What techniques could you use to elicit additional strengths in the client?

Part I: Diagnosis
Given the case information, prepare the following: a diagnosis, the rationale for the diagnosis, and additional information you would have wanted to know in order to make a more accurate diagnosis.

Part II: Biopsychosocial Risk and Resilience Assessment
Formulate a risk and resilience assessment, both for the onset of the disorder and for the course of the disorder, including the strengths that you see for this individual.

1. What techniques could you use to elicit additional strengths in the client?
2. What interventions can be utilized to help this patient? One intervention*

Chapter in text for diagnois is called: Bipolar and Related Disorders also use powerpoint if easier

Case:
Carol is a 44 year old African America female who was diagnosed with Multiple Sclerosis (MS), a degenerative autoimmune disease, nearly 15 years ago. The disease has progressed to the point where she walks
with two canes, one in each hand, when she leaves her house. She is able to use only one cane around the house. Carol is unable to hold a job because of her disability and receives about $500 in supplemental security income each month. In addition, she receives food stamps and Medicaid.

Carol first sought assistant from the Department Of Human Services a month ago because of her housing situation. She has lived with a friend in her basement bedroom for the past 18 months. The friends grown son, who does not live with them, owns the house. The friend also has two other sons living in the house. Carol pays them $200 in rent each month and uses her food stamps to buy food for the entire household. The situation is causing great stress, because the two young men make her feel unwanted. They are loud and make it difficult to sleep. She is unable to use the shower because it is not big enough for her safety seat, and has fallen a few times while using it. She takes sponge baths in her room instead.

The stress of her living situation is upsetting her, and she is afraid that she will have another attack of MS and require hospitalization. Since moving in with this friend, she has been hospitalized once and has checked herself into psychiatric hospital twice. Now, for the past several weeks, she has found herself crying every day, feeling hopeless, has poor appetite, and wanting to hurt herself. She has never actually attempted self-harm, however. She stays in her bed, either sleeping or watching television most days, except for the times she has her physical therapy appointments. She described feeling “incredibly tired” and also says that she wants to stay out of the way of her roommates so that they will not bother her.

Carol’s family situation is marked by conflict and estrangement. Carol is divorced and has two daughters and a son, all grown. Her son is in jail. Her younger daughter is pregnant, and he older daughter just moved into a subsidized apartment. She says her relationship with her older daughter is strained, but they do speak. Her ex-husband died a few years ago while in prison. She has a sister who lives in a shelter in a neighboring county, but they are also not on speaking terms. Carol says this is because while she was still married, he sister had an affair with her ex-husband. All her brothers are in jail, and she is not close to any other relative.

Carol is not eligible for public housing. She used to live in section 8 apartment, but was evicted. Her children were responsible for paying her bills, and she did not realize they were not paying her rent until she learned that she owed over $2000. She is ineligible to get back on the public housing list until she has paid this money. She has worked with a housing assistance program to try to find alternatives, but the cheapest apartments they have found have rents higher than her monthly income.

On her most recent admission, 8 months ago, the psychiatrist prescribed her an anti-depressant medication and recommended psychotherapy when she left the hospital. Carol said she went to only one therapy appointment and stopped taking the antidepressants when she began feeling better. She now reports that she is starting to wonder if she should go back to the psychiatric hospital, but she is afraid that if she leaves her friend’s house this time, the friend will not let her move back in. She would rather work on easing the stress in her life.

One method Carol uses to cope with her feelings is smoking marijuana. She started smoking it to relieve the symptoms of her MS, but in the past few months, she admits she has been using it more to cope with psychological stresses. She said she smoked approximately every other day and gets marijuana form the young men with whom she lives.

Carol does not have many outside social activities. She used to belong to a church, but when she was evicted and moved in with her friend it was too far to walk, so she stopped attending. Her faith is strong, and she believes that despite all the troubles she is having, things could be much worse. She is grateful that she has housing for the moment and is able to receive her medical care.

Carol has a tenth-grade education. She said she used to smoke crack in her “younger days,” but after her then-husband went to prison for drugs for 20 years, she stopped. She said that it was not that difficult when she “made her mind to do it.” She said that both her parents drank too much and fought with each other verbally and physically when she was growing up. She said both her parents died when she was a young adult- her father from emphysema and her mother from cancer.

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