1

Case Analysis

Tydelia Hunt

SWK 653-01 Advanced Clinical SW Practice

Dr. Jay Poole

UNC Greensboro and NC Agriculture and Technology University

April 13, 2020

 2

Theoretical Framework

The theoretical perspective(s) that will influence how I will analyze the case of Jose will

be psychodynamic theory and systems theory. I will use psychodynamic theory because I will

focus on the client’s unconscious thoughts. I will dive deeper into why the client is in the space

that he is in. Psychodynamic theory will provide insight into how the client views his

relationships, experiences, and the world and how that affects his preferences, behaviors, and

drives, and therefore personality ("Psychodynamic"). I could also use systems theory. I could

use systems theory to identify how different systems in Jose’s life plays a part in behavior and

thoughts. I will want to make sure to hit every aspect as best as I can as I go through the sessions

with Jose.

Psychodynamic theory will influence how I will analyze Jose’s case because it will touch

every aspect of what is influencing him. It will touch on his unconscious thoughts of his parent’s

death, the loss of his job, the loss of his girlfriend, and his drinking. I would want to examine

what happened during childhood that has affected him up to his adulthood. Why did he come to

the United States with his uncle? Why was his parents and siblings left behind? I would like to

know what he remembers. Systems theory will give me a deeper understanding of who Jose is by

connecting all pieces.

Skills Used to Engage

I have seen Jose for 3 sessions so far and have gotten a lot of information from him

regarding his background and where he is in life now. To continue to engage and assess, I will

continue to ask open- and closed-ended questions. This will be allow me to get direct answers
 3

and answers where he can provide more. I will utilized assessment tools to learn more about how

he’s been feeling such as depression, hopelessness, suicidal ideation, etc..

During a session or two, I will allow the client to lead the discussion with what is on his

mind to not make it like a therapy for session. I will allow him to express his concerns around all

that is going on whether that is the thoughts he has been having about his parents, his

relationship with his ex-girlfriend or the loss of his job. These things can be common and can

lead someone to the state that he has found himself in.

Code of Ethics & Personal Biases

The Code of Ethics for social work will influence my approach on Jose’s case by making

sure that I help him in the best way possibly and ethically. I will use the NASW Code of Ethics

to respect the inherent dignity and worth of the person ("NASW Code of Ethics"). Regardless of

the cultural differences between myself and Jose, I will respect him and give him the care that I

would anyone else. I will recognize that the client may not want therapy and that I will have

adapt my work to align with him. I will help him in a way that he feels comfortable to build that

rapport and human relationship.

I will allow the client the right to self-determination. One thing that I always tell myself

when working with a client is that they know themselves better than I do. They will make the

right decision and will set goals that they know are attainable and achievable. I have that much

faith in my clients.

My personal biases that I recognize in response to Jose’s case is the alcohol use. In my

family, alcohol use has played a part in the way that some people act and results in unsatisfying
 4

consequences. When working with Jose, these biases may present itself because I may reflect on

what alcohol has done to my family instead of focusing on how it is affecting the client.

Other personal biases that I recognize in response to Jose’s case is the fact that he worries

constantly about his family and that he is living with a relative. I am huge on family. I am very

family oriented and care about my family a lot. I could not begin to imagine my life without my

parents or siblings. We all have a close bond and not being able to be around them will tear my

heart apart. I may find myself focusing on how he is coping with the thought of not having his

parents or siblings around because I would be thinking about how I would cope without them

around.

Cultural Aspects

The cultural aspects that stick out to me in this case is that Jose is of the Hispanic

community. The experience of living in a village where drugs were prevalent. He crossed the

border with his uncle who was undocumented as well. He then learned later of his parents being

killed and not knowing where his siblings were. Once living in the United States, he did not

complete high school and did not speak good English which could have been a barrier growing

up and moving through life in the USA. Jose then started working in construction where he later

lost his job.

