Making a Differential DiagnosisPrior to beginning work on this assignment, please read Chapter 1: Differential Diagnosis Step by Step in DSM-5: Handbook of Differential Diagnosis and review the same c
Before this week, I chose case 18, Julia. I first started with a list of 15 but do not have enough time to include them all so I will go straight into my session with Julia.
Transcript
Dr.: Hello, Julia my name is Dr. Yant, and I am glad you could make this appointment and to meet with you; if you like you can call me Heather. Is it Julia you like to be called or is it something else you would prefer?
Julia: Good Afternoon Heather I am glad you got me in so quickly.
Dr.: It is no problem and glad I had a slot that worked for you. I listened to your phone call and would like to hear more why everyone is so concerned about you and why it upsets you?
Julia: So here I am a college student and my mom still think she can tell me what to do it got to the point she even reached out to my roommate, coach of the track team and the dean. Oh yes, I am a runner if they did not mention that I got a full scholarship for track. I started running in high school it took a lot of time up. Now that I am in college it is stressful. A lot is going on school work, trying to keep up on studying and track, so I put on some extra weight on at the time I did not think it was a big deal till my coach and teammates were disappointed in me because I could not keep up and my record times were not so good. I even dropped a few races from being out of shape. When my coach pulled me aside about my track records, I figured after speaking with him I took his suggestions into consideration of doing a little bit of dieting and getting extra work out or two in. The coach said to start eating more salads and to cut out sugar I did not think that was too much and it got me back to running record times, and I was performing much better on the team which we needed. I also felt better but then my parents, roommate, and friends started saying stuff about my weight, and I told them that I was fine and was offense. I am in college I am not a little girl anymore.
Dr.: So Julia would you say you have been going through a lot more since college started?
Julia: Yeah, I guess so I have a lot of studying to keep up my grades, I let my team down so I am now working on getting my weight where it should be by extra workouts and small amount of foods. I just do not have enough time in a day with additional exercises and class. I feel I left my team down especially since I was at the top of my game during high school who knows what they think of me.
Dr.: Earlier you mention that your coach talked to you about your weight do you think what he said to put you into gear about your weight and how you saw yourself?
Julia: I mean I don’t know. I know my weight gain was holding me back from performing at my best. I guess you can say when my coach mentioned it that it made it real which made me want to fit back in with my team as I use to in high school so the coach could have been a motivator to me at that time. I do not see a problem here I have lost weight and my tracks record times have improved. I am just trying to keep going and maintaining a still think I need to lose additional weight but if you ask my friends and family, they will tell you something different. Is it so bad that I feel great and want to keep going on losing some more weight? I am chubby what’s wrong with a girl wanting to improve her health and the way she looks. My parents and friends nagging is enough you would think they would want me to be happy and living a prosperous, healthy life. I just do not get where they are coming from.
Dr.: Has any of your relationship with your friend’s family and your peer’s change that would be sending red flags to them to make them worry?
Julia: Well yes, I mean no, maybe there has been a lot going on I do not live at home anymore. I had pulled away from all my friends, no late night study groups, I do not even see my roommate anymore. I am up before she is, and out late where she is sleeping when I get back. I eat by myself, so I do not indulge in significant amounts of food. I have come a long way in losing this weight. I do not want to put it back on. I thought being at college away from home would be easy my mom would hound me as much but surprised not any better. Why does she have to be so involved in my life?
Dr.: Well it is good to see that you can relate to what is going on. Your mother’s involvement is because she loves you and you will always be her daughter no matter where you are in the world. Your friends they miss you and are worried because this is not the girl they met in the first semester. Would you say I am correct so far? I would like to meet with you again I have taken some notes down, but it all depends on how you and where you would want to go with this so let me know what you are thinking?
Julia: Yeah, I would like to come back it has taken a lot of stress off my shoulders.
Dr.: Okay, Julia we can go schedule at the front desk and will see you next time thank you for coming.
I think giving Julia a chance to talk, and I listen it helped Julia get comfortable because it let her build rapport with the (Tasman, Kay, & Ursano, 2013). She was unsure of herself, but she was also, aware of close loved ones and friends out. Julia had agreed to come back for another session which lets us build on her case it will let Julia see the answers that she may or may not be looking for. After a few more sessions Julia Maybe comfortable enough to discuss diagnosis, treatment, and a plan to help her get everyone off her back and to understand. Julia did mention in our session that she was dieting, does not want to indulge to gain weight, that she eats small amounts and that she is chubby and needs to lose additional weight (Morrison, 2014).
Gorenstein, E., & Comer, J. (2015). Case studies in abnormal psychology (2nd ed.). New York, NY: Worth Publishers. ISBN: 9780716772736
Morrison, J. (2014). DSM-5 made easy: The clinician’s guide to diagnosis. New York, NY: The Guilford Press.
Tasman, A., Kay, J., & Ursano, R. J. (2013). The psychiatric interview: Evaluation and diagnosis.Chichester, England: John Wiley & Sons. Retrieved from http://www.ebrary.com
