Case Study: Ella is a 19-year-old bisexual-identified female of Asian American heritage. She has been referred to you by her college advisor following a consultation about her academic struggles and weight loss. In your first meeting with Ella, she appears anxious and hesitant to discuss her challenges. She does admit that she is having a hard time connecting with others at school. She feels pressured to fit in with the "pretty, thin, rich girls" and is hoping to pledge a sorority by the end of the year. Ella denied being in a romantic relationship presently and stated that her parents are unaware of her bisexuality.

Ella was raised in a middle-class neighborhood by both parents. Her dad ran the family business and was away from the home for many hours and even days at a time. Ella stated that she respects her parents for their roles in the family (mother as primary caregiver and father as breadwinner). She admits that her parents were restrictive and that she had little freedom growing up. She describes her mother's parenting style as somewhat critical and controlling. Ella states that she is expected to achieve good grades and participate in school organizations. Ella does not want to disappoint her parents nor misrepresent the family.

Ella reports using methamphetamine occasionally and, at times, several days in a row to stay awake when studying or working her part-time job. Ella also reports that she likes that methamphetamine decreases her appetite and has helped her to lose approximately 15 pounds since the start of the school year.

Questions to consider

1. Four questions that you can ask the client as part of a clinical interview/assessment, and explain why these questions are important.

2. Identify the preliminary diagnoses you are considering for this client and why.

3. Identify what information you need to seek out to complete the diagnostic process. Include background, contextual information, and any co-occurring disorders that may be present.

4. Select two assessment instruments that you might use during the assessment of this client, and explain why you selected them and how each instrument informs diagnosis.