Social workers take particular care when diagnosing anxiety due to its similarity to other conditions. In this Discussion, you carefully assess a client with anxiety disorder using the steps of differential diagnosis. You also recommend an intervention for treating the disorder.

To prepare: Read the case provided by your instructor for this week’s Discussion. Review the decision trees for anxiety and OCD in the Morrison (2014) text and the podcasts on anxiety. Then access the Walden Library and research interventions for anxiety.

Post a 300- to 500-word response in which you address the following:

• Provide the full DSM-5 diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention).  Keep in mind a diagnosis covers the most recent 12 months.
• Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
• Discuss other disorders you considered for this diagnosis and eliminated (the differential diagnoses).
• Describe an evidence-based assessment scale that would assist in ongoing validation of your diagnosis.
• Recommend a specific intervention and explain why this intervention may be effective in treating the client. Support your recommendation with scholarly references and resources.

Note: You do not need to include an APA reference to the DSM-5 in your response. However, your response should clearly be informed by the DSM-5, demonstrating an understanding of the risks and benefits of treatment to the client. You do need to include an APA reference for the assessment tool and any other resources you use to support your response.

CASE of BRICESON

    Intake Date:  November 2020

Identifying Information:

       A 27 year old African-American, male student was referred for a psychiatric consultation after a workup for gastrointestinal distress proved negative.  Briceson has consulted his family physician after months of feeling bloated and nauseated in anticipation of certain distressing events and circumstances.

History of Present Illness:

  Briceson described 3 years of “anxiety attacks” accompanied by palpitations, shortness of breath, hot flashes, sweating and parathesias, in addition to abdominal discomfort. Their onset was clearly traced to a blind date arranged by a close friend.  On the way with his friend to pick up the girl, he suddenly felt extreme nausea and was forced to pull the car off to the side of the road.  He got out for a breath of fresh air and promptly vomited. Although his friend forced him to go through with the date, Briceson was extremely nervous and preoccupied throughout, took his date home immediately after the movie was over, and sped away without even walking her to the door.

     Briceson has continued to think about this situation and feels down when thinking of what happened in the past.  Over the past several months, his mood is low and he has had trouble staying asleep at night.  Although he had previously been shy around girls, following this incident, Briceson panicked at the thought of a date.   There were girls to whom he felt attracted, but whenever he brought himself to even consider asking one out, he became symptomatic. The anticipation generalized so that he became anxious going to local basketball games, bars, and concerts with friends because he might see girls he was interested in meeting, talking to, or dating.  He frequently felt like staying home but forced himself with the help of some peer pressure to go out at least “with the boys.” More recently, he does not even want to do that.  He finds himself staying home more and eating to relax himself. 

    As he neared completion of his MSW program, he had to go for job interviews, these began to cause anticipatory anxiety.   He described feeling “trapped” in the interview with “no way out.”   He then developed a fear of talking on the phone to people to arrange appointments for interviews or follow-ups.  He was hired by a large municipal welfare agency and stayed mostly to himself on the job.  His telephone fear extended to conversations with clients.  Briceson finds himself being more challenged now because he is forgetting things at work and is having difficulty focusing.