Instructions
Details of task:
The purpose of the Clinical Research Report is to extend your understanding of the
varied ways that mental disorders can present in clinical practice, and to apply your
knowledge and research skills to a single case study. The textbook is great at collating
the current conceptualisations and research on psychological disorders. From this
source, you will become broadly familiar with a range of different mental disorders,
examining diagnosis, aetiology, prognosis and treatment. Case Studies, on the other
hand, take your understanding to the next level, by providing you with the opportunity to
delve deeply into one person’s experience of a mental disorder and to apply the core
knowledge you have accumulated to complex, real world examples.
For this case study, you will be adopting the role of a scientist-practitioner. What this
means is that you will be required to analyse the case study using information available
from the DSM5 diagnostic framework, to reference the empirical literature in terms of
what is known about aetiological factors that may be relevant for the client’s
presentation, and to consider treatment options that are available based on current
scientific evidence. You will be given the opportunity to analyse a fictitious clinical case
using knowledge that you have learned in the unit in relation to gathering clinical
information, assessing potential diagnoses, conducting case formulation, and
recommending treatment options based on available empirical research. This will
culminate in the production of a Clinical Research Report.
To complete the Clinical Research Report, you will need to:
summarise the important clinical information into a client profile
analyse the symptoms and justify a potential diagnosis (or diagnoses) and case
formulation for the client
detail two evidence-based psychological treatment options and conduct a brief
literature review of the efficacy of these treatments considering the client’s
circumstances and needs.
Word limit: 2,500 words (upper limit – no 10% leeway).
Presentation requirements: The report is to include the following sections:
A title page
o Including the title of the report, your name and student number, your tutor,
and word count.
Client profile
o Referral reason
o Presenting problems
o Client history
Potential Diagnosis and analysis of symptoms
o Diagnostic Impression, specifically 1) primary diagnosis, 2) comorbid
diagnosis (if any), and 2) differential diagnoses (expected to give at least
2 other psychological disorders with some overlapping symptoms, and
explain why the client’s presentation cannot be explained by these other
disorders)
o Reference to the DSM -5
Case formulation
o Using the 4P biopsychosocial framework (see clinical report template for
more information)
o Referencing empirical research supporting the role of the identified
factors in the client’s presenting problems in relation to their primary
diagnosis.
Treatment options
o Recommending two evidence-based psychological treatment options
(note: not medications), and referencing relevant, good quality empirical
research demonstrating the efficacy of the treatment for the primary
diagnosis that the client presents with
o Describing in brief how the treatment works
o Highlighting gaps (if any) in the empirical literature with regards to this
treatment’s application to the client, along with future research that may
be needed to learn more about the treatment’s application for the
disorder.
References in APA
Case Study
CASE STUDY – ERIC At the time of his presentation to the outpatient clinic of a psychiatric hospital, Eric
Beck was a 32-yearold single Caucasian man who lived with his parents. Although he had worked as a
stockbroker after completing his undergraduate degree and was a trained paralegal, Eric had not
sustained stable employment over the subsequent years. Currently, Eric was unemployed. He was
referred to the outpatient clinic by his family doctor for assessment and treatment of anxiety. During his
initial visit to the clinic, Eric stated that the primary reason for seeking treatment was for help with his
persistent difficulty in concentrating, and chronic worry and anxiety. These symptoms had lasted for
more than eight months, and began after he lost a job as a paralegal in a law firm a year ago. He
mentioned that his inability to sustain a career and his self-perception that he might perhaps always be
a "failure" were key areas of concern to him. Eric reported that he worried about everything, including
his inability to be self-supporting, losing support from his family or being too much of a burden on them,
the possibility of his car breaking down, accidentally insulting people, and his lack of a girlfriend. He
claimed that he was having considerable difficulty controlling these worries to put them out of his mind
and concentrate on something else. Behaviours associated with these worries included difficulty
throwing away newspapers (based on his concern that he might discard suitable job announcements
from the classified ads), excessive preparation for job interviews, and frequent revisions to his job
resume. These behaviours were mild in nature however, and were not time consuming. All of Eric's
worries were accompanied by other symptoms such as irritability, feelings of shakiness, muscle tension,
rapid heart rate, and extreme restlessness. Eric's restlessness was so severe that he often paced back
and forth in his bedroom when he was feeling keyed up and worried about some matter. His pacing had
been so extensive and persistent that he had actually worn holes in the carpet of his bedroom. The
symptoms had interfered with his ability to carry out his daily routine, and he complained of not being
able to focus enough to find a new job. He also tended to cope with stressors by engaging in excessive
rumination about his problems. At the time of his intake evaluation, it became apparent that Eric had an
extensive history of depression dating back to his high school years. Over the years, Eric had
experienced depressed mood, a loss of interest in pleasurable activities (at the intake evaluation, Eric
stated, "I suffer even when doing things I should enjoy"), concentration difficulties and problems making
decisions, and feelings of guilt and worthlessness (e.g., feeling that he was not a contributing member of
his family or society, with little expectation of becoming one). In addition, Eric experienced recurrent
thoughts of suicide and had a history of four suicide attempts. Eric's first suicide attempt occurred
during high school when he "crashed the family car on purpose because I wanted to die." Each of his
other suicide attempts had occurred over the past 3 years; on all three occasions, Eric had tried to hang
himself. PSY3032 – Clinical Research Report During his first year of university, when Eric was 19, he
experienced a 2-week period when his mood was both excessively elevated and excessively agitated. In
addition to feeling as if he was on a high and very energetic, Eric became quite talkative and spoke very
loudly and very quickly. He became even more distractible and was often late or missed classes and
appointments because he would be engrossed in some trivial task (such as rearranging the furniture -in
his room). In addition, during this time Eric engaged in a number of reckless behaviours, one of the most
