Case Study
Allen is a 43-year-old African American male living in a rural town in west Texas. Two months ago, he was laid off from his full-time job of 7 years. Allen has been experiencing a significant amount of grief and sadness over the loss of his job. He is single, with no children and no family nearby. His job was a significant source of meaning in his life. He comes to you for counseling and seems to focus mostly on feelings of loss and sadness. As you continue your assessment with Allen, he talks about difficulty sleeping. He reports sleeping fewer than 4 hours each night, saying that he cannot fall asleep because he feels so anxious about the loss of his job and what the future will hold for him financially as well. Allen states that he typically feels very anxious at night and then early in the morning after he wakes up. He shares that he feels very helpless right now and that this feeling reminds him of when he was a child. Allen discusses that he and his mother went through a period of being homeless when he was about 5 years old. He seems to be very distraught when he talks about this experience, almost as if he is reliving the emotions right there in the session with you. As Allen continues to talk about his experience, he shares that he has started to drink some in the evening to “take the edge off” of his anxiety and fear. When asked a few times, Allen shares that he drinks about a pint of vodka four or five times a week now. He states that he rarely drank prior to losing his job and that “sometimes it’s just easier to have a few drinks than it is to go see the doctor or a counselor, you know?” He shares that he has been drinking more over the past month because it does not seem to be helping as much now. Allen describes feeling as if he is constantly “on edge” most of the day as well. He has tried to search for jobs and apply for unemployment, but he has had a difficult time concentrating and focusing in general. Overall, Allen says he is feeling exhausted from worrying “literally all day every day,” to the point where he just cannot get his mind to rest anymore.

Be sure to include the following components in your paper:

Part 1

Rule out inaccurate diagnoses.
* Discuss at least two alternate, but inaccurate, diagnoses that should be considered for the case study.
* Give a rationale for why both diagnoses are not accurate.
* Include symptoms that are missing from the diagnoses.
* Include symptoms from the case study that do not match both of the diagnoses you are ruling out.
* Explain at least one additional test that you would want to ensure is provided to the client to rule out any substance induced symptoms and one additional test to rule out any medical conditions that may be influencing current symptomatology.

Part 2:

Apply symptoms to the overall diagnostic impression.

* List the DSM–5 coding for the diagnosis or diagnoses you have arrived at for the client.
* Apply the symptoms from the DSM–5 to support your diagnostic impression.
* Include why the client’s symptoms are a match for the diagnosis or diagnoses you have provided.
* Align your rationale with the diagnostic symptoms listed in the DSM–5.
* Discuss at least two additional pieces of information that are missing from the case study and that would help you arrive at a conclusive diagnosis.