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zzzzVVzzzzzVlzz0Szzzz0zzzzzzzzzzzzSzzzzzzzzzzzzz B Name ______________________________ Date _________________ DOB ________________
Age ________________________________ Start Time ____________ End Time ___________
Identifying Information
David is a well-settled man with a happy family of 2 adult children and the job of his choice. He married his high school girlfriend and have no issues with her in the relationship. However, recently he is bizarre and showing behavioral issues in his attitude towards life. He lost interest in the activities he used to enjoy. He now spends time with himself and has stopped meeting his friends.
Presenting Problem
As it is mentioned in the case study that Davids sister Lisa had depression in the past so it might be possible that he is suffering from the depression too. He might have become a victim of Major depressive disorder. There is also a possibility that he might be suffering from a personality disorder.
Life Stressors
It is assumed from the case study that something might be bothering him in his personal life which is affecting all of his relationships. He desperately needs a counseling session with a psychologist. Cognitive therapy needs to be done on an immediate basis so that his real issues can be revealed.
Substance Use FORMCHECKBOX Yes FORMCHECKBOX No
He was a heavy drinker in the college but now he has reduced his habit of drinking and do not take any substance as well.
Addictions (i.e., gambling, pornography, video gaming)
He does not have any addiction but was to drink heavily before falling into depression.
Medical/Mental Health Hx/Hospitalizations
He needs detailed counseling in the form of cognitive therapy.
Abuse/Trauma
No trauma or abuse of any kind is mentioned in the case study but as his sister was also a depressed person that it might be otherwise as well.
Social Relationships
As he used to have multiple activities in his life that means he had a lot of friends in his circle too but recently he detached himself from all social relationships.
Family Information
He has a very good family and has a loving life but they do not spend much time as a couple.
Spiritual
Spiritual issues might be his reasons for depression as he feels an emptiness in his present life.
Suicidal
He has become suicidal in the last two months and might end his life if the concern is not shown on time.
Homicidal
No matter of homicidal is detected in the case study.
Assessment
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Initial Diagnosis (DSM)
________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Initial Treatment Goals
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Plan
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Name _____________________________________________ Date __________________
Psychosocial Assessment ____ Part 1 (Topic 2)
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2
H0 Name ---
2
u0 72
x0 _____________________________ 2
0 _ --- 2
l0 Date
2
0 ---
2
0 2
0 ________________
2
0 _
2
0 --- 2
0 DOB ---
2
J0 2
N0 ________________
2
0
2
H0 ------------ 2
H0 Age ---
2
h0 2
l0 _______________________________ 2
d0 _ --- 2
p 0 Start Time
---
2
0 2
0 ____________
2
0 --- 2
( 0 End Time
---
2
o0 2
u 0 ___________
2
0
2
0
2
H0 ---
2
H0 - @ H- /2
H0 Identifying Information
2
0
2
H0 --- 2
x0 David 2
0 is a well
2
0 - J2
0 settled man with a happy family of 2 adult
2
0 F2
0 children and the job of his choice. He 2
AHi0 married his high school girlfriend and have no issues with her in the relationship. However, recently he 2
fHm0 is bizarre and showing behavioral issues in his attitude towards life. He lost interest in the activities he 2
H0 us 2
US0 ed to enjoy. He now spends time with himself and has stopped meeting his friends.
2
q0
@Microsoft Sans Serif-@Microsoft Sans Serif--
2
0 ---
2
H0 - @ H- (2
H0 Presenting Problem
2
0
2
H0 --- 2
xe0 As it is mentioned in the case study that Davids sister Lisa had depression in the past so it might S2
H00 be possible that he is suffering from the depres 2
s 0 sion too. H 2
0 e might have beco 2
/0 me
2
A0 2
G0 a victim of Major (2
1H0 depressive disorder 2
1V0 . There is also a possibility that he might be suffering from a personality disorder.
2
10 ---- @ dGH- 2
UH0 Life Stressors
2
U0
2
hH0 --- 2
zxT0 It is assumed from the case study that something might be bothering him in his perso 2
z 0 nal life 2
Hl0 which is affecting all of his relationships. He desperately needs a counseling session with a psychologist. 2
Hb0 Cognitive therapy needs to be done on an immediate basis so that his real issues can be revealed.
2
0
@Microsoft Sans Serif-@Microsoft Sans Serif--
2
0
2
H0 ------- @ H---- 2
H0 Substance Use - @ - 0--- 0 -------
2
0 --- 2
0 Yes
---
2
0 - @ - 0 0 -------
2
0 --- 2
0 No
2
0
2
H0
2
H0 --- 2
2x0 He was a heavy drinker in the college but now he has reduced his habit of drinking and do not 52
WH0 take any substance as well.
