Diagnostic of Mental Disorders and Family Support - Case Study Example

Marceline is a nineteen year old young mother who finds herself in a very troubled relationship. While Marceline is still married to Michael, her first love, she is separated from him because he left her for another woman and is now in a relationship with a man named Leon, from which a number of problems have spawned. Since she has been in a relationship with Leon, her life has been tumultuous. Both Marceline and Leon have went in over their head financially, as they purchased a home to later walk away from it because they were not able to afford the bills that came with the purchase of the house. Now, her and Leon reside in a studio apartment in substandard living conditions. The toilet constantly runs, and there is peeling paint, which can become a safety hazard to the baby. Marceline and Leon have complained to their landlord about these issues; however, the landlord is not receptive to the complaints, though, he does allow Leon and Marceline to pay the rent late, so long as they pay in the same month and pay the late fee. Along with the financial trouble that she finds herself in, she is having relationship troubles, as Leon is very impatient towards her son, who obviously suffers from a developmental or behavioral problem of some sorts, and he is not at tentative to her, since the both of them have fallen into financial trouble. She has fallen into alcoholism to cope with life's difficulties, as she states that she consumes a number of alcoholic beverages during the evening in order to calm her nerves, and she abuses other substances from time to time. Leon engages in this behavior right along with her for the same reasons. Marceline is very confused about who to remain in a relationship with, as she has been intimate with Michael, as a result of troubles with Leon, and Michael wants to be in her life again, helping and caring for his son Michael Jr. Marceline is so consumed with her troubles that she has even considered suicide as a means to ridding herself of the current problems and frustration at hand. In addition to her relationship troubles, her son, Michael Jr. is having troubles of his own. Michael Jr. is twenty-six months old. He is extremely avoidant, and has significant troubles communicating his wants and needs. He does not try to talk, and he throws tantrums on an almost constant basis. His young mother is so overwhelmed with him that she takes him over to his grandmother Grace's house, who is the mother of Michael Jr.'s father, and this woman also wants to take full custody of him because she feels that she is able to care for him better than his mother, who has even stated, out of frustration, that she has no desire for him, as she regrets having this child because she is unable to bond with him, due to his behavioral issues. Marceline is actually willing to give this child to Michael and his mother Grace without issue because the baby already spends a significant amount of time over at Grace's house, and Leon is in agreement. Though Marceline is frustrated with her son's behavior, and though she is fed up it is noticed that this is not what she wants to do, as she ends her first session by stating that she wishes to move in with Grace and her first love, Michael. In order to repair this family's situation and bring about stability, there are a number of issues that need to be addressed in a systematic fashion. In order to even begin helping the family tackle any of their issues, interviews need to be conducted with parties will be significantly involved in the outcome of Marceline and her son Michael Jr. These individuals are the baby's father, Michael, Grace, who is Michael's mother, and Marceline herself. There is no need for an interview with Leon, as he is merely a man on the side, and Marceline's goal seems to be that she wants to restore relations with her husband and move into her husband's family's home. Though she states in the beginning that she wants to repair her relationship with Leon, this is not what she really wants, as her statement at the end of her session makes it clear what she truly wants to accomplish. Should the need arise for Leon to be interviewed, that can certainly be arranged; however, the current course does not call for Leon to be interviewed. Along with interviewing members of the family that are vital to helping the family achieve stability, it is important that the necessary paperwork is on file, as this paperwork will be essential to not only addressing each problem thoroughly, it will also help in formulating treatment plans. The paperwork that will need to be on file are any custody agreements that the family has arranged with one another in regards to Michael JR., any pertinent medical reports from treating physicians, reports in regards to drug and alcohol rehabilitation, psychological evaluations, notes from interviews of each client involved, as well as notes taken from each therapy session, which will include what was discussed, the goals that the family wishes to meet, and the plans on how these goals will be reached. Should the file lack any of the aforementioned paperwork, there will be significant difficulties in successfully rendering proper services to the family. While providing treatment and helping the family to achieve goals, there are a number of ethical issues that need consideration. First and foremost is the issue involving Marceline and her son. While one might consider severing Marceline's parental rights on a permanent basis and giving her son to her in-laws, since she has stated that she is frustrated and regrets ever having her son, it will not be virtuous to do such a thing, as Marceline is merely a young mother who is frustrated, needs help and resources, and is confused and perplexed as to why her son behaves in the fashion that he does. This situation would be troubling to many mothers in her situation. Marceline does not really mean what she says. She is merely making such statements out of frustration. She is distraught that she is not able to bond with her baby as most mothers do. If she were not concerned about her son and his wellbeing, she would not have brought these issues up in therapy. Being that she is concerned and shows a desire to be a mother, the virtuous thing to do would be to help her by providing necessary resources to not only help her cope but to also deal with her son's behavior issues. Another ethical consideration is how I must behave towards my clients in this setting, appropriately stating with clarity which members of the familial group are actually my clients and which ones are not. Should the need ever arise that I must be a witness at any court hearings of any kind, such as acting as a family therapist to the entire family but then needing to be a witness for one of the family members at a divorce or custody hearing, I must take steps to modify my role or withdraw completely and appropriately, should the need arise (American Psychological Association, 2003). These are the consequential ethics that I must follow in this case in order for me to do my job effectively and efficiently. Though I'm wearing the hat of a marriage councilor at this present time, as a therapist, I'm able to perform a number of different psychological tests in order to diagnose my client and put him or her on an appropriate treatment plan. In the instance of Marceline and her family, I will need to run tests and evaluations on the family members involved, especially those who will be involved with caring for the baby. First of all, I will run psychological evaluations on Marceline, Grace, and Michael, as they will all be active in the baby's