Apply the current symptoms to theDSM-5-TR criteria and arrive at a diagnostic impression.

Case Study

Alicia is a 38-year-old African-American female living in a rural town in west Texas. Two months ago, she was laid off from her full-time job of seven years. Alicia has been experiencing a significant amount of grief and sadness over the loss of her job. She is single, with no children and no family nearby. Her job was a significant source of meaning in her life. She comes to you for counseling and seems to focus mostly on feelings of loss and sadness. As you continue your assessment with Alicia, she talks about difficulty sleeping. She reports sleeping fewer than four hours each night, saying that she cannot fall asleep because she feels so anxious about the loss of her job and what the future will hold for her financially as well. Alicia states that she typically feels very anxious at night and then early in the morning after she wakes up. She shares that she feels very helpless right now and that this feeling reminds her of when she was a child. Alicia discusses that she and her mother went through a period of being homeless when she was about five years old. She seems to be very distraught when she talks about this experience, almost as if she is reliving the emotions right there in the session with you. As Alicia continues to talk about her experience, she shares that she has started to drink some in the evening to "take the edge off" of his anxiety and fear. When asked a few times, Alicia shares that she drinks about a bottle of wine four or five times a week now. She states that she rarely drank prior to losing her job and that "sometimes it's just easier to have a few drinks than it is to go see the doctor or a counselor, you know?" She shares that she has been drinking more over the past month because it does not seem to be helping as much now. Alicia describes feeling as if she is constantly "on edge" most of the day as well. She has tried to search for jobs and apply for unemployment, but she has had a difficult time concentrating and focusing in general. Overall, Alicia says she is feeling exhausted from worrying "literally all day every day," to the point where she just cannot get her mind to rest anymore.

Be sure to include the following components...

Part 1:Rule out inaccurate diagnoses.

• Identify at least two alternative, but inaccurate, diagnoses that should be considered for the case study.
• Give a rationale for why both diagnoses are not accurate.
  • Include symptoms that are missing from the diagnoses.
  • Include symptoms from the case study that do not match both of the diagnoses you are ruling out.

Part 2:Apply symptoms to the overall diagnostic impression.

• List theDSM-5-TRcoding for the diagnosis or diagnoses you have arrived at for the client.
• Apply the symptoms from theDSM-5-TRto support your diagnostic impression.
  • Include why the client's symptoms are a match for the diagnosis or diagnoses you have provided.
  • Align rationale with the diagnostic symptoms listed in theDSM-5-TR.
• Discuss at least two additional pieces of information that are missing from the case study and that would help you arrive at a conclusive diagnosis (i.e., medical information, additional testing).