Diagnosis and Formulation Exercise for Mental Health Patients

This report analyzes the diagnosis and formulation exercise factors, analyzing parameters effecting overall wellness within the case study of Claire. It determines analysis on symptoms, wellness goals, and extended new aspects where changing psychological factors have to be worked on. The report also includes a Cognitive Behaviour Therapy Case Formulation and a CBT diagram.

Diagnosis and Formulation
Exercise

Table of Contents
INTRODCUTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
Diagnosis.....................................................................................................................................3
Cognitive Behaviour Therapy Case Formulation........................................................................4
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................1

INTRODCUTION
Diagnosis and Formulation Exercise plays crucial role in identifying patient conditions,
generating specific factors which are lowering wellness within case. Present report will analyse
diagnosis and formulate exercise factors, analysing parameters effecting overall wellness within
case study of Claire. It will determine analysis on symptoms, wellness goals and extended new
aspects where changing psychological factors have to be worked on.
MAIN BODY
Diagnosis
Claire is 15-year-old girl, where she is very less confident in her life due to anxiety,
dizziness and crying where she has unable to speak within school. She refuses to leave house
alone and is being forced to interact diversely. Clarrie has been facing extreme confidence issues
were analysing her psychological issues and aggressive lowered efficiency in various activities,
further has been found to be competent (Farri and Kibbey 2022). It was identified Clarrie was
aggressive, facing fear and variedly less confident in various activities based on social
institutions. DSM-5 is manual assessment and diagnosis of mental disorders, where accurate
diagnosis which treats medical conditions where mental disorders can be identified effectively.
DSM analysis factors are as follows:
 Exposure to actual death, serious injury or sexual violence –
directly experiencing a
traumatic event
from long time
 B. Presence of intrusion symptoms of traumatic event –
recurrent distressing dreams.
 C. Persistent avoidance of stimuli associated with traumatic event
–Effort to avoid external
reminder.
 D. Negative alterations in cognitions and mood associated with
traumatic events – persistent
negative emotional state, feelings of detachment from others.
 E. Marked alterations in arousal and reactivity associated with

traumatic event – irritable
behaviour, angry outbursts, hypervigilance, problems with concentration,
sleep
disturbances.
 F. Duration: symptoms > 1month
 G. Symptoms must cause significant distress or impairment in
functioning
 H. Symptoms not due to medication, illness, substance use
Analysis of criterias
 Analysing criteria A) Clarrie faces exposure to injuries, where traumatic event has been
found to be significantly crucial parameter where person is uncomfortable. Claire
described her mother as loud, excitable, aggressive, and “a little frightening which has
also impacted her psychological wellbeing.
 Analysing Criteria b) Presence of intrusion symptoms of
traumatic event – recurrent distressing has been competently found as
Clarrie faces fear and anxiety issues from many years. She had nightly nightmares about
the bullies in her
old school.
 Analysing Criteria C) Persistent avoidance of stimuli associated with
traumatic event, explains that Clarrie has been unable to get over experiences
of trauma faced from childhood (Lopes and et.al, 2022).
 Analysing Criteria d) Negative alterations in cognitions and mood
are highly experienced by Claire, where this has been also found to be essential
factor. She felt even more unable to venture into public spaces and felt less confidence
within her daily life. She was increasingly embarrassed by her inability to develop the
sort of independence typical of a 15-year old
 Analysing Criteria E) Clarrie faces irritability, cognitive behaviour due to fear and
anxiety from less peace and extended angry outbursts. Claire anxiety and social isolation
were impacting her wellness variedly which lowered her confidence variedly. She was
less involved in extracurricular activities that were necessary to receive enrol in, and
pursue university studies.
 Analysing Criteria F) Based on this criterion, Clarrie does not feel symptoms from 1
month, but has been experiencing anxiety, fear from long time which further has been
found to be essential.
 Analysing Criteria G) Symptoms such as distress, impairment and functioning are being
found in Claire which has caused excessive distress (Eldredge and Nogar, 2022).
 Analysing Criteria H) Claire symptoms are not due to medicines.
The DSM-5 assessment will enable to critically identify specific aspects, where various
parameters will determine optimised structured symptoms in Clarrie.

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), eg,
provides “provisional” when the clinician thinks a particular disorder is present and realizes
more information is required to be confident of a specific diagnosis. As per DSM-5 it can be said
that although Claire meet more than one condition of diagnostic criteria but with respect to its
treatment it is important that provisional diagnosis will be identified. The Claire’s provisional
diagnosis shows that she has suffered from Depression under which she fears to go alone
outside in the society and like to live at home.
Cognitive Behaviour Therapy Case Formulation
Predisposing factor:
These are the risk factors that lead to raise the client vulnerability that may lead to the
development of problem or issue (Katsaras, and et.al. 2018). In case of Claire the factor that lead
to increase her vulnerability is social or environmental factor that may include the continued
substance abuse which happened to Claire till the time when she has not been taken to the
psychiatric. This may also include the neglecting and abuse which she faces for a long period of
time. With the facing of continuous abuse in the school and the outside of her home i.e. in the
locality too she has developed a fear and anxiety at that level wherein she afraid from moving in
a restaurant alone.
Precipitating factor:
These are the factors which contribute to the occurrence and continuity of problem. In
case of Claire the precipitating factor include the social factor because she continues face the
trigger from the environment in which she persists. She had been continuously bullying even
when she has shifted to arts high school at the age of 9. Also her condition remains maintained
because this was socially ignored form society and none has taken any step for her which lead to
the continuity of her issue.
Perpetuating factor:
These are the factors that lead to maintain the problem or exacerbate the symptom after
the establishment of problem (Wyman, Shiovitz-Ezra and Bengel, 2018). These factor inhibit
recovery. In the case of Claire social factors are majorly responsible that has inhibited her issue.
This may include her toxic family wherein she said that she need to change the school because
she was bullying in it but it was ignored from her family. Likewise, the nature of her mother

create fear in Claire. The unsupportive social structure is also included here wherein Claire has
not received support from society and colleague. Her environment of home is also not positive
and the practice of bullying has not stopped yet which inhibit her recovery.
Protective factor:
These include the factor that lead to support the client for managing the problem or
symptom (Mason, Tofthagen and Buck, 2020). In Claire case with a focus towards the social
factors the issues and symptoms can be minimised. This may include enabling strong social
support, support from her family in her issue. This means with a focus towards the concerned
social factors the issue of Claire can be protected and reduced. As the problem of Claire has been
developed majorly because of social factors which will be protected with an inclusion of
concerned social factor only. This will include the social support or family support.
CBT Diagram:
As per the above diagram it can be interpret that with the trigger start at the early stage of
life i.e. when Claire was young and in Kindergarten. As Claire was shy in nature so she
continuously bullied and scold by her peers. With such scolding and bullying she felt and
Environment
At Kindergarten, she was shy
and teased
Thoughts
I’m stupid, ugly and crazy
Behaviour
Avoid moving in social
places, stay long at home
Emotions
Sadness and fear
Physiology
Disturbed, stress, fear

thought that she is crazy and stupid as she is continuously teased by her peers. This has
developed the emotion of sadness and fear among her. With the persistence of her situation she
gets disturbed and develop the psychology of stress and fear or disturbed. This has directly
impact towards her behaviour which results that she stopped moving in the public places and
social areas which has leads to raise her issue and problem. With such scenario Claire started
spending more time at home but with the presence of negative environment at her home in terms
of her mother nature her issue remains continue and has not been resolved.
CONCLUSION
From the above report it can be concluded that diagnosis and Formulation Exercise among
patients enable to improvise healthcare standards, and ideally identifying rapid improvement
which has to be worked on diversely.

REFERENCES
Books and journals
Eldredge, J. and Nogar, C., 2022. Physician Assistant Student Training in Question Formulation:
A Quasi-Experiment. The Journal of Physician Assistant Education, 33(1), pp.47-50.
Farris, S.G. and Kibbey, M.M., 2022. Be brave, BE-FIT! A pilot investigation of an ACT-
informed exposure intervention to reduce exercise fear-avoidance in older
adults. Cognitive Behaviour Therapy, pp.1-22.
Katsaras, & et.al. (2018). Bullying and suicidality in children and adolescents without
predisposing factors: A systematic review and meta-analysis. Adolescent Research
Review. 3(2). 193-217.
Lopes, and et.al, 2022. Risk for Imbalanced Blood Glucose Pattern: Construct Analysis and
Nursing Diagnosis Proposal. Clinical Nursing Research, p.10547738211073395.
Mason, T. M., Tofthagen, C. S., & Buck, H. G. (2020). Complicated grief: risk factors,
protective factors, and interventions. Journal of social work in end-of-life & palliative
care. 16(2). 151-174.
Wyman, M. F., Shiovitz-Ezra, S., & Bengel, J. (2018). Ageism in the health care system:
Providers, patients, and systems. In Contemporary perspectives on ageism (pp. 193-212).
Springer, Cham.
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