upbringing, and this situation concerns them chiefly. The test that all of them will need to take is the Minnesota Multiphasic Personality Inventory. The Minnesota Multiphasic Personality Inventory is a test that is widely used not only for diagnosing various mental disorders, it is also used to assess people's personalities, get an idea of their outlook on life, and get an idea of some of the goals that they wish to achieve. This test is also used to determine who will have custody of a child during divorce proceedings or adoption, should the need arise for the test to be taken in those circumstances, as is not always the case. Along with the test that is to be administered, there are instruments to be used to see that recipients have taken the test honestly and have not faked their personalities, telling what they think is socially acceptable or what the therapist might want to hear (Butcher, 2006). The reason I will have these individuals take this test is to see if they will be able to provide a stable environment for the baby, as well as treat any psychological disorders that may be present. While it is not necessary for Grace to take the test, as she is not only running a daycare and is fit to do so, but she has successfully raised her own children without significant problems, except for what is normal to the average parent, which makes her more than qualified to care for Michael Jr. However, just to be sure her motives are pure, and to see to it that she merely wants to provide a caring environment for her grandson without hidden motives, I feel that it is fitting that I administer this test to her. Marceline will definitely have to take this assessment, as she has not only indicated that she has had suicidal thoughts on more than one occasion, I suspect that she has symptoms of an underlying mental illness, such as depression, due to her circumstances being as they are. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, depression is characterized by a general loss of interest in life's activities. The book also notes that the term "depression" is used interchangeably to describe other mood or mental disorders (American Psychological Association, 2000). Suicidal thoughts indicate a general loss of interest in life altogether, and Marceline is feeling this way because she feels that she is an inadequate mother to her son, as she is not able to love him the way she wants to. Then, there is Michael. I feel that it is appropriate to give him this assessment to see if he is going to be a stable support for his son. One would question whether or not he will be an adequate and stable support for his son, since he left his wife for another woman without thought, which may indicate that he may possibly make decisions without thinking them through. But because one cannot make such an assumption about someone's character based on solely the decisions that they make, it is important to evaluate Michael extensively. Then, I will carefully observe the baby and take my own personal notes on his behaviors. I feel that it is important that he be observed is because he is part of the centration of this problem. Because I do not specialize in children's therapy, I'd then refer the baby to a children's therapist to be evaluated extensively because his behaviors indicates that he is possibly Autistic. I draw the conclusion that Autism may be the reason for his inability to communicate, his hyperactivity, and his lack of involvement with others is because according to an article published by Mayo Clinic, people with Autism have difficulties in three areas, which are social interactions, language, and communication. Autism in its severest form causes an individual not to communicate at all with other people around him (Mayo Clinic, 2009). Michael Jr. is avoidant of other people, which is a sign of Autism, since those with Autism seem to enjoy being in their own world compared to engaging with others (Mayo Clinic, 2009). Furthermore, Michael Jr. is always constantly moving about, which is another characteristic of Autism that falls under the behavioral category (Mayo Clinic, 2009). Not to mention, Michael Jr. is not communicating, and he acts out frequently. Upon evaluating Michael Jr. it is a good idea that he continues to receive services at a behavioral clinic for children at the discression of the psychological professional who evaluates him. Along with referring Michael Jr. to a psychological professional who specializes in children therapy, I will also refer Marceline to Alcoholics Anonymous, which will enable her to overcome her alcohol addiction, and she will learn better ways to cope with her problems and face them, rather than using alcohol as a means to coping. Narcotics Anonymous is another service that I will refer Marceline to, as she utilizes other substances along with the alcohol from time to time as a means to cope. This service will benefit Marceline, as she will find other ways to cope with and face stresses without having to resort to substance abuse. It is also fitting that Marceline take parenting classes, and Michael should as well, since he is planning on being part of his son's life. Since they are young and appear to be inexperienced in the way they behave and carry themselves, it will do them some good to attend parenting classes, so they can learn how to properly care for a child. On top of the parenting classes that they should take, I also will strongly recommend that they take classes that teach them to parent a special needs child, since Michael Jr. displays many behaviors which indicate him being as such. I will also be referring the couple, Michael and Marceline, as well as Michael's mother Grace, to various support networks that help parents of special needs children. These supports will not only provide them with necessary information that will enable them to work to provide him with the best quality of life possible, these supports will also provide resources that will enable the family to cope with having a special needs child in their midst. Respite services may also be available, should the need arise for them. Such programs and supports will enable the family members to obtain relief when feeling frustrated, and they will feel that they are better adequate to care for Michael Jr. Furthermore, since the child is not talking or displaying age appropriate behaviors, it is fitting that he be enrolled in a head start program or in home therapy to work with him on the basic skills that he should have mastered on his own. Such programs offer him the hope of catching up to peers in his age group, if not completely, at least he will be able to progress further than he is currently. Over the course of time that I spend working with and evaluating each member of the family who are my clients, I will be carefully tracking their progress, as well as setting goals for each one of them to achieve. The object of these sessions is to help the family establish a support network that will remain solvent in times of trouble, create a stable family dynamic for the child, and get Marceline on the right track with life. If all of these goals are met, the therapy sessions will have proven to be a success. References American Psychological Association. (2003). APA Ethical Principles of Psychologists and Code of Conduct. Retrieved from http://www.apa.org/ethics/code2002.html#2 American Psychological Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington D.C.: Author. Butcher, J. N., Ed. (2006). MMPI-2: A Practitioner's Guide. Washington D.C.: American Psychological Association. Mayo Clinic. (2009). Autism: Symptoms. Retrieved from http://www.mayoclinic.com/health/autism/ DS00348/DSECTION=symptoms Read More