(Confidential Information)
Gender: Male Ethnicity: Caucasian
Tests Administer: Advanced Assessment Student
CLINICAL INTERVIEW
Reason for Referral
CK is a 24 year old Caucasian male. He is the son to a close family friend and for sometime his family has raised a lot of concern about his behavior. CK has been showing difficulties in concentrating on either work of study. This has proven to be a major hurdle in his academic and vocational life. He was unable to complete his course successfully and is unable to hold down a job. Due to this, he was referred for psychological evaluation to determine his current mental status. The contributing factors include serious family issues and some physical problems.
This report was prepared for a class assignment in order to fulfill the course requirements.
Source of information
The background information was obtained from the patient and family using a clinic interview, family assessment and developmental history. This information appears to be from a valid and reliable source.
Background Information
Current Concern
CK has been a good student up until he graduated from high and joined the University. He has since been struggling with his academic performance and social behavior. His relationship with his parents is a bit complicated since they got a divorce. He has difficulty focusing on work and study and has developed dependency on online gaming. His smoking habits have become extreme; he smokes approximately four times daily. CK hasn’t shown signs of being suicidal, but he has expressed a lot of verbal aggression to his family; that is unlike his usual demeanor. However, the most pressing matter of concern is establishing the reasons behind his inability to concentrate on his studies.
Medical and Developmental History.
Pregnancy and Birth History
CK’s mother was 35, and his father was 37 when he was born. There were no pregnancy complications, and his delivery was normal.
Developmental history
CK had an easy temperament as a child. Developmental milestones were reported to be within the normal range. He was very active and playful and suffered a few minor injuries as a result. However, he did not have a smooth childhood. He experienced some problems in his childhood that have had a huge impact on the development of the current issues he is experiencing. His father was a very strict military man and was not caring to CK and his siblings. Due to his military background, his father was very serious and hard on him and his other siblings. His mother on the other hand was a very business woman hence she did not spend enough time with them. She left CK in the care of his older siblings and the maid. CK was an a very cheerful young boy up until the onset of the issues he is facing currently. Despite having the same parents, CK bore close to no physical resemblance to his parents, siblings or other close relatives; he had unique facial features, was shorter and had darker skin compared to other family members. His was a smart student and his teachers liked him.
Medical history
He suffered the usual childhood illnesses of chickenpox and ear and eye infections. As an adult, he experienced a lot recurrent stomach pains that were related to stomach ulcers. He started displaying symptoms associated with the onset of stomach ulcers six months ago and is currently receiving treatment.
Educational History
CK was a smart student who began school quite early. He was a one of the best students in English, and his mother always praised him on his good handwriting and mastery of English. He performed well in school and eventually graduated from high school with a decent degree of 81 percent. He then joined Zayed University but due to family issues and some physical problems he did not attend lectures that led to him failing all his courses.
Family and Social History
CK is the youngest of seven children. He has two sisters and four brothers. His mother is a businesswoman who travels a lot whereas his father works with the military. His parents divorced immediately after he completed high school, and he has described their relationship as highly conflictual. He currently lives with his mother who is their primary caregiver. He stated that he was not close to both of his parents since his mother was always busy, and his father did not show concern for them. As a young boy he was very close to his elder brother who is the fifth born but they slowly grew apart as they grew up. There were no reports of previous cases of psychiatric issues in the family.
CK stated that he currently had a good number of friends and had no problem with making friends. It was of great concern that he met most of them through online gaming. Despite having friends, most of his friendships were casual in nature, therefore, he doesn’t confide in his friends about his problems. It was evident from the tone of his voice and body language that he longed to have a close friend. He has been a social person since he was a small boy, and his teachers and friends in school liked him.
Behavior Observations and Mental Status Exam
During the interview, CK presented himself as polite and relatively cooperative. He was not well groomed and presented a disorganized appearance. His short stature and slim frame gave him a youthful look. During the interview, he was dressed in a hooded jacket and pulled it over his head and failed to maintain eye contact for the most part of the interview. He was very withdrawn and shy and also quite defensive when it came to responding to questions. He was fidgety and displayed restless psychomotor behavior. His speech patterns were slow, and he often took long pauses before responding to the questions. He was easily distracted and evaded questions that made him uncomfortable. His thought form was not logic, and he tended to deviate from the subject topic quite easily. His insight and judgment seemed fair whereas his self esteem seemed low. CK displayed encumbered ability in his receptive language abilities. He required reread of the questions and was slow in giving his responses. He requested breaks when the questions became challenging and displayed difficulty in articulating how he felt. He seemed more anxious to towards the end of the interview and kept asking about the time. When asked questions repeatedly, he became quite defensive and agitated. He displayed some anxiety when answering questions involving his family. This was evidenced by his fidgety and restless psychomotor behavior.
