeping primarily interrupted sleep and occasional sleeplessness
low energy
varied eating – periods of not feeling hungry followed by increased eating
irritability and moodiness
anxiety
decreased sexual desire
self-esteem - decreasing
feelings of guilty – economic challenges have resulted in significant income losses
Carl has been married to his partner for eleven years. The marriage has experienced
challenges but is
relatively happy and intact. Carl's partner is an entrepreneur with many irons in the fire,
and whose drive contributes to the business’s success and a healthy income ($185,000).
Like Carl, his partner must reinvest the majority of their income back into their business
ventures. Recent economic shifts have put pressure on the couple's shrinking savings and
investments, and on the upper-middle-income lifestyle, the two have become accustomed
(buying and engaging in desired activities without much worry).
Carl holds a master's degree from the University of Virginia, Darden School of Business.
He pursued and obtained his MBA with the goal of establishing his own business. He has
a receptionist who works remotely from home on an hourly basis and one full-time
employee. Carl recently made the move_from the home office, shared with his partner, to
a new office space that has room for his employees. The office is well-sized and includes
a conference space where clients can meet. His client list has expanded, but Carl is
experiencing difficulties getting clients to pay within the 45-day billing period specified
when invoiced for services rendered. As a result, Carl is often forced to pay his
contracted account a service fee to prompt clients for payment.
Carl pays the accountant’s fee because he requires a steady cash flow to pay his
employees, pay bills, and meet family responsibilities. The health insurance premium he
pays for his family is high (over $1400 per month) due to a pre-existing health condition
(his partner has a chronic condition). Additionally, he pays the health
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insurance premium for his full-time employee. Carl's partner willingly, and lovingly paid the
family healthcare premium on their plan for over two years at a monthly cost of $1,700.
Carl took over the healthcare premium four years ago, as he felt that his partner had carried that
monthly burden alone while he built up his client base. His partner also covered expenses Carl
was not able to pay while he attended graduate school and established his business. During the
intake visit, Carl shares that he could not have pursued his business endeavors without his
partner's support (financial and otherwise). He believes that this has created tension in his
relationship with his partner, particularly during the current economic downturn.
Carl and his partner have three children, ages 2, 5, and 8. All are healthy, intelligent, fun-loving,
and well- mannered, per his reporting. At the time of his visit, Carl has no concerns regarding the
little ones. His partner works doggedly to contribute to the finances and to attend to the children.
While Carl works most days from 7 a.m. to all hours of the evening, his partner “does it all,”
making $185,000 and being a stay-at-home parent.
Carl feels that his partner's deteriorating physical well-being is the result of this effort to do it all
- being there for him and the children. While his partner does not express dissatisfaction, Carl
feels (in his words, “understands”) that his partner must feel resentment toward him for the nonstop, around the clock, work he must dedicate to his business. As the funds in their savings have
shrunk, Carl feels his personal state has deteriorated, physically, emotionally, professionally, and
personally.
Carl concludes his intake visit expressing he needs help. He needs help regaining control in his
life. He wants your help to develop a strategy for reversing this downward spiral.
Your Task:
Review Carl's case and give a preliminary diagnosis using the knowledge gained in this course.
Relevant diagnostic criteria can be found in the International Classification of Diseases, Tenth
Revision (ICD-10 link), and the Study Guide to DSM-5. You may find useful, as a supplement,
the sequential presentation of disorders found in Lumen Learning Abnormal Psychology,
https://courses.lumenlearning.com/abnormalpsychology/ . (Caveat – the Lumen Learning
resource uses DSM-IV-TR criteria with DSM-V revision summaries. Updates and changes
within the DSM-V discussed in this course should be taken into consideration, should they
apply.)
Answering the following six items, provide evidence of your logic for each decision. Reinforce
responses with scholarly resources and appropriate detailing. Discuss how and why you arrived
at the conclusions drawn. See rubric for depth and detail expectations.
Develop your analysis in an organized, well-developed 5 to 7-page paper.
Required Items to be Addressed (scored):
1. Based upon this intake visit, what diagnosis do you think is most appropriate for Carl? Be
mindful, this is your first session. Information is limited to the data collected in this first
visit. (12.5 points)
2. What are the principal symptoms contributing to the diagnosis proposed? Clearly explain,
providing details. (12.5 points)
3. Discuss Carl's strengths. These will facilitate constructive work with him. (10 points)
4. Delineate Carl’s opportunities for growth and/or improvement. (10 points)
5. Looking to the next visit and beyond, what is your preliminary sketch of the treatment
goals you have
for Carl? Why do you identify these goals as appropriate for Carl? (10 points)
6. What will you explore with Carl in future visits (e.g., interpersonal, aspirations)? Present
rational. Why
do you want to this information? (10 points)
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