Dr. Susan A. Adams, LPC, NCC

(662) 846-4360

Email: sadams@dsu.deltast.edu

Case Presentation Format

               Stoltenberg, C. D., McNeill, B., & Delworth, U. (1998). IDM supervision: An integrated developmental model for supervising counselors and therapists. (pp. 187-191) San Francisco:  Jossey-Bass.

 Format is designed to help therapist collect and integrate relevant information for case conceptualization, diagnosis, treatment, organize client information, and facilitate discussion leading to understanding and ultimately decision making.

  1.      Clinic Data

a.       Therapist name

b.      Status (first practicum, intern, staff)

c.      Agency / clinic site

d.      Number of sessions with client

e.      Type of sessions (individual, group, marital, family)  

2.      Client Demographic Data

a.       Name (initials or altered name for confidentiality)

b.      Date of birth/age

c.      Sex

d.      Marital status

e.      Children (in and out of home, ages, sex)

f.       Living situation

                 i.          House, apartment

                ii.          People living in the home and relationship with client

 

3.      SES Data

a.       Occupational Status

                 i.          Client

                ii.          Family Members

              iii.          Average Family Income

               iv.          Transportation status (drives own car, public transportation)

                 v.          Other economic resources (own house, savings, family support)

               vi.          Economic stressors (debts, child support, etc)

 

4.      Presenting Problem(s) (include a description of the problem areas (listed separately) from the client’s perspective, particularly noting client’s view of their order of importance. Suggested items of focus:

a.       Were there precipitating factors?

b.      How long have the problems persisted?

c.      Have problems previously occurred?  What were the circumstances?

d.      In what way, if any, do the problems relate to each other?

 

5.      Relevant History (this section will vary in comprehension according to depth and length of treatment and in focus according to theoretical orientation and specific nature of problems.  Suggested focus:

a.       Family and relationship history

                 i.          Family of origin / developmental issues

                ii.          Past marriages/significant relationships (duration, sexual functioning, dissolution factors, sexual preference, etc.)

              iii.          Children (from current and prior relationships and current status)

               iv.          Current family status and structure

b.      Cultural history and identity

                 i.          Issues of ethnicity and race

                ii.          Identification / acculturation

c.      Educational history

                 i.          Childhood / developmental

                ii.          Adulthood / current status

d.      Vocational history (types, stability, satisfaction, etc.)

e.      Medical history (acute / chronic illness, hospitalizations, surgeries, major patterns of illness in family, accidents, injuries, with whom/where/how often receive medical care, etc.)

f.       Health practices (sleeping, eating patterns, tobacco use, exercise, etc.)

g.      Mental health history (prior problems, symptoms, diagnoses, evaluations, therapy experiences, past prescribed medications, current and family of origin mental health histories)

h.      Current medications (dosages, purposes, physician, compliance, effects, side effects, etc.)

i.       Legal history (arrests, driving under the influence, jail/prison, lawsuits, any pending legal actions)

j.       Use/abuse of alcohol or drugs (prescription or illegal)

k.      Family (current and origin) alcohol/drug history

 

6.      Interpersonal Factors (contains a description of client’s orientation toward others in environment)

a.       Manner of dress

b.      Physical appearance

c.      General self-presentation

d.      Nature of typical relationship (dependent, submissive, aggressive, dominant, withdrawing, etc.)

e.      Behavior toward therapist (therapeutic alliance, etc.)

 

7.      Environmental Factors

a.       Elements in the environment, not already mentioned, that function as stressors to the client – those centrally related to the presenting problems and more peripheral

b.      Elements in the environment, not previously mentioned, that functions as support for client (friends, family recreational activities, etc.)

 

8.      Personality Dynamics

a.       Cognitive factors: data relevant to thinking and mental processes such as:

                 i.          Intelligence

                ii.          Mental alertness

              iii.          Persistence of negative cognitions

               iv.          Positive cognitions

                 v.          Nature and content of fantasy life

               vi.          Level of insight (awareness of changes in feelings, behavior, reactions of others, understanding of the interplay, etc.)

             vii.          Capacity for judgment (ability to make decisions and carry out practical affairs of daily living)

b.      Emotional factors

                 i.          Typical or most common emotional stress

                ii.          Predominant mood during interviews

              iii.          Appropriateness of affect

               iv.          Range of emotions client can display

                 v.          Cyclical aspects of client’s emotional life

c.      Behavioral factors

                 i.          Psychosomatic symptoms

                ii.          Existence of problematic habits or mannerisms

 

9.      Testing (both past and present)

a.       Methods or instruments

b.      Evaluator, location, dates, reasons for testing

c.      Results

 

10.   Life Transition / Adaptation Skills

a.       Coping skills: Concrete efforts to deal with distressing situations (for example: anticipation, preparation, response)

b.      Social resources:  Summary of supportive social networks

c.      Psychological resources:  Adaptive personality characteristics (for example: self-efficacy, hardiness, optimism)

 

11.   Formal Diagnosis

a.       DSM-IV-TR diagnosis (all applicable axes)

b.      Checklist of symptoms/criteria showing how client meets diagnostic criteria

 

12.   Therapist’s Conceptualization of the Case

This section contains a summary of the therapist’s view of the problems and their effects on the client.  Include only the most central and core dynamics of the client’s personality, relationships, and environmental influences.  Note the interrelationships among the major factors.  What are the common themes?  What ties it all together?  This is a synthesis of all the relevant data and the essence of the therapist’s understanding of the client.

 

13.   Treatment Plan

Based on the above information, describe the treatment plan you will follow to address the presenting and emerging problems.  Make it consistent with your theoretical orientation and available empirical evidence.  Estimate the number and types of sessions needed to address the issues.  

14.   Questions  / Issues – Note questions you have regarding case and any issues you would like to address.