The following case study is connected to the questions below: Please assist with answering the following questions related to case study: Brief Overview of Client DSM Diagnosis and rationale (Including code) Approach to Treat Disorder (including assessment techniques or tools) Treatment Plan (Minimum THREE goals with measurable objectives) with following format: Goal 1: Objective 1: Objective 2: Objective 3: (Complete for minimum three goals) Anticipated discharge criteria (i.e., When is process complete?) Additional Information (What more information about the client would need to be gathered to better understand the client?

At age 35, Julie, a new assistant professor of communication, had finally, after changing careers in her 20s and receiving her Ph.D, begun to live the life she had always envisioned. She was an energetic and outgoing woman, a social butterfly who enjoyed long talks with friends, traveling to the backcountry of exotic places on the cheap, and trying new foods. Having been raised in the exurbs outside Washington, DC, she considered herself somewhat of a city girl. She knew how to be in the city, how to be safe, to explore, to have fun, and then to return to the predictability and familiarity of home. But she didn't feel entirely safe in the city.

Her first job was in the suburbs of DC, on the Virginia side, working for a large consulting firm. She hated it. It was good money, sure, but for what? To help companies make decisions about how to maximize profits by "reallocating resources"? Firing people, she used to tell her friends over drinks in the corporate chain cookie cutter bars after work. I get paid to give CEOs spreadsheets and slide decks that they use to fire hard working employees. Nah. No thanks. After receiving her doctorate, Julie had moved to a small college town in North Carolina for her first job as a professor. Unlike her job as a consultant, teaching was very rewarding. She loved the feel of campus life and the rhythm and pulse each day. And she loved her students. Her favorite moments, the ones she would talk about endlessly with joy and optimism, happened when her students found themselves with a sense of purpose and meaning. She didn't care in which newfound direction they were headed, as long as she could see the spark ignite within them, something she herself had wished she could have felt as an undergraduate.

As a child, Julie had grown up free of any physical or mental health problems. Her parents, however, had not been so lucky. Julie's African American father, Roger, spent his childhood and adolescence in Alabama during the civil rights movement. During his senior year of high school, Roger began protesting in nonviolent marches and attending meetings with local leaders designed to plan solutions in the fight for social justice. As he would tell Julie many years later, during these years Roger had been in many, many situations where he feared for his life.

At age 14, Roger was the youngest of his friends to join the men from his neighborhood in protests outside the county courthouse. The first time he stood in the crowd, he knew he belonged. It was scary, but he felt like he had found purpose in standing for something bigger than himself. He would recount to Julie the pride he felt standing in awe listening to the reverend exhort the crowd of mostly young, Black men to stay strong, to believe in their cause, and to remain nonviolent. Every chance he could find, Roger attended events in support of the cause. It also put him at risk for being a victim of violence. By the time he was 15, he had been chased, grabbed, and shoved to the ground by the counterprotesting white men. When he was 16, he watched his friend's older brother get badly beaten and left to die by two men, their steel-toed boots breaking his ribs and brass-knuckled fists bloodying his face. Even as an older man, Roger wept as he recalled the details of this memory to Julie. He never forgot a moment of it. The smell of asphalt in the summer heat, the thick humid air, a driver honking their horn in delight after slowing to watch the gruesome scene. Roger had wanted to help, but he froze. He had stood behind a tree, alone, frantically turning his head every which way, looking for help, fearing he would be next. Sadly, this was only one of many violent incidents Roger had witnessed firsthand. By the time he moved north to Virginia and married Julie's mom Sandy, Roger had been exposed to no less than a dozen traumatic experiences. Roger had accumulated many emotional scars stories he would share with Julie that would impact him the rest of his life.

As Julie grew up, she heard her father's stories many times. Roger wanted her to know her family history, the struggles and sacrifice before her, who he was, so she too could bring focus and passion to the things that mattered most to her. He had been significantly affected by what he witnessed. He felt survivor's guilt, wondering aloud why he was never the victim of violence. He witnessed horrific things happen, but he had never been physically injured directly. He told Julie these stories again and again. True to the nature of flashbulb memories, his stories had remarkable clarity and consistency. Details had been preserved in defiance of the distortions common to autobiographical memory.

