Reference no: EM133408238

Read the Case of Emily Considerdiagnosis and symptoms. What would be your final diagnosis based on the information given. What interventions or treatment you would provide. Include what model(s) of therapy you would use in your therapy. Why did you choose the interventions or treatment considering the client's presenting issues and symptoms.

The case of Emily

Emily is a 41-year-old Caucasian female who has never been married and has no children. She is a substitute teacher for the Los Angeles school district, but has been on unemployment since May 2010. She currently shares an apartment with a roommate in Venice. She has a B.A. in communications from the University of Michigan. Client is the oldest child and also has a younger sister, age 38. Her sister is married with 2 children. Her parents and sister still live in Michigan where she was born.

Growing up, her mother was an alcoholic and both physically (hitting, pinching, pulling hair) and verbally abusive (threatened to kill client and her sister). Her mother constantly put her down, stating that she was not good enough to do anything. Emily states that her mother attempted to kill her father when she was a child. She further states that her mother never physically hurt anyone outside of the family. Both client's uncle and grandfather (mother's side of the family) have Bipolar Disorder. At age 8, Emily attempted suicide by ingesting the ink in board pegs thinking it was poisonous. She currently denies any suicidal ideation. Emily's father was passive and quiet he "never got involved and kept to himself."

Client was bulimic from ages 15-18, but recovered on her own. Her sister was also bulimic in high school. Client left home senior year of college and has since lived in Boston, San Francisco, and Los Angeles. Client has been attending Alanon for the past year to deal with her mother's alcoholism as a child. She stated in session that she has learned in life to be "invisible" which has negatively affected her adult relationships.

Presenting Issue:

Client reports increasing depression since she has been on unemployment since May 2010. Since her move to the Venice area, she has difficulty getting continuous work due to low student enrollment in the LA school district. She is struggling with unemployment and not being able to pay the bills. Client has major dental work that needs to be done but has been holding this off due to lack of income. This further frustrates her.

Client currently attends DA (Debtors Anonymous), which she finds helpful. She admits that she gets bored easily and has had numerous careers over the past several years including screenwriter, documentary filmmaker, and stuntwoman. Client has not been in a long-term relationship with a man in 10 years. In the past, she dated narcissistic, alcoholic men who treated her poorly. If not, "I feel like I have to destroy him before he destroys me. "

She has few friends (mostly acquaintances) but reports her closest friends live back home in Michigan. She also reports that she doesn't have much of a relationship with her roommate.

Client feels that she is not able to move forward and tends to "sabotage" anything good that comes her away. She thinks this is because her mother did not allow her to feel good about her self and did everything in her power to make her life difficult.

Symptoms:

Client is very depressed and angry. She moves from topic to topic but mainly discussing her mother with much anger and resentment. She becomes tearful in session during much of the time. Client makes self-defeating remarks. A significant point the therapist has observed is that during every session, Emily picks at her fingernails consistently. As she talks about more sensitive issues, her picking becomes more aggressive.

Client/Therapist information:

Client is on time and even early for most sessions. She shows a very strong attachment towards the therapist. During one session, she was 10 minutes late and was very apologetic to the therapist for being so tardy. She gives holiday cards and small gifts to the therapist and continuously praises the therapist for helping her.