PSYC 806 ORAL TEST PRESENTATION

PRESENTED BY TAYLA OWEN-JONES

EDUCATIONAL PSYCHOLOGY
223054423
PS S 016 8742
POINTS TO BE COVERED TODAY
⊹ Biographical Information
⊹ Presenting Problem
⊹ History
⊹ Provisional and Comorbid Diagnosis
⊹ Theory
⊹ Formulation
⊹ Treatment Plan
⊹ Case Management 2
REASON FOR REFERRAL &
PRESENTING PROBLEM
⊹ Aaquil has been referred for Psychological Intervention
by his boss
⊹ He (the boss) has noticed he has been coming late to
work, missing deadlines and not performing to his
normal standard
⊹ Aaquil noted in the intake his wife left him 5 weeks ago,
which is having a significant impact on his eating,
sleeping and work performance
⊹ Aaquil noted he is getting about 3 hours of sleep a night
which is impacting his ability to do his work
⊹ This also includes excessive hand washing and having a
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need to feel clean
 HISTORY:GENOGRAM
Father Wife'
Mom Wife's
Unknown s
Dad
Mom

Aaquil Wife
28

• Relationship with wife is strained

• No significant father figure Boy
• Has a relationship with wife’s son 6
• Relationship with mom is significant
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 MSE
⊹ Appeared well groomed
⊹ Speech was of a low tone and slow pace
⊹ Aaquil was co-operative in the session and
engaged well
⊹ No evidence of perceptual disturbance
⊹ No evidence of wanting to harm himself or others
⊹ Mood appeared to be low, in which his affect was
congruent
⊹ His thoughts were well articulated, focusing on
his concerns for and of his wife and hand
washing
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TIMELINE OF SIGNIFICANT
EVENTS
He has always felt the need His wife left for the second
to feel pure and clean Wife leave the first time time 5 weeks ago

1 3 5

2 4 6

Aaquil and wife get Aaquil and wife seek help He started to experience
married, this is his first real from the Arlum distress and heightened
relationship, he felt need to feel clean
pressure to get married

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CULTURAL
CONSIDERATIONS
⊹ The DSM 5-TR notes that
cultural factors may shape
obsessions and compulsions
⊹ Hand washing and ritual is a part
of Aaquil’s Muslim religion
⊹ However, he now notes this is
becoming a concern
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 PROVISIONAL DIAGNOSIS
Major Depressive Disorder: F32.2
⊹ Aaquil meets this diagnostic criteria for MDD in the following ways:

× Depressed mode as noted through subjective reports of feeling hopeless

× Has a noted decrease in appetite

× Is struggling with insomnia: specifically falling asleep

× Psychomotor agitation nearly everyday that has become worse

× Diminished ability to think or concentrate

(American Psychiatric Association, 2022) 8

 PROVISIONAL DIAGNOSIS
Major Depressive Disorder : F32.2
⊹ This is causing significant distress and impairment in his occupational area of
functioning
⊹ In response to a significant lose causing intense sadness, rumination, insomnia and
poor appetite
⊹ Not better explained by a schizoaffective disorder of hypo/manic episode
(American Psychiatric Association, 2022)

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 COMORBID DIAGNOSIS
Obsessive – Compulsive Disorder : F42.2

“
With good or fair insight

⊹ Aaquil meets this diagnostic criteria for OCD in the following ways:
⊹ Has the presence of Obsessions, Compulsions or both in the following ways:

× Obsessions: Has recurrent and persistent thoughts, urges or images that are
experienced at some time during the disturbance as unwanted, ie: feelings of
being impure and germs that causes marked anxiety or distress

× Compulsions: repetitive behaviors such as hand washing that the individual

feels driven to perform in response to hand washing or strictly applied rules ie:
praying ritual

× The obsessions are time consuming, causing impairment in occupational

functioning: Aquila comes late for work (American Psychiatric Association,
10
2022)
 COMORBID DIAGNOSIS
Obsessive – Compulsive Disorder : F42.2

“
With good or fair insight

× Not attributed to a substance or other medical condition

× Not better explained by another mental disorder: ruminations in MDD

× It is noted in the DSM that men are more likely to have an onset in
childhood

(American Psychiatric Association, 2022)

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 THEORY INTEGRATION:
SYSTEMS THEORY
⊹ Systems theory argues that an individual cannot be understood in
isolation but rather in relation to the different systems that exist and
the subsequent relationships (Wilkinson, 2011)
⊹ A change in one component of the system will impact other
components of the system and impact the overall entity
(GoodTherapy, 2017)
⊹ Expands to the idea of Family Systems Theory : Individuals cannot be
understood in isolation – linking back to their family of origin
(Gilbertson & Graves, 2018)
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 THEORY INTEGRATION:
SYSTEMS THEORY
⊹ When looking at Aaquil, he cannot be understood in isolation but rather
considering:

× His mom and her hand washing : what can this mean for him?

