PSYC 6104 DQ

8.1 Discuss a case conceptualization for BPS

factors and CRSJ considerations that contribute to
anxiety and depression in adolescence.
#1

Counsellors apply the CRSJ framework to examine our worldview may impact our
counselling approach (Collins, 2018). Collins (2018) indicates that we adopt
metatheoretical lenses and theoretical flexibility to respond to our clients in a culturally
responsive and socially just manner.

The BPS framework examines how BPS factors may contribute to anxiety and
depression. According to Sperry and Sperry (2020), the biological elements to consider
the severity of the anxiety and depression? Current and historical personal and familial
health. Shebib (2020, p.274) indicated a deficit of GABA can contribute to anxiety (2020,
p.282). Does heredity, current medical conditions, medications, substance use (alcohol,
marijuana) exacerbate the client's presenting challenge? (Sperry & Sperry, 2020)

When we examine psychological factors, we look at coping skills, personality, and

internal and external circumstances (i.e. racism and oppression). We explore their lived
experiences (Collins, 2018; Sperry & Sperry, 2020) and their current behaviours and
beliefs (Sperry & Sperry, 2020) and how these psychological factors might contribute to
the primary concerns?.

The socio-cultural factors we examine are family dynamics, social support network,
external stressors, such as oppression, marginalization (Sperry & Sperry, 2020),
intersectionality, cultural identities and social locations (Collins, 2018). How may these
socio-cultural elements contribute to the client's depression and anxiety?

References
Collins, S. (2018). Culturally responsive and socially just counselling: Teaching and
learning guide. Faculty of Health Disciplines Open Textbooks, Athabasca University.
https://crsjguide.pressbooks.com/
Shebib, B. (2020). Choices: Interviewing and Counselling Skills for Canadians (7th ed.).
Pearson Canada.
Sperry, L., & Sperry, J., (2020). Case conceptualization. (2nd ed.). New York, NY :
Routledge. http://search.ebscohost.com/login.aspx?
direct=true&AuthType=ip,sso&db=nlebk&AN =2572771&site=eds-live&custid=s7439054

#2

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 Thank you for introducing specifics in regards to adolescent clients presenting with
depression and anxiety. Although you presented a case of Maria, I will speak more
generally.
In regards to predispositions, according to table 6.2 by Sperry & Sperry (2020, p.94),
from a biological perspective, adolescents with family histories of anxiety and
depression might be more vulnerable and predisposed (Sperry & Sperry, 2020, p.92).
From a psychological perspective, a study by Orchard et al. (2019) indicated depressed
adolescents globally describe themselves more negatively than they and use fewer
positive self-descriptive words. The potential predispositions to depression and anxiety
from a social standpoint, adolescence may not have developed the resources to cope,
which can dually be viewed as a maladaptive pattern. According to Shebib (2020, p.
284), the biological origins of depression can be associated with hormones, brain
chemistry and heredity. Shebib indicated that a deficit of GABA can contribute to
anxiety. Pinel and Barnes (2021, p.248) specified the GABAerigic system is found in the
prefrontal cortex, and the prefrontal cortex doesn't fully reach maturation until
approximately 24 years of age.
References
Orchard, F., Pass, L., & Reynolds, S. (2019). 'I Am Worthless and Kind'; the specificity of
positive and negative self-evaluation in adolescent depression. The British journal of
clinical psychology, 58(3), 260–273. https://doi.org/10.1111/bjc.12215
Pinel, J. P. J., & Barnes, S. J. (2021). Biopsychology (11th ed.). Pearson Education.
Shebib, B. (2021). Choices: Interviewing and Counselling Skills for Canadians (7th
Edition) (7th ed.). Pearson Canada.
Sperry, L. (2020). Case Conceptualization (2nd ed.). Routledge.

#3

How do you incorporate the CRSJ framework into case conceptualization? My

interpretation of the diagram from Collins (2018, Chapter 15) is that counsellors learn to
view the world from many lenses, we have lots of theories and models to draw from and
utilize. Similar to what Trina indicated whichever manner in which we collect, gather and
orgnaize information we want to do so in a way that
focused on Collins diagram and teachings, how would you apply that the case
conceptualization of anxiety and depression with adolescents?

Depending on which model I am using in practice, and using multiple lens, there may be
different reasons for different ones, and there may be advantages and disadvantages.
However, the model needs to examine the same questions, what is happening for the
client, how we as a team make sense of it and how would the client want these
experiences to be different? (Collins, n.d., 12:48). How do we understand what is
happening for the client in order to construct meaning from his or her experience, so
that he or she can move forward? In this understanding, we would then need to
collaborate towards interventions and resources that would provide support towards
treatment goals, and work toward a treatment strategy that would successfully allow the
client to be independent and no longer require treatment, as clinically indicated. I will
explore the assessment of multiple factors using case conceptualization in my next
post.

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 Presentation Increased social isolation and depressive symptoms
Precipitant news that she was being considered for a job
promotion and a new supervisor (current precipitant);
demands
of close relationships and the expectation that she will
be criticized, rejected, and feel unsafe (continuing
precipitant)

avoids and disconnects from others when feeling unsafe

Pattern-maladaptive

Predisposition biological: family history of depression

psychological: shy, avoidant, non-assertive; rejection
sensitive
social: current: avoids critical and demanding people; past:
demanding, critical, emotionally unavailable parents;
teasing, taunting, critical peers

Perpetuants maintained by her shyness, living alone, and generalized

social isolation

Protective factors & close, trusting friend and confidante; stable meaningful job
strengths eligible for job accommodation;

Cultural identity middle-class African American with limited ethnic ties

Cultural stress & highly acculturated; no obvious acculturative stress but

acculturation family gender roles reinforce the notion that she is
inadequate

Cultural explanation sadness results from job stress and chemical imbalance in
her brain

Culture and/or personality dynamics are significantly operative

personality

#4

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 Thank you for providing an analysis of the Collins (2018b) diagram from Chapter 15 into
a case conceptualization for adolescence exhibiting symptoms of depression and
anxiety. The diagram from Collins (2018, Chapter 15) and the Collins Video (n.d)
outlines that counsellors learn to view the world from many metatheoretical lenses, we
have lots of theories and models to draw from and utilize. However, whichever
framework we use to gather the information we must do so in a Culturally Responsive
Socially Just (CRSJ) manner. This means to be theoretically flexible, anti-pathologizing,
look at the many ways our clients view the world and their cultural identity, and to come
from a strength-based approach (Collins, 2018; Collins, n.d). Another thing we also
need to consider when incorporating CRSJ into our framework is for therapists to
continually cultivate self-awareness through examining their worldview and hidden
biases, and how it may impact the counselling approach and therapeutic relationship
(Collins, 2018; Collins, n.d).

References

Collins, S.(n.d) Conceptualizing Client Lived Experiences: Part

II[Video].YouTube.courses.yorkvilleu.ca

Collins, S. (2018). Culturally responsive and socially just counselling: Teaching and
learning guide. Faculty of Health Disciplines Open Textbooks, Athabasca University.
https://crsjguide.pressbooks.com/

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