Description
CNL-605 Biopsychosocial Assessment (Obj. 6.1 and 6.2)
Assessment Description
Review Josh’s recorded video of his intake interview with therapist Dr. Amy Wenzel, and complete the attached biopsychosocial assessment.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Resources if you need assistance.
This assignment is informed by the following CACREP Standards:
2.F.5.i. Development of measurable outcomes for clients.
2.F.5.n. Processes for aiding students in developing a personal model of counseling.
5.C.1.c. Principles, models, and documentation formats of biopsychosocial case conceptualization and treatment planning.
5.C.2.d. Diagnostic process, including differential diagnosis and the use of current diagnostic classification systems, including the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD).
5.C.3.a. Intake interview, mental status evaluation, biopsychosocial history, mental health history, and psychological assessment for treatment planning and caseload management.
5.C.3.b. Techniques and interventions for prevention and treatment of a broad range of mental health issues.
Attachments
Transcript of Video
Cognitive Behavioral Therapy for Anxiety and Depression (Session 1 of 6)
1: Opening the Session
Josh, I’m so glad you were able to come in for a visit today.
JOSH: Um hmm.
AMY WENZEL:
5 seconds AMY WENZEL
[00:05] AMY WENZELWhat was it you were hoping to accomplish today in our visit?
JOSH: Um, I just thought it was a good opportunity
10 seconds JOSH
[00:10] JOSHto take care of some of the anxiety issues, or at least talk about it.
AMY WENZEL: Sure.
JOSH: So any opportunity I have, especially because I’m not fully insured to talk about it with a professional. I usually take up, pretty frugal that way.
AMY WENZEL: Yeah. No, it sounds like you’re seizing an opportunity and we’re gonna
30 seconds AMY WENZEL
[00:30] AMY WENZELmake the best use of it.
JOSH: Yeah.
AMY WENZEL: That’s terrific. That’s terrific. So I definitely wanna hear more about the anxiety and then so one of the things that I was hoping to do here today is to hear a bit more specifically what you’re experiencing in terms of anxiety and I saw in here there’s a little bit of depression as well. So we’ll kind of talk about, not only those emotional experiences that you’re having, but also some of the things going on in your life, the stressers and things that might trigger some of the depression and anxiety. And as you’re talking I will link what you’re talking about to the questionnaire here, to some of the responses that you made on here. And then I’ll also link it to this model right here. This is the cognitive behavioral model that underlies the particular type of therapy that I do, cognitive behavioral therapy.
1 minute 15 seconds AMY WENZEL
[01:15] AMY WENZELAnd this is a way of just really making sense of your emotional experiences and other experiences in your life. So as you’re telling me about this, we’ll kind of make sense of it in terms of this model so you can start to understand how the pieces get put together.
JOSH: Sure.
AMY WENZEL: How does that sound?
JOSH: Uh, yeah,
1 minute 30 seconds JOSH
[01:30] JOSHthat sounds fine. It looks a good, looks like a pretty textbook model.
AMY WENZEL:
1 minute 35 seconds AMY WENZEL
[01:35] AMY WENZELTextbook model, you got it. You got it.
JOSH: Very professional.
AMY WENZEL: Good. Good. You know, the other thing I was hoping to do here today was just share a little bit more about what cognitive behavioral therapy’s all about and just hear from you if you think it’s a good match or if there’s some things that you think might pose some obstacles to some of our work together in the future.
JOSH: Sure.
AMY WENZEL: Sound okay?
JOSH: Yeah.
AMY WENZEL: Okay. So tell me a little bit more about the anxiety.
JOSH: Um, my anxiety, I guess a good way
2 minutes 0 seconds JOSH
[02:00] JOSHto track my anxiety would be just like my educational experience. Since when I was 18, if you would’ve asked me what I’d be doing now I’d be taking over the world. I’m 24. I’ve been in school for six years and I get my bachelor’s degree in May. And a lot of that, I think about two years into my college education I just really developed some sort of anxiety, just like this, I wanna call it, almost like a fog in my head where certain things became harder.
AMY WENZEL:
2 minutes 30 seconds AMY WENZEL
[02:30] AMY WENZELHow difficult.
JOSH:
2 minutes 35 seconds JOSH
[02:35] JOSHThe closer to school related it is, the harder it became.
AMY WENZEL: Okay.
JOSH: Right before I really started getting a lot of anxiety I became involved in a business fraternity. And we actually started on campus at ISU. But over the course of two semesters, I completely fell out of the group of friends I was with. I went from being the social chair to just not showing up. I took a semester off and then never went back to the fraternity.
AMY WENZEL:
3 minutes 5 seconds AMY WENZEL
[03:05] AMY WENZELOkay.
JOSH: So I’ve definitely gone down since then but I’ve come back up since then too.
AMY WENZEL: Okay. Good to hear that. Good to hear that. So when you started off by saying, boy, when you were 18 you thought you were gonna take over the world, I’m taking that as that you didn’t really have problems with anxiety up until that time. Is that correct?
