Case Study Treatment Plan Stella
For your course project, you will develop a treatment plan for one case study subject that you select from two possible candidates. These potential clients are ethnically diverse and are struggling with psychological disorders, which may require medication.
During the course of this project you will:
- Evaluate client information.
- Review possible assessment techniques.
- Offer a diagnostic impression.
- Review various behavioral and pharmacological treatments.
- Discuss the legal and ethical ramifications of the disorder and proposed treatments.
- Review the impact of diversity issues on various disorders and their treatments.
- Develop a suggested treatment plan for the client.
You will select one of the case studies presented on the next page of this presentation as your client for this treatment plan project. Then you will use the Case Study Treatment Plan Template, provided in the Resources to complete your assignments for this project. Each section of the template includes a description of the type of information you will need to include. You should type your paper directly into this template, save it as a Word document with your name, and then submit it to the assignment area.
STELLA’S CASE STUDY
Stella is a 38 year old biracial (African American and Native American) woman who has just been assigned to you as a client. You are currently working as a counselor for your county community mental health agency. You received the following information about her as background and history.
Stella is the only child of a Caucasian couple who are now deceased. She was adopted as an infant in a closed adoption, so that none of her birth parents’ records are available. The only informal information that Stella remembers her parents telling her is that her mother was 16 years old at the time of Stella’s birth and had been raped while at a high school football game.
Stella currently lives in a small city of 150,000 people where she is employed as a book-keeper for the local meat packing plant. She has worked there for 3 years. Her educational background includes an associate’s degree in accounting and continuing education in tax preparation. Before working for this plant, she was employed as a tax preparer for a national company. She enjoys her work, saying that numbers are easier to get along with than people.
She has been married to her husband (Doug) for 18 years and has a 16 year old son (Tyrone), who is currently a junior in high school. Her son plays baseball on the school team and is a solid B student. Her husband is a long distance truck driver. He is often away from home for two weeks at a time. He is then at home for 3 to 4 days before he leaves on another trip. Stella reports that she stays at home and feels “blue” when her husband is on the road. Although there have been some problems in the marriage due to Stella’s mental health concerns, the couple seems committed to each other and to staying in the marriage.
Stella reported that her problems began when she was in late adolescence. She started sleeping and eating excessively. She missed several days of school because she couldn’t get out of bed and gained 15 pounds. Because of the weight gain she experienced, Stella obtained some methamphetamines from a friend of hers in school so she could lose the weight quickly. She was able to do so, but found that when she stopped taking the pills she felt even lower than before. She asked her friend for more pills, but her friend refused to provide them. Stella’s mood continued to decline; she believed that she would never be successful at anything and stopped talking to her friends. She stated that she felt “blue” during this time, a word she frequently uses to describe her mood. This episode lasted about one month until school ended for the summer. She felt better because she had a summer job as a stocker at the local grocery store where her boyfriend was also working. The following year she once again became “blue” and this time she took 25 aspirins in a suicide attempt. She told her mother, who took her to the emergency room to have her stomach pumped. Stella did see a counselor briefly, but when she began to feel better, she stopped her counseling. She was not prescribed any medication at this time.
Stella was able to successfully graduate from high school and earn an associate’s degree at the local community college. Her first full-time job was back at the grocery store, where she worked in the office preparing bank deposits and reconciling bank statements. She reported that she enjoyed this job “a lot”. During this time she also married her high school boyfriend. However, after 3 years, she again experienced depression, this time more severely than ever before. “It felt like my ‘blue’ had taken over my whole world and I couldn’t see anything else. I just wanted to die. That had to be better than how I was feeling.” Her suicide attempt this time was more serious; she cut her wrist in the bathroom at work. A co-worker found her and called 911. She spent four days in the hospital and was referred to a psychiatrist for follow-up care. The psychiatrist prescribed an SSRI for the depression and referred Stella to her previous counselor.
Quickly, Stella began to feel much happier and elated. She began going out when her husband was out of town for work and soon began bringing other men home for sex. During the parties with the other men, she would drink excessively and smoke marijuana. She reported that these substances “took the edge off” of her excess energy. She also spent money on new clothes, until she had maxed out her credit cards and borrowed money from her parents. Her performance at work became erratic and her employer began to suspect that money was missing. He was unable to prove the missing money, but became so uncomfortable with Stella’s change in behavior and her deteriorating performance that he let her go. When her husband returned home, he took her to her psychiatrist, who made adjustments to her medication regime, adding a mood stabilizer. Stella was not fully compliant with taking her medications and continued to smoke marijuana from time to time.
Since that time, Stella has had a series of jobs, most of which she was able to keep for several months and, on one occasion, for a year, until her mood changed. She feels very fortunate to have kept her current job for so long. She attributes this to a “kind boss,” who has kept her employed through her highs and lows. Since this is a family company with a high level of commitment to their employees, and since she does not have access to any money, she is able to stay employed. Her boss has asked her to continue with treatment on a consistent basis. She had been in and out of counseling and on and off her medications before she got this job. When she stopped her medication, she would once again smoke marijuana in the evenings. Since being employed here, she has managed to stay on her medications. She had not been back in the hospital until this latest admission. Recently, though, her counselor closed his practice and moved to another city. Gradually, her behavior and mood became more and more unstable over time.
This most recent hospitalization came after she was found at her work desk, sobbing uncontrollably. She reported to her boss that she was “blue.” This work site placed her on FMLA and asked her to get help for this current crisis. She admitted herself to the hospital, where she saw a new psychiatrist, who changed her medications. Stella is hopeful that she will be able to stay on the new medications.
Her husband and son are very supportive of her getting care and have met with both the new psychiatrist and your intake case worker. They want to know what they can do to help Stella re-stabilize, hopefully for good this time. They reported that her sister-in-law has volunteered to go walking with her each evening and that her son is willing to give Stella her medication each day. Her husband asked his employer for a change of route and was able to secure one that will take him away from home no more than 4 days at a time.
Upon discharge, Stella was referred to the community mental health agency where you are a counselor. After reviewing her hospital records and the intake report, you presented the case in a staffing. After listening to the other professionals’ opinions, you are ready to develop a comprehensive treatment plan that will address, among other issues, medication and treatment compliance, and stabilization.