FAMILY ASSESSMENT.
In order to determine whether CK’s family dynamics has an influence on CK’s mental status, a family assessment was carried out.
CK’s family is made up of 6 siblings and his father and mother who are currently divorced. The family is not very close with the mother constantly travelling due to work and an unconcerned father. The siblings are relatively close with some being closer to eachother than others. CK is the last born and does not have any resemblance to his family members.
The problem that CK presents is his inability to focus on work and study. A problem that arose after he had graduated from high school and joined Zayed University where he ended up failing all his courses. He then developed a dependency on online gaming and spends most his time; both day and night at the internet café playing. A few months before the onset of this problem, CK’s parents got a divorce. His dependency problem is interpersonal in nature and escalates whenever he has disagreements with his family. This problem has caused him to become withdrawn and verbally aggressive towards his family. His family in general has suffered the most difficulty since the onset of this problem with his mother shouldering most of the distress. He is very verbally aggressive towards his mother and since she pays his university fees she has suffered a lot of financial loss in terms of tuition payment. His mother and older siblings have tried to advise and to counsel him, but he has become more withdrawn and unresponsive. The problem has become persistent for a period and is getting worse.
His inability to focus on his studies has caused him to fail in all his courses. This has resulted in feelings of failure and withdrawn. Family and physical problems are contributing factors to his failure in school. He therefore sees his family as the source of his problem. In order to relieve his frustrations, he turned to online gaming that he formed an unhealthy dependency towards. This has also become a major distraction since he indulges in the games both day and night. His family’s efforts to speak to him always result in him becoming verbally aggressive, he then turns to online gaming to relieve his stress. He feels like the family has no right to lecture him since he considers them the source of his frustrations. This leads to a continuous repetition of the same behavior.
CK’s parents believe in hard work, discipline and success. His mother is a successful well travelled businesswoman who believes in the value of working hard in order to attain success. His father on the other hand who believes in discipline and hard work. The family is focused on practical results and does not give room for expressing weakness. Just like his parents, his older siblings hold the same beliefs. The relationships within his family members are based on mutual respect. CK’s family is not very close; this is because everyone has established their own paths. They do not show a lot of emotional expression towards each other; this is because of their father’s strict nature when raising them and the unavailability of their mother due to her job. Emotional expression was considered a sign of weakness in the family.
CK’s family was greatly affected by the divorce between their parents. This caused some divide because their parents did not part on good terms; their relationship can be characterized as conflictual. CK and his siblings were torn between their two parents. Having only one parent around turned out to be a great adjustment for the children. They are not able to see their father freely because of the nature of their parent’s relations, therefore, they have grown further apart from him. With the divorce, came financial constraints that infringed on their quality of life. The divorce therefore resulted in a lot of instability in the family with each person being affected in one way, or another.
Summary
CK is a 24 year old male who was referred for psychological assessment inorder to establish his mental status. She experiences difficulty in focusing on work and study and has formed a dependency to online games. From the results of the clinical interview, it is clear that CK is experiencing intense distress due to family issues combined with inadequate coping skills that appear to be interfering with his ability to focus and maintain attention and organize tasks, thereby impacting negatively on his academic, emotional and social functioning. He also lacks appropriate stress management techniques and inability to express his emotions. He has developed harmful smoking habits but doesn’t display symptoms suggesting that he is susceptible to committing suicide. However, CK is feeling overwhelmed by emotions and is susceptible to depression and aggressive verbal outbursts. He has a need for close interpersonal relationship, but these need have not been met resulting in feelings of anger, helplessness and indulgence in counterproductive activities such as online gaming. He also displayed themes of negative self worth and being overly self-critical while focusing mostly on the negative aspects of his life. The persistent self loathing is generating emotional anguish. He is fearful in expressing his feelings because of his background, where emotional expression is perceived as a weakness. He acknowledges that he has a problem with controlling his anger and feels like he cannot rely on his family to help him when he is feeling overwhelmed. These factors contribute to his inability to focus on his study and work and his dependency on online gaming. Overall, all the above bring about a cycle of felling overwhelmed by anger, anxiety, helplessness a consequently leading to his inability to make use of support from his family. This in turn increases the patient’s vulnerability to indulging in unhealthy practices such as constant online gaming and heavy smoking.
Therefore, CK requires immediate counseling to help him deal with the intense emotions that are impacting negatively on his academic, social and emotional wellbeing. Family therapy is also important in order to increase communication between family members and to provide a supportive forum where difficult family issues such as a divorce can be addressed.
