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Treatment Plan

Carrie Treatment Plan

D’Corey Sullivan

Department of Social Work, University of Mississippi

SW 686 Traumatic Stress & Crisis Intervention

Dr. Watson

April 22, 2021

Demographic Information

Based on the information given, the client is female, and her name is Carrie Anne Carmichael.

We can infer that she is 26 years old, but further information is needed. There was little

information provided on where she lives; however, there are mentions of a place named Carson

City. There was also no information proved on the client's race and ethnicity. 

General Description

According to the information provided, there have been instances of possible oppression and

vulnerability. Carrie states that she feels like people treat her differently because they think she is

gay. There were also reports of a "problem" that occurred at a church involving Carrie and

another unnamed female. This "problem" happened when Carrie was 13; another female camper

was discovered engaging in mutual masturbation. 

Medical History

It was reported that Carrie was hospitalized in a psychiatric hospitalization 12 times between the

ages of 13-25. Her first hospitalization happened a few months after the "problem" at the church

camp. She had stabbed herself in the stomach and walked into her mother's room to show her.

There were no reports of previous diagnoses or Rx and non-Rx med. 

Psychiatric History

Based on the information, we know that Carrie was hospitalized 12 between the ages 12-25. 

Information on Psychotropic medications and dosage were not provided. 

Family History

Based on the information provided, we learned that Carrie is an only child. Her immediate

family consisted of her mother and father. The family was heavily involved in the Church of

Christ because Carrie's father was an elder. Her mother and father divorced when she was 3.
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Treatment Plan

Since her parents were divorcing, her father lost his position as an elder in the church because

divorce is frown upon in their culture. Her father claimed her mother ruined his life, so he

walked completely out of their lives. It was reported that Carrie has talked to him on the phone

once; she describes the experience as awkward. Her father also sent her a postcard for her 18th

birthday. 

Marital History

No information provided

Education

Carrie completed a few semesters at Carson City Christian University but did not complete a

degree. She missed a lot of class because she isolated herself in her room. Her mother stated she

was never really comfortable around large groups of people. She also struggled to get chapel

credits to pass a semester, so she was put on probation and dropped out.

Carrie reports never been employed because of her numerous hospitalizations during her teens

and early adulthood. 

Legal History

No information was provided. 

Current Functioning

Based on the information provided Carrie's current functioning is depressed. She's never been a

fan of large crowds and often isolates herself. A suicide assessment will need to be done to

determine if Carrie is suicidal. The self-harm and where she self-harms is very alarming, but

more information is needed. 

Strengths and Assets

Carrie has a home. She has a financial support system (her mom). She also had a high school

diploma and some college credits. 

Working Hypothesis

The core beliefs of Carrie and her family are deeply rooted in religion and spirituality. The

trauma and shame that Carrier holds from her mom and church, along with feeling like she can't

be her true self, I believe, is directly causing her depression. 

Clinical Impression 

According to the information provided, Carrie is disconnected and lacks emotions. I believe this

stems from the unresolved trauma and shame she felt after she was caught mutually masturbating

with another female camper at a Church of God camp. The camp counselors shamed and

traumatized Carrie when they involved her in a series of scriptural counseling sessions after the

incident. Her mother reinforced this shame when she chose to ignore the incident and never

spoke about it again. From that situation, I feel Carrie learned how to bury and repress her

feelings instead of learning how to communicate them. I feel because of the reactions of the

adults in Carrie's life had on the situation, she now feels she cannot be her true self. Since she is

not being allowed to be herself, she isolates and has slipped into a depression. Carrie also has a

perception that people dislike her because they think she is gay; this perception also stems from

the camp incident. 

 Diagnosis

o Major Depressive Disorder 296.3x (F33.X)

Modality

I will be using Motivational Interviewing with Carrie. According to Prochaska & Norcross

(2018), “MI is a person centered, directive approach that enhances intrinsic motivation to change
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Treatment Plan

by helping clients explore and resolve ambivalence.” I am also choosing MI because it is

evidence based for being culturally competent. Based on information in this case we know that

Carrie has a cultural background in the Church of God.

Treatment plan

 Problem Statements—

1. Carrie self-harms.

 Demonstrates a maladaptive pattern of self-harm manifested by

butting, burning , hitting self, to cause physical injury and to

control uncomfortable feelings,

2. Carrier isolates herself from other people, has no real social life.

 Social withdrawal

3. Carrie believes everyone dislikes her because they think she is gay

 Depressed mood related to traumatic event consequences

4. Carrie shows little to no emotion.

 Constricted or flat affect.

 Goals

1. Accept the powerlessness and unmanageability over self-harm and

participate in a recovery-based program.

2. Develop healthy interpersonal relationships that lead to effective

resolution of current conflicts or problems.

3. Alleviate depressed mood and return to previous level of effective

functioning.
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Treatment Plan

4. Develop healthy cognitive patterns and beliefs about self and the world

that lead to alleviation and help prevent the relapse of depression

symptoms.

 Objectives

1. Verbally admit to powerlessness over self-harming behavior. (G 1)

2. Learn and implement problem solving and/or conflict resolution skills to

resolve interpersonal problems. (G 2)

3. Verbalize an understanding of the relationship between depressed mood

and repression of feelings that is, anger, helplessness, hurt, and so on. (G

3)

4. Learn and implement relapse prevention skills. (G 4)

 Interventions

1. Help Carrie resolve depression related to interpersonal problems through

the use of reassurance and support, clarification cognitive and affective

triggers that ignite conflicts, and active problem-solving. (OBJ 2)

2. Explain a connection between previously unexpressed (repressed) feelings

of anger (and helplessness) or hurt and current state of depression. (OBJ

1&3)

3. Build Carrie’s relapse prevention skills by helping her identify early

warning signs on relapse, reviewing skills learned during therapy, and

developing a plan for managing challenges. (OBJ 4)

 Obstacles
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Treatment Plan

Carrie has a few obstacles that may keep her from reaching her goals. Her

lack of income, insurance, and most importantly the lack of support from her

parents, church, and community.

Proposed method of evaluation of effectiveness of intervention

 1. Use motivational interviewing to assess client’s readiness to

change; to empower her to change by drawing out her own meaning,

importance and capacity for change; intervene accordingly, building

motivation and increasing commitment to change. (INT 1)

 2. Beck Depression Inventory (BDI) will be used to measure Carrie’s

attitude symptoms, and characteristics of depression. The BDI will consist

of 21 items and will be rated on a 4-point scale ranging from 0-3. (INT 2)

 3. Assess how Carrie rates her ability to use skills learned on relapse

prevention strategies and began to think of ways to apply these strategies

to her home life by using The New General Self-Efficacy scale. The scale

will consist of 8 items and will be rated on a 5-point scale. 1-strongly

disagree, 2- disagree, 3-neither agree nor disagree, 4-agree, 5-strongly

agree. (INT 3)
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Treatment Plan

References

Prochaska, J. O. & Norcross, J. C. (2018). Systems of psychotherapy: a transtheoretical Analysis

(9th ed.). Oxford University Press