Diagnosis and Differential Diagnosis

Based on the first three sessions and knowing what I know about Jose, I would diagnose

him with major depressive disorder with mild anxious distress. Based on the symptoms that Jose

presents with and what I have been able to get from him, he exhibits depressive symptoms with a

little anxiety surrounding parts of his life. Jose presents with a depressed mood. Some of the
 5

symptoms that align with MDD is markedly diminished interest of pleasure in all, or a lost all,

activities most of the day, nearly every day which is the movies that he had once enjoyed

(Diagnostic and statistical manual of mental disorders: DSM-5, 2017, pp. 160-168). He also

stated that he has no interest in doing much lately. Jose also expressed not sleeping well, not

having a good appetite, and not being able to concentrate as well as he used to.

Jose expressed feeling angrier lately and getting to a fight with his uncle. He has also

expressed feeling upset about not having documents to be in the United States. He states that this

is very upsetting for him. He worries about his status and if the authorities will come in the night

to take him away. These symptoms can explain the diagnosis that I would give him with the

anxious distress.

The differential diagnosis that I would give Jose is the substance/medication-induced

depressive disorder. Jose has been drinking since he has been 16 years-old which could fall

under producing the depressive symptoms, but I had to look at all the cultural aspects of the

client. Also, there is no evidence from history, physical examination, or laboratory findings of

depressive mood developing during or after substance intoxication or withdrawal or substance

used is producing the symptoms of depression.

Interventions

Interventions that I would use to assist in treatment for Jose is interventions around the

diagnosis that I diagnosed Jose with. Interventions that I think will help Jose will be cognitive

behavioral therapy (CBT), supportive therapy and a little bit of problem-solving to help with his

anxiety.
 6

I would start with a little supportive therapy to get Jose talking. I want him to feel as if he

can share what he wants to be able to receive the help that he needs. Jose presented for services

because he recently got into a fight with his uncle. I would want to dive deeper into why the fight

began and what caused the fight.

As we progress through the sessions, I will use CBT to assist in therapy with Jose. I want

to know what causes Jose to feel anxious about his status and use problem-solving techniques to

intervene with straying away from that anxiety of not being documented. I would like for Jose to

problem-solve and to figure out what he can do to decrease his anxiety.

I chose these interventions above others because with CBT, it is a technique that can be

taught to the client whom can practice outside of sessions. CBT targets the brain and the way that

someone thinks. It can help with depression and helps the client to discover the underlying

reason of why he feels the way that he does in the moment. It allows the client to look at the

mind consciously and unconsciously. Is his thoughts valid? Can his thoughts be changed due to

facts?

I will use problem-solving techniques because if there are any changes Jose is willing to

make, he will need to figure out how to solve them. Being that he is an undocumented individual,

he would not want to cause any trouble within his household that would possibly lead to

authorities being present. He will need to problem-solve how he can get along with his uncle so

he would not be anxious about authorities coming in the middle of the night.

Evaluation

When it comes to evaluating the impact of the interventions I’ve chosen, I will continue

to monitor how my client feels by using check-in methods before each session. I will find an
 7

assessment that assesses for depression and will continue to monitor his outcomes. I will directly

ask the client about his feelings and how he feels that he have progressed since coming to the

sessions. Goals will be set from the beginning and monitoring where the client is with his goals

will be another way that I will evaluate the impact of the interventions.

I will modify my interventions based on my evaluation by changing the way that I do

things. I ask the client what has been working for him and what has not. Based on his answers, I

will modify the interventions with changes that will produce change. After making

modifications, I will then re-evaluate my services by asking for feedback on how he feels that his

progress is going and by looking at assessments.

 8

Citations

(n.d.). Retrieved from

https://examples.yourdictionary.com/examples-of-psychodynamic-perspective.html

About. (n.d.). Retrieved from

https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

American Psychiatric Association. (2017). Diagnostic and statistical manual of mental

disorders: Dsm-5. Arlington, VA.

NAMI. (n.d.). Retrieved from

https://www.nami.org/Learn-More/Mental-Health-Conditions/Depression/Treatment