Case Study
Patient Demographic: Client Age: 20 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: African American Relationship Status: Single Counseling Setting: College Campus Counseling Clinic Type of Counseling: Individual Counseling Presenting Problem: Depression and “Odd Behavior” Diagnosis: Bipolar 1 Disorder, Current Episode Manic Without Psychotic Features, Moderate (F31.12)
Mental Status Exam: Mental Status Exam: The client states that she slept for 4 hours the night before, which was the most she has slept in one night in the past week and that she now feels tired for the first time. The client had dark circles around her eyes and was wearing sweatpants and a t-shirt with stains on it. The client is oriented to person, place, time, and situation. The client’s affect and speech are
Presenting Problem: You are a licensed therapist working on a college campus in the counseling center. A 20-year-old female client comes to counseling following 8 days of experiencing the following symptoms: little to no sleep most nights with the longest stretch of sleep being 2 hours, several middle-of-the-night shopping sprees, and distractibility. She reports that some of her college professors have called on her to stop talking during class and that she has not been doing very well in school this semester. The client identifies that she has felt this way before over the past 2 years and that this last time scared her because she was more aware of the negative impact it is having on her schooling. The client continues to relate that she also experiences depression at times and that she does not understand where it comes from but that it happens for a few weeks at a time every few months. When in a depressive episode, the client experiences a depressed mood more often than not, decreased enjoyment of activities, hypersomnia, fatigue, and a significant decrease in appetite.
Other Contexts:     flat. Family History: The client says that she and her family moved to the United States from Kenya when she was 5 years old. The client is the first member of her family to go to college, and she reports significant pressure from her parents to succeed. She feels that she has a good relationship with both of her parents. Her sister is 2 years younger than her, and they talk on the phone on a daily basis. The client identifies no other close family members because most are still living in Kenya

Question: Which of the following is the most effective form of treatment for bipolar disorders?
(A): Medication management
(B): CBT and medication management
(C): Dialectical behavior therapy
(D): CBT

Correct Answer: CBT and medication management
Explanation: The most effective form of treatment for bipolar disorders is a combination of medication management and psychotherapy (Mayo Foundation, 2021). Medication and CBT together are an effective treatment combination for this lifelong disorder that requires cognitive adjustments that can be supported by medication. Therapy alone, although it can be helpful, is more effective when combined with medication. Medication alone would address the behavioral and cognitive changes needed to create the lasting changes that are not impacted by medication. Dialectical behavior therapy is useful in treating mood disorders and substance use and is not proven to be beneficial for treatment of bipolar disorder. Therefore, the correct answer is (B)
Competency: treatment planning