Discuss one counseling intervention you would use with your client (based on the theory you would use: journaling, teaching coping skills, stop talk, etc.).

As a student you will be responsible for evaluating a case study that includes a case conceptualization, ICD coding, diagnosis, treatment goal, and application of your choice of theory and an application of a theoretical intervention. Utilizing the DSM 5 you will assign a diagnosis to the clinical case. You will be given a “starting point” within the DSM 5 classification under which the possible diagnosis falls. With the information provided, you will then write a summary by discussing the following:
a Short discussion on client information (gender, age, and so forth)
b Symptoms that lead to a diagnosis and ICD-10 coding
c Length of time symptoms have been present to the client (2 week, 2 months, etc)
d Co-occurring disorder, if any (ie: depression and substance use)
e Diagnosis and ICD coding; reason for choosing that diagnosis (state facts for deciding on that diagnosis for the client)
f Theoretical orientation that is considered most appropriate for this mental health disorder, or you can choose the theory you would consider using (do your research) and discuss your reasons for using that theory (ie: research shows that CBT is theory of choice for depression, BUT you would like to use Solution Focused therapy: state your reasons and back it up.)
g Discuss one counseling intervention you would use with your client (based on the theory you would use: journaling, teaching coping skills, stop talk, etc.)
h Discuss one treatment goal you would implement with your client (ie: improve communication skills, or improve coping skills, etc.)
Clinical Case Scenario: Germs
DSM V Section II: Obsessive-Compulsive and Related Disorders
Trevor Lewis, a 32-year-old single man living with his parents, was brought to his psychiatric consultation by his mother.

She noted that since adolescence he had been concerned with germs, which led to long-standing hand-washing and showering rituals. During the prior 6 months, his symptoms had markedly worsened. He had become preoccupied with being infected by HIV and spent the day cleaning not only body, but all of his clothing and linen. He had begun to insist that the family also wash their clothing and linen regularly, and this had led to his current consultation.
Mr. Lewis had in the past received a selective serotonin reuptake inhibitor and cognitive behavioral therapy for his symptoms. These had had some positive effect, and he had been able to complete high school successfully. Nevertheless, his symptoms had prevented him from completing college or working outside the home; he had long felt that home was relatively germ free in comparison to the outside world. However, over the past 6 months he had increasingly indicated that home, too, was contaminated, including with HIV.
On mental status examination, Mr. Lewis appeared disheveled and unkempt. He was completely convinced that HIV had contaminated his home and that his washing and cleaning were necessary to stay uninfected. When challenged with the information that HIV was spread only by bodily fluids, he answered that HIV might have come into the home via the sweat or saliva of visitors. In any event, the virus might well be surviving on clothes or linen, and could enter his body via his mouth, eyes, or other orifices. He added that his parents had tried to convince him that he was excessively worried; not only did he not believe them, but his worries kept returning even when he tried to think of something else. There was no evidence of hallucinations or of formal thought disorder. He denied an intention to harm or kill himself or others. He was cognitively intact.

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