× Lack of a father figure and how Aaquil now behaves

× His wife’s behavior alongside his behavior

What does this all mean for Aaquil and his current presenting problem?

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Formulation

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 Biological Social Psychological

• Possible
genetic • Adverse
• Strict
vulnerability childhood: no
Predisposing religious
• Engage from significant male
practices
a young age figure

• Wife poking
Precipitating • Wife leaving
finger in his face

• Isolation • Thinking about

• Mom’s
Perpetuating • Knowing it her leaving = not
tendencies
is a concern sleeping

• His wish to
continue
• Commitment to
with the
Protective therapy
relationship
• Being good
at his work

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 Treatment Plan : Cognitive
Behavioral Therapy (CBT)
⊹ CBT is identified to be one of the main, effective
treatments for the different depressive disorders (Barlow et
al, 2017, American Psychological Association,2017 )
⊹ CBT is seen to assist depressed individuals through
replacing their negative, depressed thoughts and attributes
with more positive ones (Barlow et al, 2017) – challenging
a faulting way of thinking (APA, 2017)
⊹ Psychological Patterns are seen to be part of learned,
unhelpful patterns of behavior (APA, 2017)
⊹ Develop more effective coping behaviors and skills (APA
2017) 16
 Application to Aaquil
⊹ CBT for Aaquil will explore the following:
⊹ Assisting Aaquil to recognize his distortion in
thinking, for example hitting his wife and need
for everything to be clean like hands and food
⊹ His hyper fixation on his hand washing
⊹ Helping Aaquil to develop appropriate problem-
solving strategies : focus on what is within his
control, Psycho-education
⊹ Explore ways we can assist his problems of
eating and sleep – ie: Mindfulness 17
 Application to Aaquil
Sessions
× Mood check : check into his sleeping and eating
× Setting agenda for the session
× Exploring our presenting problem, how have we
progressed on this
× Exploration of goals/setting of goals
× Homework: looking at past homework and setting for
future session
× Bring together a summary of the session

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 Case Management Plan
Individual Psychotherapy Reaching out
• Aaquil will continue to benefit • Aaquil may benefit from
from individual Psychotherapy reaching out to his
• Using CBT to assist with the wife’s parents
current depressive episode • Closure
• When he’s ready, explore the • Movement in the
OCD deeper therapeutic process

• In line with CBT, Aaquil

• Aaquil voiced an interest in
may benefit from
engaging in couples counselling
• Should contact with his wife be activities such as
re-instated, a refferal can be exercise
made
• Referral to a GP may be
• Continue to consult with the
religious leader, should that be warranted to assist with
of interest
his sleeping concerns
Couples Counselling Other Aspects 19
 References
⊹ American Psychiatric Association. (2022). Diagnostic and statistical manual of mental
disorders (5th ed., text rev.)

⊹ Barlow, D.H ,Durand, V.M, du Plessis, L.M. & Visser, C. (2017). Abnormal
Psychology: An Integrative Approach. (SA Edition) Cengage Learning.

⊹ Gilbertson, S & Graves, B.(2018). Heart Health and Children . In Watson, R. R., &
Zibadi, S. (Eds) Lifestyle in heart health and disease. essay, Elsevier.

⊹ GoodTherapy Editor Team. (2017). Systems Theory /

Therapy. https://www.goodtherapy.org/learn-about-therapy/types/systems-theory-
therapy

⊹ Wilkinson, L.A. (2011). Systems Theory. In: Goldstein, S., Naglieri, J.A. (eds)
Encyclopedia of Child Behavior and Development. Springer, Boston, MA.
https://doi.org/10.1007/978-0-387-79061-9_941

⊹ What is Cognitive Behavioral Therapy?

(2017). https://www.apa.org. https://www.apa.org/ptsd-guideline/patients-and-families/
cognitive-behavioral
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THANK YOU !
I look forward to engaging in any
questions and thoughts

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