Psychological Case Studies - CRIATIVIDADE E MATERNIDADE



Psychological Case StudiesJordan MartinJessica is a 28 year-old married female. She has a very demanding, high stress job as a second year medical resident in a large hospital. Jessica has always been a high achiever. She graduated with top honors in both college and medical school. She has very high standards for herself and can be very self-critical when she fails to meet them. Lately, she has struggled with significant feelings of worthlessness and shame due to her inability to perform as well as she always has in the past. For the past few weeks Jessica has felt unusually fatigued and found it increasingly difficult to concentrate at work. Her coworkers have noticed that she is often irritable and withdrawn, which is quite different from her typically upbeat and friendly disposition. She has called in sick on several occasions, which is completely unlike her. On those days she stays in bed all day, watching TV or sleeping.At home, Jessica’s husband has noticed changes as well. She’s shown little interest in sex and has had difficulties falling asleep at night. Her insomnia has been keeping him awake as she tosses and turns for an hour or two after they go to bed. He’s overheard her having frequent tearful phone conversations with her closest friend, which have him worried. When he tries to get her to open up about what’s bothering her, she pushes him away with an abrupt “everything’s fine”.Although she hasn’t ever considered suicide, Jessica has found herself increasingly dissatisfied with her life. She’s been having frequent thoughts of wishing she was dead. She gets frustrated with herself because she feels like she has every reason to be happy, yet can’t seem to shake the sense of doom and gloom that has been clouding each day as of late. (Lane, PhD)Jessica is one of millions of people who are subjected to psychological analysis and interpretation in order to write what is known as a psychological case study. A psychological case study is defined as an in-depth study of a person. The main purpose is to not only provide the psychologist and patient with a sense of organization, but also to identify a problem, and once that problem is identified, it helps to better define the path best taken to improvement. That is the purpose of a psychology career in my opinion. The purpose of a psychologist is to work with a patient to better improve their state of mental well-being. Similar to case studies, while there is not one “correct” way to do it, each psychologist chooses how to do their own work, regardless of what is typical.Psychological case analyses seem to vary from patient to patient and psychologist to psychologist. There is only one widely accepted format, but that definitely isn’t the only way, and it probably isn’t the one used by most. In this format, the psychologist must first provide background information on the case at hand. This could range from the patients age to past drug use. The next section should include the presentation of the problem. What is wrong with the patient? Why are they being seen? They must then provide the diagnosis that they feel best fits their patient. This can be illustrated in the psychological case study of 50-year-old Rebecca. Name: Rebecca Date of Birth: 04/12/63 Sex: Female Ethnicity: Black Date of Examination: 06/22/-- Referral Question: Explore for presence of Post Traumatic Stress Disorder, rule out panic disorder, with agoraphobia; rule out phobia – natural environment type History of Treatment: No previous treatment for psychological disorder Medical History: Hospitalized for broken ribs and femur, which required surgery to reset, other indications of domestic abuse present, e.g. history of suspicious bruising and hematoma Recent treatment for smoke inhalation and minor burns on hands Discussion of Observations: Rebecca appeared nervous and tense throughout the interview. While willing to respond to questions, she was easily distracted by concerns over the whereabouts of her children. (They were in a nearby office with a person watching them, but they were out of her sight). She was also troubled by being in an enclosed office until she was shown both how to exit the building in case of an emergency and where the fire extinguisher was located. Approximately one and a half months ago, Rebecca was in an altercation with her estranged husband. She does not recall what precipitated this altercation, although she expressed that he had been getting more violent and angry at her. She indicated that several relatives tried to intervene and convince him to get help for his anger, but that just made him angrier. On the evening of the altercation, Rebecca recalls that her husband was “yelling, cursing, and throwing things.” She further stated that he would blow up like that and “fly off of the handle” when he was really mad or had been drinking, which usually resulted in her being “smacked around.” During the most recent incident, Rebecca stated he must have hit her really hard because she “passed out cold.” She stated that when she woke her estranged husband had set fire to the kitchen, which was rapidly spreading. She felt that both her life and the lives of her children were in danger. She indicated that she thought she was going to die. She remembers staring at the fire, too horrified to move. She doesn’t know how, but a neighbor appeared and shook her out of her trancelike state. Rebecca remembers saying “my kids, my kids, somebody find my kids.” The neighbor also found and saved both of her children (ages 8 months and 2 years). She has no recollection of being taken from her house to the hospital where she and her two children received treatment for smoke inhalation. Since the time of the fire, she has been living in a women’s shelter. She has had a difficult time sleeping as she relives the events in her dreams; which have been increasing in frequency and severity. She indicates that she wakes up almost every night “feeling the flames getting