U14 - 9.2 - Larry Schenk PDF

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Unit 14 9.2 Larry Schenk 1. What was the reason for the referral?  Larry is a patient that has been in the social worker’s care for the last 6 weeks. He went to the ER because he got into a car crash however was acting abnormal which is why the social worker was called. 2. Target Symptoms/behaviors: Symptom #1: mildly depressed mood Symptom #2: he was at times declared “missing” Symptom #3: unexpected milage on his car Symptom #4: agitation Symptom #5: talking out of his head Symptom #6: unusual behavior in the emergency room compared to his normal reserved behavior Symptom #7: “I lost track of time, I don’t know how I got here.” Symptom #8: talking in third person Symptom #9: the entity that’s speaking “in place” for Larry explains that he’s the one with the guts in him. 3. Length of time symptoms present:  Since childhood 4. Impairments in functioning (issues with home, school, work, relationships)  The only impairments that are mentioned are the fact that Larry and his wife recently got a divorce because she suspected infidelity because of the times that he would end up “missing.” 5. After interview in ER, what diagnoses are you considering at this point? After the ER interview, I am considering dissociative identity disorder. 6. Is there additional collateral information you wish you had? I would like past medical records to decide whether or not Larry’s frequent memory loss could be the cause of an injury. Furthermore, I would like additional information on his Larry experienced emotional trauma. 7. What preliminary diagnosis would you give Larry at this time? (F44.81) 300.14 Dissociative Identity Disorder Z63.0- Relationship Distress With Spouse or Intimate Partner

8. What other diagnosis would you rule out (differential)? Other diagnoses that I’d like to rule out is medically induced psychosis, to decide whether Larry’s behavior and delusion are triggered from any drug use. 9. What strengths do you see in Larry? What psychosocial resources do you want to alert him to immediately? Revised 1-7-21

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The fact that Larry is actively in therapy proves that he has self-awareness of any issues he might be facing and be willing to work on them.

1. Interventions: a. Psychosocial: Psychotherapy, Cognitive Behavioral Therapy b. Psychmeds: SSRI’s, atypical neuroleptics (Risperdal).

Revised 1-7-21

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