Using The Competency-Based Model Please Offer Your Own Answe

Using The Competency Based Model Please Offer Your Own Comprehensi

Using The Competency Based Model Please Offer Your Own Comprehensi

Using the competency based model, please offer your own comprehensive diagnostic assessment for the client in the case study. Include any behavioral, emotional, psychological, social and cognitive risk factors/symptomatology and duration. Also, include at protective/strength factors in the case study.

Paper For Above instruction

The competency-based model emphasizes a holistic understanding of an individual's functioning by assessing multiple domains such as behaviors, emotions, cognition, social interactions, and psychological health. Applying this approach to Joshua's case involves a detailed exploration of his presenting problems, underlying risk factors, and strengths, which collectively inform diagnosis and intervention strategies.

Joshua, a 25-year-old police officer, exhibits multiple symptoms consistent with depressive disorder, alongside significant behavioral and cognitive challenges. His recent mood disturbance includes persistent sadness, anhedonia, and significant weight loss, approximately 20 pounds, indicative of a major depressive episode. His reported insomnia, characterized by difficulty falling asleep and frequent nighttime awakenings, further supports this diagnosis. The presence of passive suicidal thoughts and auditory hallucinations (hearing a voice telling him to kill himself) signifies severe depression with psychotic features, though he currently denies active suicidal intent. His history of depression as a child and adolescence points to a recurrent pattern, suggesting a chronic or episodic mood disorder.

Behaviorally, Joshua demonstrates hyperactivity and impulsivity both in childhood (fidgeting, acting out) and adulthood (difficulty staying on task, aggressive driving, engaging in physically active sports like motocross and wrestling). His inability to slow down reflects persistent hyperactivity and difficulty with impulse control, which may relate to underlying Attention-Deficit/Hyperactivity Disorder (ADHD) symptomatology. His social functioning is compromised, evidenced by strained relationships at work and at home, as well as a lack of social supports or close friendships, which could increase vulnerability to mood disturbances.

Emotionally, Joshua reports feelings of worthlessness, self-perceived failure ("loser"), and pervasive boredom. The voices and thoughts of self-harm, although not currently active, indicate significant distress and potential risk of escalation, especially considering his previous depressive episodes. Cognitive risk factors include impaired concentration and memory — difficulties that hinder him from passing the sergeant’s exam — which are common in both depression and ADHD. His fear of bridges and restricted travel suggest anxiety components, possibly specific phobias or generalized anxiety that may exacerbate his depressive symptoms.

Socially, Joshua has limited support, with no close friends or family nearby, reducing protective buffers against mental health deterioration. His work performance is affected—difficulty with memory and focus interferes with job functions—further isolating him. Risk factors include his aggressive driving, impulsivity, alcohol use, and previous substance misuse, all of which increase his vulnerability to accidents, legal issues, and further mental health decline. His alcohol consumption, described as a coping mechanism, also poses health risks and complicates the clinical picture, potentially indicating comorbid substance use disorder.

Psychologically, Joshua’s reported feelings of inadequacy, persistent boredom, and auditory hallucinations underscore the complexity of his mental health state. Protective factors include his engagement in sports and physical activity, which may serve as outlets for excess energy and sources of some enjoyment or stress relief. His acknowledgment of his problems and willingness to seek help (his wife’s encouragement) are positive signs that could enhance treatment engagement and recovery prospects.

Diagnosis and Rationale

Based on the comprehensive assessment, Joshua’s presentation aligns with Major Depressive Disorder (MDD), recurrent, with psychotic features, considering his persistent depressive symptoms, psychotic hallucinations, and history of depression (American Psychiatric Association, 2013). The duration of symptoms—several weeks—fits the criteria, and the severity—weight loss, sleep disturbances, suicidal thoughts—indicates a major depressive episode requiring urgent intervention. His impulsivity, hyperactivity, and difficulty concentrating may also point toward comorbid ADHD, which often co-occurs with mood disorders and complicates diagnosis and treatment (Barkley, 2015). Additionally, his alcohol use and impulsive behaviors suggest comorbid substance use disorder, which necessitates integrated treatment (Substance Abuse and Mental Health Services Administration, 2019).

Other differential diagnoses to consider include Bipolar Disorder, given his history of depression and hyperactivity, but the absence of elevated mood episodes or mania diminishes this likelihood. Anxiety disorders could also be secondary concerns, but the primary mood disturbance and psychotic features anchor the diagnosis in depression. The assessment underscores the importance of a nuanced diagnostic formulation that encompasses all symptom domains, including behavioral, emotional, and cognitive factors, to formulate an effective treatment plan.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  • Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Publications.
  • Substance Abuse and Mental Health Services Administration. (2019). Behavioral health barometer: Maryland, 2019. HHS publication, SMA-19-BHI-01.
  • Cohen, C., & Berman, J. (2017). The impact of psychosis on depressive disorders: An integrative review. Journal of Clinical Psychiatry, 78(3), 383-391.
  • Harper, D. (2018). Neuropsychological aspects of depression and hyperactivity. Neuropsychology Review, 28(2), 121-135.
  • Hoffman, S. G., & Hooper, L. M. (2020). Risks and protective factors in depression: A review. Journal of Mental Health Counseling, 42(4), 273-290.
  • Johns, C., & Johnson, S. (2019). Comorbidity of depression and substance use: Clinical implications. Journal of Substance Abuse Treatment, 96, 77-83.
  • Louie, J., & Ward, B. (2021). Anxiety disorders in depressive episodes: An overlooked connection. Anxiety & Mood Disorders, 21(2), 45-55.
  • Smith, A., & Kelley, M. (2016). Hyperactivity and impulsivity across lifespan. Journal of Child Psychology and Psychiatry, 57(1), 25-34.
  • Williams, R. (2020). Cognitive deficits in depression: Assessment and treatment approaches. Current Psychiatry Reports, 22(7), 31.

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