nearer and nearer.” When this happens, she experiences shortness of breath and increased heart rate. She has become hypervigilant of her children, unable to let them out of her sight even in a safe environment. She also feels as if she snaps out in anger at anyone around her. Although she has relatives who live nearby, she is resistant to the idea of seeing anyone she knew prior to the fire. She has lost interest in her job and doesn’t react when asked how she would feel if she lost her job. Rebecca has also experienced several panic attacks; one when she saw a news report about a house in a nearby town catching on fire; and the second when she smelled smoke. During both instances she said she hyperventilated, couldn’t catch her breath, inability to move and increased heart rate. Recommendations: Due to the severity and chronicity of the symptoms, Rebecca would benefit from continued psychotherapy she also would benefit from an anti-anxiety medication. Further exploration of this should be made with a psychiatrist. (University of Pittsburgh: School of Social Work 1-2)This entire study has no rubric. They are not required to have 200 words in each section; they are merely organizing for themselves. The format of a case analysis is determined by two things: 1. the preference of the analyzer, and 2. the depth of analysis needed to best assist the patient. While one psychologist may write a half of a paragraph on a patient who seems to be pretty close to society’s definition of normal, that same psychologist can go very far into depth on a patient with schizophrenia. Overall, the determining factor is the interaction between the only participants in the genre: the psychologist and the patient. Almost all psychological patients are subjected to this kind of analysis. Some require more in-depth observation however, like those who exhibit suicidal tendencies or are recovering from injuries as in the case of Phineas Gage. Much of what psychologists know about the human brain has come from case studies of individuals who had brain surgery or brain damage in accidents. Phineas Gage is one such case study. He was a young railroad worker in 1848 who had an accident at work. He was forcing gun powder into a rock with a long iron rod when the gun powder exploded. The iron rod shot through his cheek and out the top of his head, resulting in substantial damage to his frontal lobe. Incredibly, he did not appear to be very hurt. His memory and mental abilities were intact, and he could speak and work. However, his personality totally changed. Before the accident, he had been nice to be around, but afterward he became ill-tempered and dishonest. He lost his job and ended up working as an exhibit at fairs. Phineas Gage’s injury served as a case study for the effects of frontal lobe damage. He did not lose a specific mental ability, such as the ability to speak or follow directions. However, his personality and moral sense were altered. Psychologists now know that parts of the cortex (called the association areas) are involved in general mental processes, and damage to those areas can greatly change a person. (Pluim)These studies are subject to the seven characteristics of genre. These are social, rhetorical, dynamic, historical, cultural, situated, and ideological. These studies are social because they are based solely on the interaction between the psychologist and the patient. They are rhetorical because they allow the psychologists to make the decision of how to format them. They are dynamic because they change with the situation. These situations can be the change of psychologists or the change in behavior of the patient. They are historical because they have changed over time. The thoughts and ideals of what’s normal in society has changed over the years, making psychological case studies an effective tool of analysis. They change depending on patient behavior which is interpreted differently in certain time frames. They are cultural because the behavior of a patient, like it can be interpreted differently from time to time, it can be interpreted differently from place to place. It is situated because they change based on context. A patient will be more open with a psychologist in a private setting than in a group session. They are ideological because they represent the values of not only the patient, but also the psychologist. You can see the patients values based on their behaviors, and the psychologist’s values can be seen by what they choose to include and emphasize in their studies. Overall, the characteristics and their presences are based on the context of the counseling session.Psychological case studies are used in a wide range of situations, and they are written in as many ways as there are psychologists. Each is unique to its author and its subject. You can see the similarities and differences in the three studies included above. They may have some small differences, but overall, they seem to be polar opposites because there are no rules that are set in stone. There is no correct way to do it. There is no right way to format. There is no information that must or must not be included simply because it is all about the preference of the author. In this genre, the psychologist holds the majority, if not all, of the power. They shape the analysis to best fit what they feel is most convenient for them in the long run. It serves its purpose of creating organization for them, while helps them to interpret the actions and behaviors of their patient.Resources:Lane, PhD, Dr. Cheryl. "." Depression and Mental Health Resource. N.p., n.d. Web. 17 Apr 2013. < of Pittsburgh: School of Social Work, . "308: Adult Mental Health Issues: An Introduction for Child Welfare Professionals." Pennsylvania Child Welfare Training Program. (2012): 1-2. Web. 17 Apr. 2013. < AdultMentalHealthIssues/HO/HO 17 Sampe Psych Eval.pdf>.Pluim, Alison. "case studies." Psyc'd for Psyc. N.p., n. d. Web. Web. 17 Apr. 2013. <;. ................
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