JOSH: No. Even up until I was maybe like 19 or 20.
AMY WENZEL: 19 or 20. Like one or two years in.
JOSH: I mean, I was always very educationally
3 minutes 30 seconds JOSH
[03:30] JOSHsound. I always had a lot of ambition. I was the young entrepreneur on the block, you know?
AMY WENZEL: Oh, really.
JOSH: So yeah, you needed something done around your house, the odds are you could find me to do it.
AMY WENZEL: Okay. Okay. So you were ambitious. You were entrepreneurial.
JOSH: Very ambitious. Yeah.
AMY WENZEL:
3 minutes 45 seconds AMY WENZEL
[03:45] AMY WENZELOkay. You went to a four year school. Sounds like you were gonna major in business.
JOSH: Yeah. Yeah, I actually went into
3 minutes 50 seconds JOSH
[03:50] JOSHaccounting.
AMY WENZEL: Okay. You went into accounting. And then, so tell me a little bit more
3 minutes 55 seconds AMY WENZEL
[03:55] AMY WENZELabout that period when you had the onset of that fog and the anxiety.
JOSH: Um, it was the winter time when I first noticed it.
4 minutes 0 seconds JOSH
[04:00] JOSHI guess looking back now I probably didn’t realize it then. I probably just brushed it off as a seasonal disorder, something like that. I remember telling my grandmother on the phone about it and she’s, my grandmother’s kind of a close mentor for me, and she told me to go to see somebody. And they diagnosed me with just really mild depression and anxiety. But.
AMY WENZEL:
4 minutes 25 seconds AMY WENZEL
[04:25] AMY WENZELOkay, okay. So it sounds like there was no specific trigger.
JOSH: There certainly were a few things in my
4 minutes 30 seconds JOSH
[04:30] JOSHlife. I’m sorry, I was trying to think what the original question was.
AMY WENZEL: Sure.
JOSH: I had a breakup with a high school sweetheart. I don’t wanna say that was it. I was living away from home. I had that stresser. And I had just moved out of the dormitories into an apartment. So there’s the not being cradled by the university anymore.
AMY WENZEL: Okay.
JOSH: And my parents started getting their divorce, which didn’t really affect me as much, I don’t know, I was away from home. But maybe affected me, I just didn’t realize it.
AMY WENZEL: Okay. Okay.
5 minutes 5 seconds AMY WENZEL
[05:05] AMY WENZELSo it sounds like you didn’t have a history of depression or anxiety prior to this period. What about anybody that your biologically related to in your family?
JOSH:
5 minutes 15 seconds JOSH
[05:15] JOSHUm, my mother had, I believe I remember hearing she had post baby depression, postpartum depression.
AMY WENZEL: Postpartum depression.
JOSH: And I know she’s had an anxiety attack or two in her life.
AMY WENZEL: Okay.
JOSH: I don’t know too much about her experiences and all. But I know she’s experienced it in the past. And then of course with the divorce, you ask which parent what’s wrong with the other one, they’ll give you a whole list of medical; she’s bipolar, she’s this, he’s that.
AMY WENZEL: Sure. Sure. Okay.
JOSH: Most people I’m with would say I’m nothing like my parents.
AMY WENZEL: Okay.
JOSH: Cause I work in a family business.
AMY WENZEL: Oh. Okay.
JOSH: So they all know my parents.
AMY WENZEL: So the reason I was asking that question about your
5 minutes 55 seconds AMY WENZEL
[05:55] AMY WENZELfamily is because I’m trying to put this together now into an understanding of the onset of your anxiety. And one of our models of depression and anxiety that we oftentimes use in our field is something called a vulnerability stress model. And a vulnerability could be like a genetic predisposition to depression or anxiety. And one of the ways we know if a person has a genetic predisposition is if they have a family history of depression or anxiety. So you know the way I’m starting to understand this is that you might have this vulnerability and when things are going well and you’re successful and entrepreneurial, you’re not experiencing any symptoms.
6 minutes 30 seconds AMY WENZEL
[06:30] AMY WENZELBut it sounds like you had a trifecta of stress there, a transition between the breakup, the moving out of the comfort of the university taking care of you into the apartment, and then your parents’ divorce. And so that was a stresser, that really sort of brought that anxiety out or brought it to the next level.
JOSH: Yeah.
AMY WENZEL: Does that resonate with you?
JOSH: Yeah, certainly,
6 minutes 50 seconds JOSH
[06:50] JOSHlike the perfect storm.
AMY WENZEL: Perfect storm. You got it. So then you experienced
6 minutes 55 seconds AMY WENZEL
[06:55] AMY WENZELit as fog, you said.
JOSH: I just didn’t wanna do anything with anyone.