2
W0
2
x0
2
x0
2
H0 System0 KgCtU-- 00//..
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l TitleL
T l
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xsdelement refns1DocumentComments minOccurs0/
xsdelement refns2TaxKeywordTaxHTField minOccurs0/
xsdelement refns1SecurityClassificationTaxHTField0 minOccurs0/
xsdelement refns1DocumentCategoryTaxHTField0 minOccurs0/
xsdelement refns1DocumentBusinessValueTaxHTField0 minOccurs0/
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xsdelement refns2TaxCatchAll minOccurs0/
xsdelement refns2TaxCatchAllLabel minOccurs0/
xsdelement refns1DocumentTypeTaxHTField0 minOccurs0/
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xsdelement nameSecurityClassificationTaxHTField0 maindex13 nillabletrue mataxonomytrue mainternalNameSecurityClassificationTaxHTField0 mataxonomyFieldNameSecurityClassification madisplayNameClassification mareadOnlyfalse madefault2Internal98311b30-b9e9-4d4f-9f64-0688c0d4a234 mafieldIddeadbeef-dd47-4075-83f4-7a25a42617f9 masspId5ddf6d74-a44e-45e9-afc0-d7ad5ae01d3b matermSetIdb4b0d153-30b9-455a-9458-c3a4d77c91e8 maanchorId00000000-0000-0000-0000-000000000000 maopenfalse maisKeywordfalse
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xsdelement nameDocumentCategoryTaxHTField0 maindex14 nillabletrue mataxonomytrue mainternalNameDocumentCategoryTaxHTField0 mataxonomyFieldNameDocumentCategory madisplayNameCategory madefault mafieldIddeadbeef-df57-4942-869e-88db097302a9 masspId5ddf6d74-a44e-45e9-afc0-d7ad5ae01d3b matermSetId52f69233-5cf0-4c4a-8a06-7adcfff7b0d8 maanchorId00000000-0000-0000-0000-000000000000 maopentrue maisKeywordfalse
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xsdelement nameDocumentBusinessValueTaxHTField0 maindex15 nillabletrue mataxonomytrue mainternalNameDocumentBusinessValueTaxHTField0 mataxonomyFieldNameDocumentBusinessValue madisplayNameBusiness Value mareadOnlyfalse madefault1Normal581d4866-74cc-43f1-bef1-bb304cbfeaa5 mafieldIddeadbeef-1563-43e8-a472-f8beecdc2f9a masspId5ddf6d74-a44e-45e9-afc0-d7ad5ae01d3b matermSetIdde6416be-ddc0-435d-937d-8647ab739be1 maanchorId00000000-0000-0000-0000-000000000000 maopenfalse maisKeywordfalse
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xsdelement nameDocumentSubjectTaxHTField0 maindex16 nillabletrue mataxonomytrue mainternalNameDocumentSubjectTaxHTField0 mataxonomyFieldNameDocumentSubject madisplayNameSubject mareadOnlyfalse madefault mafieldIddeadbeef-f57a-49aa-8e80-40b7474d5a66 masspId5ddf6d74-a44e-45e9-afc0-d7ad5ae01d3b matermSetId122e6309-b4e4-4602-9fcd-00090a755f6d maanchorId00000000-0000-0000-0000-000000000000 maopentrue maisKeywordfalse
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xsdelement nameDocumentStatusTaxHTField0 maindex17 nillabletrue mataxonomytrue mainternalNameDocumentStatusTaxHTField0 mataxonomyFieldNameDocumentStatus madisplayNameStatus madefault mafieldIddeadbeef-14b3-4711-a028-ec5ab2e777db masspId5ddf6d74-a44e-45e9-afc0-d7ad5ae01d3b matermSetId89f586f0-dd11-45fd-b561-c10d067e4b4b maanchorId00000000-0000-0000-0000-000000000000 maopentrue maisKeywordfalse
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xsdelement nameDocumentTypeTaxHTField0 maindex20 nillabletrue mataxonomytrue mainternalNameDocumentTypeTaxHTField0 mataxonomyFieldNameDocumentType madisplayNameDocument Type mareadOnlyfalse madefault mafieldIddeadbeef-9601-426a-9322-ac73799625f1 masspId5ddf6d74-a44e-45e9-afc0-d7ad5ae01d3b matermSetId56472838-225c-4fb3-b14d-139d47897cc6 maanchorId00000000-0000-0000-0000-000000000000 maopentrue maisKeywordfalse
