John is 9 years old and has been refusing to attend school for a month. He had never shown particular emotional or behavioural problems before. His parents report that about one month ago John started manifesting anxiety, physical complaints, vomit and panic related to school attendance, especially when the first lesson of the day was with his maths teacher, Anna. John’s mother, Lucy, describes Anna as a rigid and inflexible teacher, reporting that one time she did not allow John to phone his mum even though he was feeling very sick, saying that he should stay at school and probably would feel better soon. On some days John accepted to walk to school with his mum, but when they arrived close to the main entrance he started being very agitated, sweating, crying, yelling and shouting, and his mother went back home with him.
John’s family moved from another city three months ago. Lucy is a housewife, she appears worried about John and, although very controlled, she manifests a subtle anger towards her husband, Daniel, a successful entrepreneur, who travels a lot and is often away all day long for his job. John has also an older brother, Harry, a sociable 10-year-old boy.
John’s parents refer that John does not want to be separated from his mother also at home, following her everywhere. John spends his time at home, going out to play with some friends very rarely, only when his older brother is at home. John reports that his mum is often angry, because he does not want to go to school, Harry is often out with his schoolmates and his dad works a lot. Lucy is concerned about John’s difficulties, moreover, after moving from another city she is now quite isolated, even though Daniel has bought her a brand new car to let his wife visit her relatives. Although Daniel is very busy, when Lucy calls him regarding John’s anxiety and physical symptoms he tries to go home immediately.
Your assignment should show your understanding of the kind of mental health difficulty presented, the strengths and weaknesses of using a diagnosis in such a case, how to use theoretical and research evidence to formulate a case, and how your case formulation will help you to plan for an intervention.
To help you to write the case study, consider the following questions:
Identify the presenting issues in the case. What kind of ‘diagnosis’ would be most appropriate for this case? Explain why. Critically evaluate the usefulness of a diagnosis in this case. (500 words)
Identify the predisposing, precipitating, perpetuating and protective factors at play in the case you are exploring, drawing on appropriate research and theory to support your argument. (800-1000 words)
Plot this onto a case formulation model, using appropriate research and theory, explaining your formulation with clear links to case material and to the theoretical framework being used. (1000-1200 words)
Use a diagram or table if appropriate.
Outline an intervention plan. What intervention would you use, with whom, and why? (500 words)
Do use the points above as subheadings if you would find that useful. We will use these subheadings to guide our marking.
The word counts for each subsection are mere suggestions – you do not have to stick precisely to them. However, they will give you some sense of how you should weight each section in your write up.
Ensure that you use theory and research to inform your diagnosis, formulation and intervention plan.
Think critically about the material you draw on.
Make sure that your intervention relates to your formulation. Remember the purpose of formulation is to INFORM intervention.