Julie knew the parts he was most proud of, the ways he stood strong and firm, unwavering in his convictions during a tumultuous time of social and moral upheaval, and she felt inspired to do something meaningful with her own life. She also knew the parts of the stories that he was most sad about: all the loss, devastation, trauma, and imminent fear for his life. She felt these parts of his memories most profoundly. When he would talk about seeing his friend shot at, Julie could see it the way her dad would describe it and feel what he felt. Sometimes she would get so lost listening to his stories that she would forget where she was, practically feeling like she had traveled back in time to bear witness to the very same violence Roger had experienced. Sometimes she wished she could have been there with him. She loved her father so much it hurt to see him continue to be deeply affected by the events of his life so many years ago.

At the university, she threw herself wholeheartedly into her career, devoting her life to teaching, research, and writing. Her intense involvement in her work was obvious to those around her. Within her first few months, her colleagues were commenting about how much harder she worked than they did. They were playful about it, but it was clear to Julie that she was working long devoted hours as a new professor. It was a lot of fun, and she was beginning to make friends along the way. This was no surprise. Julie had always been sociable and made friends easily.

With her life taking shape as she had hoped, Julie was feeling excited about her future. She missed her family and friends back in DC, but she was making a new life for herself in North Carolina. She tried the local barbeque, Eastern-style with a balance of vinegar to offset sweetness. She frequented the farmer's market in the town center. She went out with friends to sample the local music scene, taking in unfamiliar singer-songwriters and acoustic sets with blissful lyrics that along with a drink or two in her system gave her a sense that she was on the right path. She was going to do what she had wanted since her miserable days as a new consultant. She was going to inspire others. Over time, her colleagues and students became like her family. Sensing her devotion, students packed her classes and requested her as an advisor. She won a teaching award in only her second year at the university, in near record time for a new professor. Everything was going so well for her. But one night, she was struck by a catastrophe that took her life and state of mind in a direction that she could never have anticipated or imagined Julie was walking back to her car after a night out with friends in a nearby town. She had parked a few blocks away from the bar where they had finished the night, but she thought she would be fine walking back on her own. After all, she had plenty of experience looking after herself in DC; she shouldn't have any trouble in this small city in North Carolina. She walked briskly toward her car, keeping a vigilant eye on her surroundings. It was darker than she expected, and eerily quiet, and she even noticed some signs of vandalism. She unconsciously picked up her pace as she got closer to where her car was parked. As she got into her car and quickly locked the door behind her, she breathed deeply and felt a surge of adrenaline. She was more scared than she had realized but was starting to relax now that she was on her way home.

As she drove to the first red light, she saw two men in what seemed to be a heated argument enter the crosswalk. To her alarm, they stopped right in the middle of the road, yelling and gesticulating wildly, pointing and angrily posturing toward each other. Julie froze. They didn't seem to even notice her, but she instinctively feared for her life. She wanted to honk but feared this would turn their aggression toward her. Time seemed to slow down dramatically as she saw two other men rapidly approaching from behind her car. Seconds later, she heard gunshots, five bangs that seemed impossibly loud. As the light turned green, the two men in front of her ran off into the night, and the others ran past her car, their shouts and cursing reaching her through the sound of her music. It was total chaos. The light turned red again, and she hadn't even moved. Without thinking, she hit the accelerator and sped away. She went a few miles out of town and onto the highway, then started to weep.

She was horrified. What if she had been shot? What if she was bleeding to death and no one could reach her? What if they had carjacked her? Held her hostage? She was so overwhelmed with fear that she did not even stop to assess whether she had in fact been hit by the gunfire. She didn't feel anything, but she also knew that if she had been shot, she might not immediately feel it. She knew she was alive, and she felt lucky.

When she got home, she called the police, and they arrived to take her statement and begin an investigation. While waiting, she checked her car and saw that it had been hit by gunfire. A bullet had passed through the rear quarter panel, missing the gas tank but going through her back seat. She felt numb. She could have been killed if the shooter had moved his arm just a little bit in a different direction. Her hands started to tremble, and she felt like she couldn't breathe. Everything she had worked for, all of it, could have been lost in a blink. She sat on the curb waiting for the police and sobbed. She tried to call her parents, but they didn't answer. She texted her friend from work. No response. It was chilly, and she started to shiver. When the police arrived, they could tell she was very upset. They took their time with her, and Julie told them everything in as much detail as she could.

