Sample Psychology Paper on a Vignette

Instruction:

Review the following vignette and utilizing the clinical signs/symptoms mentioned, please be prepared to verbally discuss the questions provided at the end of the vignette:

Vignette

Cory is a 33-year-old married Latin American male. Last week, he joined the IOP and has been assigned to your caseload. Prior to your first session with him, your clinical director informs you that Cory had just showed up positive for alcohol. In your session with Cory and his wife Sarah (consent provided), you opened the session by disclosing to them your practicum status, the name of your supervisor, and the limits of confidentially. Both acknowledged your practicum status and the limits of confidentiality and agreed to continue working with you. During this session, you found out that Cory had begrudgingly joined the IOP due to Sarah being fed up with his alcohol addiction. Cory indicated that Sarah gave him an ultimatum: “get sober” or “she will divorce me and take my children”. When asked about his drinking habits, Cory argumentatively stated that he only has a few drinks at night and denied having an addiction to alcohol. When asked, Sarah informed you that Cory’s drinking has not been a problem over the years until recently. She stated that over the past year his drinking had drastically escalated where Cory would drink anywhere from a few glasses to two bottles of wine per night. Sarah continued to state that the drinking began to be a problem for Cory both at home and his work. Cory admitted that his drinking had caused some problems for him at work, due to him coming into work either hungover or intoxicated after his lunch break. He is currently on administrative leave for approximately two weeks without pay. Sarah informs you that Cory’s drinking has often led to him isolating in his home office and would refuse to spend time with the family. He has also made little to no effort in helping Sarah raise their two older daughters. She has even caught him picking up his two daughters from school while being “slightly intoxicated”. Cory admitted that this had occurred on several occasions, but stated he was able to drive without any issues. No history of any DUIs. When asked about what occurred that changed Cory’s drinking habits, you noticed both Cory and Sarah’s affect shifted dramatically. Sarah informed you that over a year ago, they had lost their youngest child, Mark at five years of age, to a tragic pool accident. Sarah further explains that Cory blames himself for the loss due to Mark being under “his watch”: Mark happened to walk outside by himself and fell into the pool while Cory was on the phone with work. Cory stated that since the loss of his only son, he has been having nightly nightmares depicting how he found Mark and the guilt associated with the incident. Sarah also reported that since the incident, Cory has not allowed his two older daughters to go swimming. Cory admitted that when his guilt and depression becomes overwhelming he tends to drink in excess to numb the emotional pain of the loss. He also admitted that sometimes he would drink to avoid feeling some of the withdrawal symptoms of alcohol. Cory stated that he would like to work with you on the loss of his son, but stated that he is still ambivalent about his drinking. Cory agreed to stop drinking, while he is working with you and while he is in the IOP program, but indicated that he may return to drinking in the future.

Topics of verbal discussion:

1. Indicate any counter-transference you may experience working with the client
2. Indicate cultural considerations
3. Given the provided information, what DSM-V diagnosis would you be considering, and/or what diagnosis would you want to rule-out?
   1. If warranted, what would the severity index be and why?
4. Are there any potential ethical/legal concern(s) you may have, given the information provided?
   1. If so, what concern(s) do you have?
      1. How would you handle the concern(s)?
   2. Any other concerns you may have about Cory?
      1. If so, what concern(s) do you have?
         1. How would you handle the concern(s)?
      2. Indicate potential therapeutic modalities/interventions that you would consider using with Cory
      3. Bonus question: Utilizing the Transtheoretical Model (Stages of Change Model), developed by Prochaska and DiClemente, what stage is Cory in?