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xsdelement nameDocumentDepartmentTaxHTField0 maindex21 nillabletrue mataxonomytrue mainternalNameDocumentDepartmentTaxHTField0 mataxonomyFieldNameDocumentDepartment madisplayNameDepartment mareadOnlyfalse madefault3Academic Program and Course Development59abafec-cbf5-4238-a796-a3b74278f4db mafieldIddeadbeef-6c26-4ca2-8669-4998fb5582db masspId5ddf6d74-a44e-45e9-afc0-d7ad5ae01d3b matermSetId1601148f-bc18-4e12-8568-fe1a2a042608 maanchorId00000000-0000-0000-0000-000000000000 maopenfalse maisKeywordfalse
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/xsdcomplexType
/xsdelement
xsdelement nameTaxCatchAll maindex18 nillabletrue madisplayNameTaxonomy Catch All Column madescription mahiddentrue malist4549d8d1-fd35-42e1-a179-f6926eae1453 mainternalNameTaxCatchAll mashowFieldCatchAllData maweb30a82cfc-8d0b-455e-b705-4035c60ff9fd
xsdcomplexType
xsdcomplexContent
xsdextension basedmsMultiChoiceLookup
xsdsequence
xsdelement nameValue typedmsLookup maxOccursunbounded minOccurs0 nillabletrue/
/xsdsequence
/xsdextension
/xsdcomplexContent
/xsdcomplexType
/xsdelement
xsdelement nameTaxCatchAllLabel maindex19 nillabletrue madisplayNameTaxonomy Catch All Column1 madescription mahiddentrue malist4549d8d1-fd35-42e1-a179-f6926eae1453 mainternalNameTaxCatchAllLabel mareadOnlytrue mashowFieldCatchAllDataLabel maweb30a82cfc-8d0b-455e-b705-4035c60ff9fd
xsdcomplexType
xsdcomplexContent
xsdextension basedmsMultiChoiceLookup
xsdsequence
xsdelement nameValue typedmsLookup maxOccursunbounded minOccurs0 nillabletrue/
/xsdsequence
/xsdextension
/xsdcomplexContent
/xsdcomplexType
/xsdelement
/xsdschema
xsdschema targetNamespacehttp//schemas.openxmlformats.org/package/2006/metadata/core-properties elementFormDefaultqualified attributeFormDefaultunqualified blockDefaultall xmlnshttp//schemas.openxmlformats.org/package/2006/metadata/core-properties xmlnsxsdhttp//www.w3.org/2001/XMLSchema xmlnsxsihttp//www.w3.org/2001/XMLSchema-instance xmlnsdchttp//purl.org/dc/elements/1.1/ xmlnsdctermshttp//purl.org/dc/terms/ xmlnsodochttp//schemas.microsoft.com/internal/obd
xsdimport namespacehttp//purl.org/dc/elements/1.1/ schemaLocationhttp//dublincore.org/schemas/xmls/qdc/2003/04/02/dc.xsd/
xsdimport namespacehttp//purl.org/dc/terms/ schemaLocationhttp//dublincore.org/schemas/xmls/qdc/2003/04/02/dcterms.xsd/
xsdelement namecoreProperties typeCT_coreProperties/
xsdcomplexType nameCT_coreProperties
xsdall
xsdelement refdccreator minOccurs0 maxOccurs1/
xsdelement refdctermscreated minOccurs0 maxOccurs1/
xsdelement refdcidentifier minOccurs0 maxOccurs1/
xsdelement namecontentType minOccurs0 maxOccurs1 typexsdstring/
xsdelement refdctitle minOccurs0 maxOccurs1 maindex1 madisplayNameTitle/
xsdelement refdcsubject minOccurs0 maxOccurs1/
xsdelement refdcdescription minOccurs0 maxOccurs1/
xsdelement namekeywords minOccurs0 maxOccurs1 typexsdstring/
xsdelement refdclanguage minOccurs0 maxOccurs1/
xsdelement namecategory minOccurs0 maxOccurs1 typexsdstring/
xsdelement nameversion minOccurs0 maxOccurs1 typexsdstring/
xsdelement namerevision minOccurs0 maxOccurs1 typexsdstring
xsdannotation
xsddocumentation
This value indicates the number of saves or revisions. The application is responsible for updating this value after each revision.