After about 15 minutes of gentle questioning, she realized they were starting to ask her questions that made her feel a bit uncomfortable. "What were you doing in that part of town, ma'am?" She was out with friends. "Why were you alone then, at that time of night, in that part of town?" She told them she had walked to where her car was parked, and that this was the closest parking available when she went to meet her friends earlier in the night. "Ma'am," they kept calling her in a way that felt dehumanizing, "if you don't mind, we'd like to take you in to ask you some more questions." It turned out that there was a major problem with drug trafficking in that part of town, and the police wanted to know if Julie was involved. She was shocked and angry. "I was out with friends," she reiterated, "I was just driving home. You think I had something to do with drug trafficking and the shootings?" She was now becoming agitated. "With all due respect, would you ask the same questions of someone who didn't have brown skin like me?" The police began to escalate in return, telling her to calm down. "Ma'am, we are asking standard questions we would ask anyone to understand the nature of the events that transpired." She repeated everything she knew and had already told them. "OK, ma'am," they said, "thank you for your time and we are so sorry for what happened to you." She was very upset; she had almost died, and instead of the compassionate help she had expected, she felt like she was being blamed or accused.

Before the police left, they told her they might come back the next day to ask some more questions. She spent the next 3 hours in a highly anxious state compounded by confusion and anger about the way the police had questioned her. She ruminated about calling a lawyer or going to the local news media. She couldn't sleep that night, and in the morning, she finally talked to her parents and a friend about what happened. They were emotionally supportive and were equally aghast at her description of the police questioning her.

Julie was relieved to be talking to people about what happened. She felt loved and understood by her family and friends. Still, she felt overwhelmed and exhausted. She couldn't imagine how she could ever get over the experience. Could she ever go out at night again? Could she trust that the police were on her side? What if the drug traffickers found out who she was and came after her? These thoughts spawned others, and her mind raced anxiously, tears uncontrollably streaming in between bursts of anger. In the weeks after the traumatic event, Julie had difficulties with sleeping, intrusive memories and nightmares interfering with her ability to get a good night's rest. She was jumpy and hyperattentive to her environment whenever she left her home. Driving was difficult, even after her car was repaired and she no longer had to look at the bullet hole in her car. She took a week off from work to help her adjust at her friend and colleague's recommendation. During that week, she hardly thought at all about work, obsessively reading the local news and searching for information about the drug trafficking problems in the nearby city.

Her friends were sympathetic, and as time went on they kept asking her if she needed anything. But oddly, Julie found it difficult to answer their questions. What did she need, she wondered? She wished for it all to have never happened. She wished to never have to think about it again. She told her friends she wanted to talk about other things. She hated the blend of feelings she felt whenever she was reminded about her traumatic event. Her experience was becoming jumbled in her mind, and explaining it again and again required considerable effort. It was tiring just to talk for a few minutes about it. She talked to her father almost every day. He listened and shared his own stories of being treated unfairly by the police when he was younger. But after a month had passed and she still was struggling to return to her normal functioning, her dad told her she needed to get help from a professional. Julie felt relieved to hear that from him and decided to take his advice. During the weeks immediately following the event, Julie regularly talked on the phone to her friend Veronica, whom she affectionately called "Vee," sharing her experience. Vee was supportive at first, but over time came to dread her daily text messages and phone calls from Julie. In a later conversation with her sister, Vee tried to explain such a reaction and to describe the course that her relationship with Julie had gone in the time following the event.

"At first l hung on every word, trying to grasp the horror that had befallen her. I worried about her terribly, wanted to help her through this, wanted to be there for her. But after a few weeks our conversations all sounded the same. No matter what we talked about, Julie found a way of turning the discussion back to her situation and her emotions. If I told her about a funny YouTube channel I found, she would keep talking about the police or the problem with drugs in the area. Then she'd tell me for the 50th time how dangerous it can be to drive alone at night, how many crimes are committed in this part of the state, or some other tale of fear and crime. Eventually I felt unimportant to her, just an excuse to describe the danger she now saw everywhere. Sometimes, it didn't even seem as if she was even talking to me just reciting her fears and anger out loud. It didn't matter that I was her friend anyone would have done fine. Like I was an object to her. An ear to talk at and not a person who had her own things to talk about. It got annoying real quick. Once I realized what was happening, I would try to divert her attention from these topics. I would offer gossip about someone at the university, bring up items from the news, or recall a funny or interesting event from past times. Nothing. Julie showed no interest in anything except her newfound fears.

"I would try to make plans to see her in person, rather than just talk on the phone. Julie would not consider going out to a restaurant or movie; however, she would 'let' me come over to visit her. Of course, during these visits we would just wind up talking about her fears again. Over time, the visits became shorter and shorter. Finally, I began to feel like a delivery person. Julie would 'allow' me to take groceries to her or to pick up some laundry from the cleaners. Our whole relationship became empty and superficial. I tried letting her talk about her fears; I tried not letting her talk about her fears. But nothing seemed to help. In time, it became a moot point, because Julie pushed me out of her life.

