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: The client comes to the counseling center during walk-in hours. The client is continuing to experience a manic episode. She reports that she went out to dance with friends the previous evening and ended up buying a gram of cocaine for $100 and reported doing several lines throughout the night. The client says that she has never used any drugs before and that it scared her that she would spend that much money on drugs and that she used drugs at all. You empathize with the client’s frustration with her behavior and provide psychoeducation on impulse control to support her. The client appears tired as evidenced by her affect and slow movements, and she also appears to have poor hygiene because her clothes have visible stains and she has a slight body odor

Question: Which one of the following assessments will assist you in monitoring the severity of the client’s manic episode?
(A): Brief Symptom Inventory
(B): General Behavior Inventory
(C): Patient Health Questionnaire 9 (PHQ-9)
(D): Minnesota Multiphasic Personality Inventory (MMPI-2)

Correct Answer: General Behavior Inventory
Explanation: The General Behavior Inventory assesses the presence and severity of manic and depressive symptoms; therefore, it is the most appropriate tool for monitoring the severity of the client’s symptoms. The MMPI-2 can support a bipolar I or II diagnosis, but it would not be beneficial in regularly measuring the severity of symptoms. The PHQ-9 is the major depressive disorder portion of the full PHQ that can help with the diagnosis and measurement of depressive symptom severity over time. The Brief Symptom Inventory measures many areas of symptomatology and may be useful in providing support for a bipolar diagnosis, but it does not provide measurement for the severity for manic episodes. Therefore, the correct answer is (B)
Competency: intake, assessment, and diagnosis