/xsddocumentation
/xsdannotation
/xsdelement
xsdelement namelastModifiedBy minOccurs0 maxOccurs1 typexsdstring/
xsdelement refdctermsmodified minOccurs0 maxOccurs1/
xsdelement namecontentStatus minOccurs0 maxOccurs1 typexsdstring/
/xsdall
/xsdcomplexType
/xsdschema
xsschema targetNamespacehttp//schemas.microsoft.com/office/infopath/2007/PartnerControls elementFormDefaultqualified attributeFormDefaultunqualified xmlnspchttp//schemas.microsoft.com/office/infopath/2007/PartnerControls xmlnsxshttp//www.w3.org/2001/XMLSchema
xselement namePerson
xscomplexType
xssequence
xselement refpcDisplayName minOccurs0/xselement
xselement refpcAccountId minOccurs0/xselement
xselement refpcAccountType minOccurs0/xselement
/xssequence
/xscomplexType
/xselement
xselement nameDisplayName typexsstring/xselement
xselement nameAccountId typexsstring/xselement
xselement nameAccountType typexsstring/xselement
xselement nameBDCAssociatedEntity
xscomplexType
xssequence
xselement refpcBDCEntity minOccurs0 maxOccursunbounded/xselement
/xssequence
xsattribute refpcEntityNamespace/xsattribute
xsattribute refpcEntityName/xsattribute
xsattribute refpcSystemInstanceName/xsattribute
xsattribute refpcAssociationName/xsattribute
/xscomplexType
/xselement
xsattribute nameEntityNamespace typexsstring/xsattribute
xsattribute nameEntityName typexsstring/xsattribute
xsattribute nameSystemInstanceName typexsstring/xsattribute
xsattribute nameAssociationName typexsstring/xsattribute
xselement nameBDCEntity
xscomplexType
xssequence
xselement refpcEntityDisplayName minOccurs0/xselement
xselement refpcEntityInstanceReference minOccurs0/xselement
xselement refpcEntityId1 minOccurs0/xselement
xselement refpcEntityId2 minOccurs0/xselement
xselement refpcEntityId3 minOccurs0/xselement
xselement refpcEntityId4 minOccurs0/xselement
xselement refpcEntityId5 minOccurs0/xselement
/xssequence
/xscomplexType
/xselement
xselement nameEntityDisplayName typexsstring/xselement
xselement nameEntityInstanceReference typexsstring/xselement
xselement nameEntityId1 typexsstring/xselement
xselement nameEntityId2 typexsstring/xselement
xselement nameEntityId3 typexsstring/xselement
xselement nameEntityId4 typexsstring/xselement
xselement nameEntityId5 typexsstring/xselement
xselement nameTerms
xscomplexType
xssequence
xselement refpcTermInfo minOccurs0 maxOccursunbounded/xselement
/xssequence
/xscomplexType
/xselement
xselement nameTermInfo
xscomplexType
xssequence
xselement refpcTermName minOccurs0/xselement
xselement refpcTermId minOccurs0/xselement
/xssequence
/xscomplexType
/xselement
xselement nameTermName typexsstring/xselement
xselement nameTermId typexsstring/xselement
/xsschema
/ctcontentTypeSchemaosoft.com/office/2006/metadata/contentType/dsschemaRef dsurihttp//schemas.microsoft.com/office/2006/metadata/properties/metaAttributes/dsschemaRef dsurihttp//www.w3.org/2001/XMLSchema/dsschemaRef dsurihttp//schemas.microsoft.com/office/2006/metadata/properties/dsschemaRef dsurihttp//schemas.microsoft.com/sharepoint/v3/dsschemaRef dsuri30a82cfc-8d0b-455e-b705-4035c60ff9fd/dsschemaRef dsurihttp//schemas.microsoft.com/office/2006/documentManagement/types/dsschemaRef dsurihttp//schemas.microsoft.com/office/infopath/2007/PartnerControls/dsschemaRef dsurihttp//schemas.openxmlformats.org/package/2006/metadata/core-properties/dsschemaRef dsurihttp//purl.org/dc/elements/1.1//dsschemaRef dsurihttp//purl.org/dc/terms//dsschemaRef dsurihttp//schemas.microsoft.com/internal/obd//dsschemaRefs/dsdatastoreItemxml version1.0 encodingutf-8LongProperties xmlnshttp//schemas.microsoft.com/office/2006/metadata/longProperties/xml version1.0 encodingUTF-8 standaloneno
dsdatastoreItem dsitemID2D4B57A8-AB69-464C-91AB-93360DF403C5 xmlnsdshttp//schemas.openxmlformats.org/officeDocument/2006/customXmldsschemaRefsdsschemaRef dsurihttp//schemas.microsoft.com/office/2006/metadata/longProperties//dsschemaRefs/dsdatastoreItem
F Microsoft Word 97-2003 Document
MSWordDocWord.Document.89q