"By 3 months after the shooting, she had stopped calling me and would only occasionally answer my calls. Our communications were brief and very superficial, as if Julie couldn't wait for them to end. She seemed very fearful over what had happened to her and, worse, over what might happen to her in the future. Loving her, I truly felt for her. But she also seemed to become increasingly angry, nasty, and cynical, not at all the friendly and warm woman I have known. She acted as if she blamed me I'm not sure for what perhaps for not having gone through the same ordeal or maybe for not seeming to care enough or to do enough now. All I know is that after a while conversations or interactions with me seemed to further agitate Julie. If I suggested that she see her doctor again or gave her advice, she would act like I was bothering her and sticking my nose where it didn't belong. So I pretty much stopped. I stopped making suggestions or trying to coax her back into the world. It seemed easier for Julie that way; it was certainly easier for me.

"You know, in an odd way, I feel like I was a victim too. For the most part, I have lost my friend. I have been forced to stand by and watch her drift away. This warm, energetic, and fun woman who added so much love to my life has been replaced by a stranger an obsessive, self-centered, angry woman who seems to resent me and wants little to do with me. I am just so frustrated and sad and a little angry as well, I guess. For now, Julie and I have an implicit understanding to keep some distance between us." During the weeks immediately following the event, Julie regularly talked on the phone to her friend Veronica, whom she affectionately called "Vee," sharing her experience. Vee was supportive at first, but over time came to dread her daily text messages and phone calls from Julie. In a later conversation with her sister, Vee tried to explain such a reaction and to describe the course that her relationship with Julie had gone in the time following the event.

"At first l hung on every word, trying to grasp the horror that had befallen her. I worried about her terribly, wanted to help her through this, wanted to be there for her. But after a few weeks our conversations all sounded the same. No matter what we talked about, Julie found a way of turning the discussion back to her situation and her emotions. If I told her about a funny YouTube channel I found, she would keep talking about the police or the problem with drugs in the area. Then she'd tell me for the 50th time how dangerous it can be to drive alone at night, how many crimes are committed in this part of the state, or some other tale of fear and crime. Eventually I felt unimportant to her, just an excuse to describe the danger she now saw everywhere. Sometimes, it didn't even seem as if she was even talking to me just reciting her fears and anger out loud. It didn't matter that I was her friend anyone would have done fine. Like I was an object to her. An ear to talk at and not a person who had her own things to talk about. It got annoying real quick. Once I realized what was happening, I would try to divert her attention from these topics. I would offer gossip about someone at the university, bring up items from the news, or recall a funny or interesting event from past times. Nothing. Julie showed no interest in anything except her newfound fears.

"I would try to make plans to see her in person, rather than just talk on the phone. Julie would not consider going out to a restaurant or movie; however, she would 'let' me come over to visit her. Of course, during these visits we would just wind up talking about her fears again. Over time, the visits became shorter and shorter. Finally, I began to feel like a delivery person. Julie would 'allow' me to take groceries to her or to pick up some laundry from the cleaners. Our whole relationship became empty and superficial. I tried letting her talk about her fears; I tried not letting her talk about her fears. But nothing seemed to help. In time, it became a moot point, because Julie pushed me out of her life.

"By 3 months after the shooting, she had stopped calling me and would only occasionally answer my calls. Our communications were brief and very superficial, as if Julie couldn't wait for them to end. She seemed very fearful over what had happened to her and, worse, over what might happen to her in the future. Loving her, I truly felt for her. But she also seemed to become increasingly angry, nasty, and cynical, not at all the friendly and warm woman I have known. She acted as if she blamed me I'm not sure for what perhaps for not having gone through the same ordeal or maybe for not seeming to care enough or to do enough now. All I know is that after a while conversations or interactions with me seemed to further agitate Julie. If I suggested that she see her doctor again or gave her advice, she would act like I was bothering her and sticking my nose where it didn't belong. So I pretty much stopped. I stopped making suggestions or trying to coax her back into the world. It seemed easier for Julie that way; it was certainly easier for me.

"You know, in an odd way, I feel like I was a victim too. For the most part, I have lost my friend. I have been forced to stand by and watch her drift away. This warm, energetic, and fun woman who added so much love to my life has been replaced by a stranger an obsessive, self-centered, angry woman who seems to resent me and wants little to do with me. I am just so frustrated and sad and a little angry as well, I guess. For now, Julie and I have an implicit understanding to keep some distance between us."