This assignment focuses on vignette analysis and direct application of course concepts to the persons and situations presented in the vignette for each question. All discussions must take into account the legal and ethical considerations, as well as issues of culture and human diversity that may pertain to the situation presented below. Culture-Related Diagnostic Issues are in DSM 5. You are encouraged to use alternative cultural resources to enhance your work.
Use the text information thoroughly in an integrative discussion. You are also required to include current, evidence-based research to support your analysis. A minimum of two (2) research articles taken from online or hard copy journals are required. All work must be cited in APA format.
Please keep your responses focused on what is presented in the vignette. Do not add information but use your creativity to support what you see in the vignette as written. Avoid elaborations and assumptions. This assignment MUST be typed, double-spaced, in APA style, and must be written at graduate-level English.
To complete the Vignette Analysis, please use the DSM-5 criteria
Assignment should be 7-8 pages total, plus a title and reference page
John and Jessica, a Latino couple in their late 20’s, bring their 6 year old son James in for therapy at the suggestion of his school psychologist. Jessica tells you that James is an odd child, unlike his older brother and sister, ages 8 and 10 respectively. James didn’t talk until he was 2 years old, would often play in a corner by himself, line up toys and insist they remain in a particular organization.
He now does not show such rigidity about his toys, his play is disorganized, has difficulty keeping track of his things, complains often about not being able to find what he is looking for, and may act without thinking. When we found him trying to poke his eyes out, we immediately took him to therapy. James has come a long way and has adjusted well, until recently. He seems to be regressing and Jessica fears the worst for her James. His school counselor is worried about James because he is not performing well at school and appears to be increasingly frustrated and losing confidence. His last standardized testing placed him well below his age and grade level. He has become increasingly withdrawn and no longer interacts with peers. Last week, we caught James stabbing his leg with a toy gun”. The father appears to be disengaged and fidgeting while the mother talks.
He is responsive to your questions. He tells you, “I was a lot like James at his age and was held back twice in grade school. I see a lot of myself in my son. I don’t think he understands what others are saying to him and just goes into his own world like I did. I think he is frustrated so he punishes himself. He just needs to learn how to cope like I did. If the other kids see him as different and weak, they will tease him. I constantly tell him to ‘toughen up and act like a man’. That is how I made it in life.” You find out that John dropped out of school in 8th grade, can barely read and write beyond basic communication skills. John works 2 jobs at manual labor to support his family. Jessica is a stay at home mom and is the primary disciplinarian and provider of emotional support for James. She had a difficult pregnancy and states James was born at 34 weeks’ gestation. James has a cousin who has a diagnosis of Autism, one who was recently diagnosed with ADHD, one with Tourette syndrome and one with an intellectual disability. At home, the parents report that James is a quiet boy, but that he does play with his brother and sister, has an odd sense of humor, and has a vivid imagination.
1. What are some initial diagnostic thoughts for James? Discuss how you would formulate a differential diagnosis assessment for James? Given the information you have in the vignette, what further information might you need and why? How might your initial diagnostic formulations change over time with additional information? Consider age, gender, culture, socioeconomic status, genetics and familial influences.
2. Given the vignette information and your diagnostic thoughts in question 1, create an intervention plan for James. What treatment considerations would you incorporate in your treatment plan? Other questions to consider in your response are: Would you work with James individually? What might be different in working with James and his parents? Would you include the 2 older children in family treatment? How would you collaborate with the school for continuity of care?