case review natalie
Case (14.1 Natalie Loftin) Questions
1. Describe presenting problems. Do you think this is his/her primary problem? Why or why not? Presenting problems: Natalie came in for “concerns about her boyfriend, Larry Watkins, over the past six months”. She reported that she has “been so upset that she hasn’t been able to function at work and her coworkers told her she needs to get some help”. No, this is not her primary problem. Client stated that she felt so depressed and empty that she didn’t think she could stand it and also notes that she hates herself. Client additionally indicated “there’s just nothing worth living for and I hate everyone and everything” Furthermore, she specified how she’s been suicidal and felt worthless and hopeless and just wants to end it all and in fact indicates she has a history of attempts. She also noted that she was having financial difficulties. And of course as we know has BPD.
2. What are some of his/her strengths? Natalie is a college graduate, has a job as an administrative assistant, appears to be able to convey her feelings in an (at least somewhat) articulate manner, so far has been open and honest to our knowledge, and realizes she needs assistance and is willing to get help.
3. What potential diagnoses would you want to rule out in this case? Mood disorder - depression or possibly manic depression (bi-polar) and other personality disorders.
4. What resources might be helpful for him/her to access? Suicide hotline, some type of self-help meetings, employment services, medical doctor, family therapist or another therapist besides you, and/or psychiatrist.
5. What is your preliminary diagnosis for him/her?
A. SECT. I
a. Borderline Personality Disorder (BPD) 301.83 (F60.3)
b. NOS Unspecified Personality Disorder 301.9 (F60.9)
c. R/O Unspecified Depressive Disorder 296.20 (F32.9) or 296.30 (F33.9)
d. R/O Suicidal Behavior Disorder (not yet coded)
e. Frequent use of devaluation
f. Frequent use of passive
1. Describe presenting problems. Do you think this is his/her primary problem? Why or why not? Presenting problems: Natalie came in for “concerns about her boyfriend, Larry Watkins, over the past six months”. She reported that she has “been so upset that she hasn’t been able to function at work and her coworkers told her she needs to get some help”. No, this is not her primary problem. Client stated that she felt so depressed and empty that she didn’t think she could stand it and also notes that she hates herself. Client additionally indicated “there’s just nothing worth living for and I hate everyone and everything” Furthermore, she specified how she’s been suicidal and felt worthless and hopeless and just wants to end it all and in fact indicates she has a history of attempts. She also noted that she was having financial difficulties. And of course as we know has BPD.
2. What are some of his/her strengths? Natalie is a college graduate, has a job as an administrative assistant, appears to be able to convey her feelings in an (at least somewhat) articulate manner, so far has been open and honest to our knowledge, and realizes she needs assistance and is willing to get help.
3. What potential diagnoses would you want to rule out in this case? Mood disorder - depression or possibly manic depression (bi-polar) and other personality disorders.
4. What resources might be helpful for him/her to access? Suicide hotline, some type of self-help meetings, employment services, medical doctor, family therapist or another therapist besides you, and/or psychiatrist.
5. What is your preliminary diagnosis for him/her?
A. SECT. I
a. Borderline Personality Disorder (BPD) 301.83 (F60.3)
b. NOS Unspecified Personality Disorder 301.9 (F60.9)
c. R/O Unspecified Depressive Disorder 296.20 (F32.9) or 296.30 (F33.9)
d. R/O Suicidal Behavior Disorder (not yet coded)
e. Frequent use of devaluation
f. Frequent use of passive