noteworthy being, over this 2- week period, experimentation with almost every recreational drug
available around campus, except heroin. Because of the combination of the effects of the drugs he had
taken and his agitated mood, Eric got in several fistfights during this time. This episode ended when Eric
crashed his parents' car (by accident, not as a suicide attempt) at 3:00am when he lost control of the
vehicle going 150 km per hour on the highway. He was hospitalised for 4 days because of his injuries
from the accident. An assessment with Eric indicated that he was not on any drugs or medication prior
to experiencing the elevated mood symptoms. The hospital physicians recognised Eric's emotional
disorder and placed him on medications for the first time. After this, Eric continued to experience bouts
of depression as well as periods when his mood was elevated, agitated, or expansive. During subsequent
"high" periods, Eric wrecked a car by driving at dangerous speeds on two other occasions. At one point,
he had his driver's license revoked for 1 year. In another instance involving the family car, Eric burned up
the car's engine because he had turned on the ignition, got distracted by something, walked away from
the car, and left it running for hours. At the age of 22, Eric quit his first job as a stockbroker because he
felt that he could not handle the stress of this career. After his resignation, Eric experienced an extended
period of severe depression related to his self-perception of being a failure. However, unlike other times
when his mood was down, this episode of depression eventually was associated with other problematic
symptoms. Specifically, Eric concluded that because both his father and his brother had once been
employed in high-security jobs with the federal police, the Australian Security Intelligence Organisation
(ASIO) was monitoring his actions continuously. Eric began to believe firmly and persistently that he was
being set up to fail, career wise and relationship-wise, by ASIO. Upon learning about these beliefs, Eric's
doctors, who had been treating him with medications designed to regulate mood, decided that Eric
should be taking drugs to manage psychotic symptoms. Consequently, Eric was put on antipsychotic
drugs. As is often the case with these types of medications, Eric experienced a number of aversive side
effects and often would not comply with his medications. As a result, Eric often had a recurrence of his
symptoms (either a period of feeling very down or very high), and his unusual beliefs would return.
When Eric was not feeling very down or very high, he experienced few symptoms. For instance, during
these between-episode periods, Eric did not entertain any thoughts or hear any voices involving ASIO or
the federal government. At these times, Eric's excessive worries would also diminish, and he recalled
that his only worries would be (a) his fear that another episode might soon occur and (b) his concern
about the potential for negative and permanent effects from taking medications continuously. Despite
the latter concern, he eventually decided to keep to his medication regimen to reduce the likelihood of
another mood episode recurring. At the time of this clinical visit, Eric did not experience many
prominent symptoms of depression or feelings of elevated mood. Rather, his symptoms were
predominantly anxiety symptoms. He also denied hearing any voices of ASIO or beliefs that he was
constantly being monitored at present. Family and Social Relationships Eric was raised in a close-knit
and religious middle-class family. His mother used to be treated for anxiety when she was in her 20s. His
older brother and two younger sisters were quite well adjusted, and each had graduated from university
and had sustained productive careers (a fact that added to Eric's perception of being a failure). During
his childhood, Eric had been a quiet and somewhat inhibited child and achieved average grades in his
elementary school. He experienced bullying in school, which was never brought to the attention of his
teachers or parents. As noted earlier, the first evidence of Eric's emotional difficulties arose during his
high school years, when Eric struggled with some of his class work. His grades fluctuated between A's
and C's, and for some courses Eric had considerable difficulty in keeping up with assigned readings and
in taking exams (due to high test anxiety). Consequently, Eric became very stressed out over whether he
would gain admission to college. These issues were compounded by Eric's feeling that he was constantly
being compared to his older brother, who was on a full scholarship studying to be an electrical engineer.
Eric's symptoms quickly progressed into the more debilitating symptoms that were discussed at the
beginning of this case. Despite his emotional difficulties, Eric managed to gain admission into college but
continued to struggle academically while in college. He eventually graduated with a degree in business
administration. In general, Eric's family was quite supportive of him. In addition to allowing him to move
back into their home after he quit his job as a stockbroker, Eric's parents were quite involved in his
treatment and care over the years. They had done everything possible to keep Eric home and to prevent
him from being hospitalised, Eric's father charted his son's symptoms and medication use daily to try to
predict when Eric was at risk for an escalation of symptoms. Moreover, in an effort to avoid some of the
serious complications of Eric's condition, his father had routinely engaged in some preventive actions.
For example, he had taken away Eric's credit card permanently and had put him on an allowance to try
to prevent his tendency for overspending when he was on a high. Because Eric had either wrecked or
damaged the car on several occasions, his father prevented the car from starting (by secretly
disengaging the wire to the car's ignition when he was not using the car) to keep his son from driving at
all times. While these manoeuvres were done in an attempt to keep Eric from further harm, they
resulted in substantial discord within the family because Eric felt that he was being treated like a child,
even though he was in his early 30s. Occasionally, there was also some conflict between Eric's parents
because his mother felt that his father was sometimes overinvolved in Eric's affairs (e.g., charting Eric's
symptoms and medication use). Although he had a few close heterosexual relationships during
university, Eric had not been in a steady relationship for a few years. His last stable, romantic
relationship ended 3 years ago, when his (then) girlfriend decided to end the relationship as she was
planning to move abroad and did not see a future with him. Even though Eric used to have a few close
friends from university, he had increasingly been withdrawn from them due to his emotional difficulties.
At the time of this visit, Eric reported that he did not have many friends he could confide in, with the
exception of his childhood friend, John, who had been supportive of him all these years. Despite his
longstanding emotional difficulties, Eric was willing to give therapy a try again so that he could rebuild
his life by having a more stable job and learning better ways to cope with his emotional difficulties.