7 minutes 0 seconds JOSH
[07:00] JOSHYou have those classes in college where you go every day. You have the classes where you go Tuesday and Thursday and… I mean, I would just be sitting in class saying, “Okay, after this next slide I’m gonna leave.” Cause I turned to my homework, I don’t need to be in class. And then it just got worse from there.
AMY WENZEL: Okay.
JOSH: It’s like oh, my friend’s in class today, I don’t need to go. And then I would still always do the homework and everything but I just fell behind.
AMY WENZEL:
7 minutes 25 seconds AMY WENZEL
[07:25] AMY WENZELOkay. Okay. So you fell behind and then you said it got the point where you took a semester off from Illinois State. Correct?
JOSH: Uh, not completely a semester. I just took a really
7 minutes 35 seconds JOSH
[07:35] JOSHlight load and then I took off from the fraternity. So my membership was in pause or on hold or something. And then I just never went back to that. But I was always enrolled with the university.
AMY WENZEL: Always enrolled in university. And you said since that time there’s been basically ups and downs.
7 minutes 50 seconds AMY WENZEL
[07:50] AMY WENZELIs that right?
JOSH: Yeah. One big down and hopefully one last big up.
7 minutes 55 seconds JOSH
[07:55] JOSHBut I mean there were times where I would just lay in bed and not be able to go to class. Not because I wasn’t smart enough or I didn’t have the material or anything but I was sure that if I did the homework I would get good grades, no doubt about it. But…
AMY WENZEL:
8 minutes 10 seconds AMY WENZEL
[08:10] AMY WENZELOkay, okay. Why don’t we fast forward and tell me about the past month then, in terms of some of the depression and anxiety. What’s been going on now?
JOSH: The past month,
8 minutes 20 seconds JOSH
[08:20] JOSHI think if I look back next year, this’ll be the hardest couple, the hardest six months in the past five years of my life. I’ve really just grabbed the bull by the horns, I think. And if I don’t succeed this semester it’s just gonna be game over for college for me. I’m graduating in May.
AMY WENZEL:
8 minutes 35 seconds AMY WENZEL
[08:35] AMY WENZELGood for you.
JOSH: I have a full load of classes. And I’m trying to study for the
8 minutes 40 seconds JOSH
[08:40] JOSHenrollment exam for the IRS.
AMY WENZEL: Oh, terrific.
JOSH: So I feel good about it. And I’ve been dieting and exercising. And I think that really helps with my mood and just being really positive.
AMY WENZEL:
8 minutes 55 seconds AMY WENZEL
[08:55] AMY WENZELSo you described it as the hardest six months but it sounds like hardest in terms of working hard and accomplishing. Okay.
JOSH: But I mean there’s just,
9 minutes 5 seconds JOSH
[09:05] JOSHI had a quiz the other day I just didn’t do. You know so every once in a while I slip up like that and I have to really, for me it’s more about getting into the habit of doing it.
AMY WENZEL: Okay.
JOSH: You’ve heard of the power of the habit, the book.
AMY WENZEL: I sure
9 minutes 20 seconds AMY WENZEL
[09:20] AMY WENZELhave. I sure have. Yeah, so this is interesting because both in your paperwork as well as a couple things you said here suggest that the anxiety and depression are mainly now related to academic issues or academic stressers.
JOSH:
9 minutes 35 seconds JOSH
[09:35] JOSHAcademic stressers and just like succeeding and like what I feel I’m supposed to be doing in
2: Patterns of Thoughts, Feelings, and Behaviors
9 minutes 40 seconds JOSH
[09:40] JOSHlife at this point.
AMY WENZEL: Okay. Okay. So let’s take this specific example
9 minutes 45 seconds AMY WENZEL
[09:45] AMY WENZELof the quiz that you didn’t do very well on. When was that?
JOSH: That was
9 minutes 50 seconds JOSH
[09:50] JOSHtwo weeks ago over the weekend. I didn’t do well on it, I just didn’t do it. I read the chapter of the book. I couldn’t do it. Between Friday, Saturday and Sunday night and I found a reason not to do it every single night until Monday morning. I’m just kicking myself cause I didn’t do it.
AMY WENZEL: You didn’t do the reading? Or you didn’t take
10 minutes 10 seconds AMY WENZEL
[10:10] AMY WENZELthe…
JOSH: I did the reading. I did the work. I didn’t log onto blackboard our website and I didn’t
10 minutes 15 seconds JOSH
[10:15] JOSHhit begin quiz.
AMY WENZEL: I see.
JOSH: And then go through the ten questions.
AMY WENZEL: That’s what I was missing. It was an online quiz.
JOSH: And it’s like three points for the class. I understand how every point in the class works. Four points I had to do to get an A. You can take the quiz three times without any penalty, write down the answer every time, you get an A on the quiz. I usually do that.
AMY WENZEL: Okay.
JOSH: I just, sometimes I just freeze up.
AMY WENZEL: Okay. Let’s talk about hat freezing a little bit more. So when you’re