Diagnoses for Clients Receiving Psychotherapy

Diagnoses for Clients Receiving Psychotherapy
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Diagnoses for clients receiving psychotherapy
Mr. Knoxx is a 54-year-old single dad with a 16-year-old daughter Grace Knoxx who he petitioned.
Chief Complaint:
Petitioned by the dad, who relates that the patient feels like she is going crazy and keeps making threats to take her own life.
History of previous illness (HPI):
The patient says she has gone through so much, including her mother's death, and cannot withstand the pain anymore. She has been a victim of bullying in school. She denies that the bullying ever got physical. She relates that the bullies were controlling and picked on everything she did. She has had to trade carefully to avoid upsetting them to not get back at her. She became depressed and suffered from anxiety. She quit going to school because she could not take it anymore but did not tell her father. She would emotionally breakdown and cry every time. She checked herself into a local clinic in August. She was not suicidal at that moment, but she chose to seek help. Before that, she had visited a local chemist and had Citalopram, Propranolol ad Alprazolam. The clinic did not provide her with different medications and did not recommend her to a good medical facility for further treatment. She hopes to get assistance in freeing herself and getting better to continue with her studies. Her dad is the sole breadwinner, and sometimes she is left alone at home. Her father is not an alcoholic but works overtime to cater to his family needs and better raise his daughter. The patient feels like she has had to be alone most of the time, making her lonely because her dad is emotionally unavailable. She has been here for two weeks now. She wants to go back to school, but she is afraid of being bullied again. She needs a part-time job, but she has no idea how to apply for a work permit. She claims that no one will help her go through the process of work and permit application.
Allergies: No known drug allergies
Psychiatric history: Depression and anxiety
Medical history: None
Medications: Citalopram 20mg, Propranolol 50mg, Alprazolam 1mg.
Substance abuse: Smokes marijuana, drinks alcohol occasionally, denies tobacco and illicit drugs
Social history:
She lost her mom to breast cancer when she was 14. Dad has never remarried. Dad comes in for family therapy and presents with feeling exhausted and stressed, especially about his daughter's condition. He hopes the treatment will enhance communication between him and his daughter. Mr. Knoxx also complains of weight loss, fatigue, low appetite, and lack of sleep. He is not an alcoholic and is currently working at a construction firm.
Case formulation: 16 years old with an onset of depression and anxiety.
Plan and Recommendations
Continue Citalopram 20mg and maintenance dose. Questionnaire -9 (PHQ-9) scales were necessary for the assessment of both Mr. Knoxx and Grace Knoxx. Mr. Knoxx had mild MDD, while Grace has depres...