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5 pages/≈1375 words
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Check Instructions
Style:
APA
Subject:
Psychology
Type:
Essay
Language:
English (U.S.)
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Topic:

Vignette Analysis: PTSD and Therapy

Essay Instructions:

use your creativity to support what you see in the vignettes as written. Avoid elaborations and assumptions. This assignment MUST be typed, double-spaced, in APA style, and must be written at graduate-level English.
Use the reading assignments thoroughly in an integrative discussion. Include evidence-based research to support the textbook information. Remember to reference all work cited or quoted in APA format.
You are encouraged to use the DSM-5 Level 2 Assessment Measure(s), located under Resources, to formulate your diagnosis:
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 vignettes below. Legal and Ethical information is in Chapter 16 of the course text. Cultural information is covered throughout the course text and DSM 5. You may use alternative cultural resources to enhance your work.
Please review the Sample Vignette Analysis located under Resources
Your assignment should be 5-6 pages plus a title and reference page.
Do not include the vignette in your responses
Jacob is a 32-year old African-American man who just returned from his 2nd tour of duty overseas. Before he is able to begin a 3rd tour of duty, his commanding officer is mandating that he seek counseling due to what Jacob describes as “odd behaviors”. Jacob admits that over the past few weeks, he does not feel safe, but he cannot tell you why. He cannot leave the house without checking that all the doors are locked 3 times. Once he feels the house is safe, he is hypervigilant about walking the property to make sure that the outside is secure and that no one is lurking in dark corners. He does not believe that this impairs his life nor interferes with his judgment and ability to meet his daily responsibilities. He is only seeing you because he shared this with his commanding officer who is now requiring that he seek counseling.
During your intake session, Jacob discloses that he grew up in a rough neighborhood where it was not uncommon to hear gun shots and people screaming. When he was 6-years old, he witnessed his uncle being shot to death, but cannot tell you details. He describes his parents as very loving, trying to shield both he and his brother from life on the streets. His uncle’s death was never talked about. He does admit that he used to have flashbacks and nightmares of his uncle’s death, but that they went away.
Jacob also has experienced violence during his last tour overseas. While he denies actually seeing or participating in direct combat, he does admit to hearing gun fire and the cries of other soldiers. During this time, he admits to recurring thoughts of his uncle’s death. He is able to correlate his military experience with his childhood experience of trauma and violence. He describes his ability to compartmentalize those experiences as ‘the past’ and wants to move forward. Jacob sees the military as his family and wants to dedicate his life to his country. He is adamant about not wanting a wife or family of his own, for fear that “what if something would happen to them and that I would not be able to protect them”.
Formulate a Differential Diagnosis for Jacob. Consider what comorbid disorders may exist and what additional information you may need to confirm your diagnostic impression. Choose one provisional diagnosis for Jacob. Support your diagnostic impressions by walking thru the DSM-5 diagnostic criteria (letter by letter) for the proposed diagnosis and match each DSM-5 criterion with vignette content. (See Sample Vignette Analysis located under Resources for guidance)
Choose two (2) theoretical models and explain how each may conceptualize Jacob’s clinical presentation. From the perspective of each theoretical model, discuss how you would provide clinical treatment. Integrate vignette content to illuminate your treatment approach.

Essay Sample Content Preview:

PTSD and Therapy
Author’s Name
Institutional Affiliation
PTSD and Therapy
Case History, Signs, and Symptoms
Mr. Jacob presents with a fear of being watched all the time, hypervigilance, repeated checking of locks on his door, physical insecurity, and concerns regarding her relationship ties. He is reluctant in making a new family due to uncertainty of physical safety. His history indicates the experience of trauma. His current occupation is military-related, thus, still being subjected to violence and aggression.
Potential Diagnoses and Comorbidity
Mr. Jacob’s symptoms can be related to multiple disorders. He displays paranoia by being skeptical of his environment. He is doubtful of someone keeping an eye on him and being unsafe mostly. He does not disclose information he feels vulnerable about, does not open up to anyone, and tries to withhold his worries to be extra safe depicting a lack of trust in people. These characteristics point towards Paranoid Personality Disorder (American Psychiatric Association, 2013). Its main features are persistent suspicion without adequate proof, reluctance to find confidence in other due to mistrust and unwarranted fear, and doubting intentions or actions or friends or relatives.
The symptoms can also warrant attention towards Anxiety Disorders as hypervigilance is the main characteristic of Panic Disorder. Individuals tend to remain critical of most situations, fear that something bad might happen and are highly pessimistic about their future. Similarly, Generalized Anxiety Disorder may also be a differential diagnosis to cover justifying the symptom of overprotection towards family and remaining concerned about their physical well-being (APA, 2013). Mr. Jacob also feels the same about his future family because of which he no more wants a wife or children. Further symptoms and signs need to be probed such as the intensity, antecedent and consequences of anxiety, physical or cognitive symptoms related to anxiety, and the functioning areas it affects.
Another diagnosis that needs to be confirmed is of Obsessive-Compulsive Disorder (OCD) due to Mr. Jacob’s repeated checking of locks. OCD is characterized by repetitive, and intrusive thoughts which are then neutralized by anxiety-reducing rituals (APA, 2013), as in this case, checking locks. Information, in order to rule out OCD, has to be further elicited such as the intensity, frequency and consequences of thoughts and rituals, degree of impairment in daily life functioning as well as time utilized by those thoughts and compulsions.
Mr. Jacob’s symptoms also indicate the diagnosis of Post-traumatic Stress Disorder (PTSD). He has experienced childhood traumas i.e. murder of his uncle as well as repeated gun firing in the neighborhood. He is also continually experiencing trauma at his workplace where he sees and hears guns firing, fellow mates screaming, body wounds etc. His fears may be the result of uncertainty in the field. Moreover, his job duties and responsibilities may have been a trigger to his repressed childhood memories. Information regarding intrusive thoughts, physiological, cognitive, behavioral and avoidance symptoms may also be needed to confirm the diagnosis.
Provisional Diagnosis ...
Updated on
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