Case Study
Patient Demographic: Initial Intake: Age: 16 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Private Practice Type of Counseling: Individual
Mental Status Exam: Molly muttered one-word answers during the intake session, made little eye contact and frequently rolled her eyes. She started to warm up towards the middle of the intake session, with some prompting from her mother. She reluctantly agreed to continue counseling sessions- only due to the fact her mother stated that she could not use the family car unless she went to counseling.
Presenting Problem: Molly is a 16-year-old female who was referred to an outpatient mental health clinic after a two-week admission at a local psychiatric hospital. Molly was brought to the hospital by ambulance after she disclosed to the school psychologist that she wanted to kill herself.
 
History:
When asked what brought the family to the session, Molly’s mother was tearful as she disclosed that her husband died in a car accident 11 months ago. Molly and her father had been close, spending time together as Molly played recreational softball and her father was the coach. Since her father’s death, she has been distant with her mother, and often picks fights with her. Additionally, Molly frequently complains of stomach aches, stating that the pain is so severe, she cannot go to school. Before her father’s death, Molly was in Advanced Placement classes and maintained a high average. Recently, Molly’s grades have been declining and she is no longer interested in softball. She states that when she goes to the softball field, she can almost hear her father speaking to her.

Question: In developing Molly's treatment plan, which of the following would NOT be included in her short-term goals?
(A): Crisis planning
(B): Organizing a bereavement support group at her school
(C): Development of existing strengths to increase coping skills
(D): Joint sessions between Molly and her mother to help improve their relationship

Correct Answer: Organizing a bereavement support group at her school
Explanation: Although this may be a future goal, at this time it seems that this would be a very large step for Molly. She is newly engaged in the therapeutic process and has not yet processed her grief. Molly has given up on one of the things she enjoyed doing- softball. It would help Molly to find other things to help her cope with her grief and building on her strengths would be better than starting a new hobby she has not mastered yet. It is important for Molly to also build her support network. She and her mother may have a tenuous relationship now, but only since her father's death. Bringing Molly's mother into sessions will help identify the cause of the relationship breakdown and find ways to improve it. Crisis planning is important to do with Molly to help her identify her triggers and to establish effective coping skills. If Molly does not have effective coping skills, creating a crisis plan can be a way to start building them. This is especially important since Molly was considering cutting as a way of coping. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis