Thursday, April 30, 2020

Psychosocial Assessment Essay Example

Psychosocial Assessment Paper Will Hunting is a 20 year-old Caucasian male of Irish decent. He turned 21 before the time he was terminated from therapy. He was always casually dressed in slacks, or jeans and t-shirt or short sleeves shirt like most youths or teenagers. Although he had few clothes as evidenced by the fact that he wore the same two or three outfits to all his therapy sessions, his clothes were always clean. Referral Source He was referred to therapy by the juvenile court system. Presenting Problem Will Hunting had anger issues and was very oppositional to authority figures. He also had abandonment issues. He was arrested for fighting and beating up another young man who he went to elementary school with. At his court appearance, he was mandated to attend therapy twice a week by the judge and also required to report to Professor Lambeau once a week. History of the Problem Will Hunting had a history of assault, grand theft, resisting arrest, mayhem, impersonating an officer and physical abuse by one of his foster father since adolescence. He was arrested for assault two times in 1993, and more than twice in 1995. He also had anger problems. Previous Counseling Experience Will Hunting was mandated to attend therapy by the juvenile court system. He saw five therapists with whom he failed to connect, prior to seeing Sean Maguire. He terminated himself from some of his previous therapy sessions. Two of his therapists walked out on him. Will accused his first therapist of being gay and sabotaged his second therapy by pretending to be hypnotized. Family Background Will Hunting is an orphan. He lived in several foster homes as a child. Will was physically abused by one of his foster fathers. There was no mention of his biological family. We will write a custom essay sample on Psychosocial Assessment specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Psychosocial Assessment specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Psychosocial Assessment specifically for you FOR ONLY $16.38 $13.9/page Hire Writer He was institutionalized for most of his childhood years. He spoke of his three close friends as being his family. Personal History Will Hunting was abandoned by his parents, institutionalized as a child, and was abused as a child by one of his foster fathers. He is very smart and very good at memorizing facts. He had read and remembered facts from history and law books. He was good at solving difficult mathematical problems as evidenced by his ability to solve math problems that students at MIT could not solve or that took the Professor two or more years to solve. Work Experience and Work History Will Hunting worked as a janitor at MIT. He got this job through his parole officer. He was required by the judge to work and failure to do so would result in his incarceration. Will Hunting was a construction worker for a short period of time, and he also worked as an auto mechanic. He has a history of quitting his job after a few weeks. He also was inconsistent with attendance. Housing Will Hunting lived in a sparsely furnished apartment home in a poor neighborhood in South Boston. He also lived in several foster homes as a child. Medical History Will Hunting had a history of physical abuse as evidenced by the scars that he reported to have sustained by cigarette burns by his foster father. He also had scars from being stabbed in street fights. No other medical problems were reported. However, he reported that he exercised and did bench presses. Mental Health History He saw five therapists prior to seeing Sean Maguire. We do not know whether Will was in treatment as a child. Substance Abuse and Abuse History Will Hunting drank and smoked cigarettes even though he was under the legal age. He did not abuse any one, but he himself was physically abused as a child. Cultural History He is of Irish working class background. Spirituality and Religion Will Hunting did not talk about religion, but he wore a crucifix necklace. Because he is Irish, it is likely that he could be catholic. Social Support Networks that exacerbate or impede coping and or resolution. Will Hunting had three close friends that both exacerbated and impeded his coping and resolution of his problems. He spent most of his time with his friends. They drank and picked fights together which resulted in his arrest and incarceration. However, his friends wanted the best for him as evidenced by his friend Chuckie’s statement to him that he owed it to him to make something of his life. Will’s friends also bought him a car to assist him with his commute to work. Will’s girlfriend, Skylar, had a good influence on him. Initially, Will was unwilling to establish a lasting relationship with her but eventually decided to join her in California. Client’s Strength Will Hunting is very smart. He was described as genius as evidenced by his ability to solve very difficult mathematical problem that even the students and professor Lambeau at MIT could not solve. As a result, the professor recommended him for a job that would provide him challenge. The professor described Will as having a gift of good memory. Professor Lambeau even asked Will whether he had photographic memory. Will could solve difficult math and science problems in under an hour. Will was able to analyze a painting that his therapist had done and he concluded that it meant that his therapist was suppressing his feelings about the death of his wife. He is very loyal to his friends. Will also has good survival instinct. Psychological Defenses Used Will uses anger, denial, and sarcasm as defense mechanisms to push people away from him. He told people that he did not have a problem and that they were the ones with the problem. He used intellectualization as a defense mechanism by talking about books to avoid talking about himself. He suppresses his emotions and he appeared to be afraid of allowing people to get to know him. Suicide Assessment No suicide attempts or ideations were mentioned or addressed. Mental Status and Current Functioning Will was dressed in slacks and t-shirt most of the time. He did not seem to own any formal clothing as evidenced by the way he was dressed for his interview appointment. His hair was neat and styled the way young men his age would. He appeared his age, and was very alert. Will was also aware of his surroundings. He went to his therapy appointments by himself. Will’s memory or concentration did not show any deficit. He could be described as having hypermnesia. For example Will was able to quote sentences and pages of books when talking to the student in the bar who was arguing with his friend Chuckie. Will’s speech was normal, meaning he was coherent and logical. His speech characteristics matched his mood and affect. When Will was angry at the student in the pub his facial expression matched his speech and tone of voice. Will showed no evidence of cognitive distortions or hallucinations. He represented himself in his court hearing, and he was also able to use sarcasm to get rid of some of his therapists. Will used the phrase â€Å"I had to go see about a girl† in his note to his therapist, Sean Maguire when he was leaving for California. It was the same phrase that Sean Maguire had used when he told Will about how he met his wife. Appearance Will’s grooming was good. He wore mostly brown slacks, jeans, and t-shirts. Although he owned few clothes, they were always clean. His hair was clean and he wore it the way young men his age did. Attitude Will is very angry. He blamed himself for all the bad things that happened to him as a child including the abuse he suffered from his foster father. He used sarcasm to push people away from him. He had difficulty trusting people except for his three close friends. Motor Activity Will’s motor skills are within normal range. He could walk and do things by himself without assistance from others. Affect Will’s affect was always congurrent with his facial expression. For example, you could tell that he was angry by looking at his face during his argument with the student at the bar. His facial expression also matched his affect during his fight with the young man who had bullied him in kindergarten. Mood Will’s mood is within normal range. He exhibited anxiety and panic when he broke down in therapy, when his therapist was telling him that â€Å"it was not his fault. † He also exhibited elation and excitement when his therapist was talking about baseball. Will was also apathetic with his previous therapists. He showed no interest or concern for what they were saying to him. Speech There were no disturbances in his speech. Will is able to speak clearly, coherently, and logically. He tended to intellectualize because of his lack of experience of actual events as his therapist Sean Maguire pointed out in one of their sessions. Will also exhibited logorrhea when he challenged the student in the bar about American History, and when he responded to the NSA interviewer about the possible outcomes of him breaking a coded message. Thought Process Will’s thought process is within normal range. He can think logically and was able to solve difficult mathematical problems or theorems that even professor Lambeau could not solve. He had the ability to argue his own case in court by citing historical precedents even though he was a high school dropout. Thought Content The content of his thoughts were very detailed based on information that he had read as evidenced by the incident at his court hearing when he represented himself, and his argument with the student at the bar. However, he seemed to blame himself for his childhood problems. Perception Will was very perceptive as evidenced by his ability to analyze Sean Maguire and his previous therapists. There was no evidence of disturbance of perception such as illusion or hallucinations. Orientation There was no evidence of disorientation. Will knew his surroundings and neighborhood and could get to places by himself. Cognitive Function There was no evidence of problems with Will’s cognitive function. He was able to solve mathematical problems that even the MIT students could not solve. He could read and memorize books and apply them to real life situations such as his court hearing when he represented himself. Abstraction Will has the ability to think in abstract terms as evidenced by his analysis of the therapist’s painting where he used the abstract ideas in the painting to determine the state of mind of his therapist, Sean Maguire. Judgment Even though Will is a very smart young man, he sometimes exhibited poor judgment. For example, he attacked the young man who he said had bullied him in kindergarten, and then he proceeded to attack the police officer who responded to the incident. Insight Initially, his insight into his problem was poor as evidenced by his denial of having issues to work on or resolve. Eventually, after his therapist got through to him, he was able to recognize the effects of his childhood abuse on his life. DSM IV Multi axial Diagnosis Axis I 312. 89 Conduct Disorder, Unspecified Onset: age at onset is unknown. 313. 89 Reactive Attachment Disorder of infancy or Early Childhood Axis II 301. 82 Avoidant Personality Disorder 305. 00 Alcohol Abuse Axis III Will did not exhibit any evidence of medical conditions. Axis IV Will lacks adequate primary support system, and is an orphan who suffered abuse in his childhood. He has inadequate housing, occupational problems, problems with the legal system, and economic problems. Axis V Will has a GAF score of 51. He has moderate difficulty in social, occupational, and school functioning. Diagnostic Summary and Impression Will seems to have difficulty forming relationships. He has only three friends, and has problems relating to his peers. Will is an orphan who suffered abuse as a child. He exhibits maladaptive personality features and uses defense mechanisms to push people away from him. Will is aggressive toward people and lacks remorse. His inconsistent job attendance may have been caused by the aftereffects of his drinking. Will meets the criteria for Avoidant Personality Disorder as evidenced by his avoidance of significant interpersonal contact due to being afraid of criticism and rejection. Treatment Recommendations Will Hunting will benefit from intense psychosocial counseling. References American Psychiatric Association, (2000). Diagnostic and statistical manual of mental health disorders (Revised 4th ed. ) Washington, DC, Author Hepworth, D. et al. , (2010). Direct Social Work Practice. Theory and Skills (8th ed. ) United States. Brooks/Cole Cengage Learning.

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