Need by 9:30 pm tonight

Use DSM 5 manual 

Below are your first case you will be discussing. Make sure you provide a full diagnosis including any specifiers that may be relevant. I will be monitoring your work carefully for this first group of cases.

The Case of Aleta Austin 
Aleta Austin is a 26-year-old woman who was seen by  an LPC during her first clinic visit. When asked what brought her in, Aleta explained, “I work as an aide in a nursing home, and I was lifting a patient up from a chair to her wheelchair. Well, anyhow, all of a sudden I felt this terrible and very painful snap in the back of my neck. I lost my balance and fell on the floor. As I was falling, I hit my arm real  bad, too. The next thing I knew, I was in the hospital, and they were doing some X-rays and an MRI. The doctors said I sprained my neck, and I might have a hairline  fracture of my arm. They put some kind of neck brace on me and said I had to wear it for two weeks. I didn’t  need to have a cast on my arm, but I was supposed to be real careful.” 

Aleta continued, “I wasn’t allowed to work for six weeks, so I got workmen’s comp—but the checks stopped when the doctors said  I could  go back to work. It has been four months, and they say  that’s  too  long  to have  pain  for the  injury  I got. So now I have  money problems on top of everything else but I don’t care what they say, I still hurt.” Apparently without realizing  it, Aleta was rubbing her neck  while  she was  talking.  She went on, “After being discharged by those  doctors, I went to see several new ones. I thought, you  know, maybe the first  ones didn’t  know what they were  talking  about.”

The LPC asked what other doctors Aleta  had  seen.

“Well, over the past three months,” she replied, “I saw two orthopedic surgeons, one neurologist, two chiropractors, and  a massage therapist. I was given  lots of different medicines and  treatments, but I still  didn’t  get much relief. One of the doctors  said  I should  see a  shrink.  He thought my problems were  all  in my  head. Can you beat  that?”  Aleta sounded very  annoyed. “That  really  steamed me—doesn’t he realize  I  really  want to go back to work  and  see  all  my friends  again? Not only that, does he think I like being in constant pain?  Does he think  I like taking  all  this  medicine and not  getting  any  relief  from  any  of  it?”

The  practitioner  asked  Aleta  about the medica­ tions  she is currently using.

She answered, “In  the beginning, they gave me some  pain  pills  that helped some,  but  the doctors  won’t prescribe  anything  for me now. They  think  I’m  getting too used to all  the pills.  Now I can only take  over-the-counter stuff  like,  you know,  aspirin,  Aleve,  Tylenol, Motrin—but they don’t do much good. Nothing seems to help  nowadays.”

When asked how she spent her days, she replied, “I pretty much stay inside the house all day long. I have  a hard time finding a comfortable place to sit or lay down. My brother, Chad, brought over his favorite recliner chair for me to use, and that does help some. Most of the time I watch TV, sleep, or play with my dogs.” Aleta volunteered that she and her husband are “in the middle of getting a divorce after being married five years.” She stated, “It was his idea, but I guess it’s  all for the best. During the time we were married, I realized that I am a lesbian, so  …  I always felt different  from other women and a little confused about this. I tried really hard to  just bury these feelings—my family  sort of freaked out. It’s so hard to come to terms with this. . . . But I can’t believe he wants a divorce after all  the time we’ve been together. He doesn’t know about me being gay, and  he told me he isn’t seeing anyone else—he  just  said he was tired of me being sick  all  the  time. I don’t believe him.” Aleta studied her fingernails  for a moment. “Well,  like  I said, maybe it’s for the best.  He’s absolutely no use to me now.”

The practitioner  asked  Aleta to say a  little  more  about  that.  As it happens,  Aleta’s  parents  had  moved  into  her home three months ago, “so they  could  help  out  while  I was  recovering,”  she  explained.  “My dad  works  full-time,  as a barber, but he  finds  the  time  to mow  the  grass,  run  errands,  and  do the house  repairs. I’m  starting to get a little  behind on my bills, and  Dad  tries  to  help  out a  little  in  that  department,  too.” Aleta  repeatedly stated she wanted to go back to work; however, she also said,  “It’s kinda  nice  to have  Mom and  Dad around the  house right  now. Mom  fixes  all  my  favorite  foods— [laughing]  I know  I’m  gonna gain  ten pounds before she leaves  to go back home!”

“You know, my mom  told  me  that  when she was  younger, she had problems  like  me. I guess when she  was a teenager she had problems with  pain  in her back  for a really  long time. Isn’t  that weird? Mom said when she was around 20 she had trouble with really  bad headaches  and  something  with  her breathing—she  doesn’t  like to  talk  about it much.” Aleta related  that  she once asked her Aunt Dolly  (her  mother’s oldest sister) about it, and she had  just  said, “Oh, it’s just  something the Walker women get when they are  young’uns.”   When asked if she had experienced any previous psychological problems such as  hallucinations,  delu­ sions, depression, suicidal ideation, or anxiety, Aleta laughed, and said, “My lord, no. Aside from  this  neck  and arm pain, my health has been somewhat good.” She described herself having frequent bouts of low back pain, headaches, and “sometimes my jaw hurts real bad, off and on,” she offered, “but overall I don’t have any serious medical problems.”

During the relating of her past medical history, the  LPC observed that Aleta’s train of thought had been derailed somehow. Sure enough, she inter­rupted herself, “You know, I’ve been thinking about  the question you  just  asked, the question about  psychological problems. Does sibling rivalry count as a psychological problem?” She continued, “When Chad, my brother, and I were growing up, we fought like we were mortal enemies. I mean we hated each other. I always felt  like  Chad was Mom’s favorite, so I  grew up feeling like a Secondhand Rose, it was awful.”  The session continued along these lines for another I5 minutes or so. When the time was up and Aleta was walking out the door, she said to the LPC “You know, it’s really great to have all of my mother’s attention right now because I’m in so much pain.”



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