Indicate the possible etiologies in a general way and the steps you would take to diagnose, treat, and manage these cases, with consideration of pharmacological intervention

Considering the indicated symptoms for all three cases below you are required to:

1. Indicate the possible etiologies in a general way and the steps you would take to diagnose, treat, and manage these cases, with consideration of pharmacological intervention
2. You don’t need to discuss every detail of your treatment – just write from the standpoint of a clinical psychotherapist who does not prescribe medication, but coordinates care with physicians who do.

Case Studies:  Respond to all three (3):

1. Bob is a 47-year-old Native-American man who comes to you with his wife of 15 years. He appears agitated and complains that he feels anxious. His wife reports that Bob has had a lot of trouble sitting still, frequently jumping up and pacing. While he has been this way throughout their marriage, it is getting increasingly worse. Bob tells you that he is a lot like his abusive father, who died of alcoholism.  Bob feels that if he drank, he’d be able to relax, but swore he would never be like his father. The wife tells you that the children are frightened when Bob gets agitated as he has punched holes in walls. You notice the wife looks frightened when you ask her if she feels the children are safe in the home.

2. Steven is a 7-year-old Asian-American first grade student brought to treatment by his mother. He has been disruptive in class. His teacher and the school counselor are strongly urging that Steven be put on medication for ADHD, but his mother is reluctant to do so.  Steven is described as exceptionally gifted and appears bored in the classroom.  His mother tells you that Steven is impatient and rageful to his younger sisters at home. She is afraid Steven is taking after his abusive father, who no longer lives in the home due to domestic violence. She tells you that their father is allowed to visit the children in the home under her supervision.

3. Melinda is an exceptionally bright, 17-year-old African-American young woman, in her first year at a state college. Both parents accompany her to your office. When she came home for spring break, she started talking nonsense, saying that the college’s biology department is using a high-powered laser to alter the DNA in her brain. She has always been an “A” student and has never shown any sign of psychiatric disturbance prior to this.

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