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QUESTION A

Client is a 27 year old female who reports she has always been an anxious person from a young age but since the pandemic her anxiety has started to effect her social and work life- has had to call off a couple of days of work because of her symptoms. Client reports she has tried it all to help her anxiety- OTC supplements, meditation, talk therapy, exercising, eating right and is still unable to shake it. Client reports anxiety is about a 7/10 on a day to day basis and cannot identify any specific triggers for her anxiety and that she worries about everything and anything. Client reports increasingly troublesome anxiety for the last seven months and no identifiable triggers. Client reports sleep is okay but has some trouble falling asleep. Client reports no change to appetite. Client reports some lack of motivation to get out of bed in the morning because she knows how much the anxiety will ruin her day. Client denies any panic attacks. Client reports she has been married now for about two years and would like to start family planning but feels like she needs her anxiety in a better place. Client would like to trial a medication for her mental health but is concerned about weight gain and personality changes that she sees depicted on TV shows.

Assessment Scores

GAD- 7- Pt score 16

MDQ- negative

ISI- negative

PHQ-9- Pt score 6

Other Pertinent Information

NKDA

Current Daily meds- none

No SI, HI or safety concerns

Question 1– What medication would you recommend the client to trial and why? How you would conceptualize the case to a colleague? Please type your response below *

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Question 2– Two weeks after starting the medication you prescribed, the client above reaches out to report that they are feeling worse and not getting any better. The client reports they are not having any side effects from the medication. What would you recommend as next best steps?*

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QUESTION B

Please read the following client scenario below and answer the following questions about this client’s case.

Client is a 22 year old male who reports no one takes his symptoms seriously and is done with feeling this way. Client reports he has been having thoughts of suicide but has not had a plan and doesn’t think he would ever try. Client identifies his family and girlfriend as support.

Assessment Scores

GAD- 7- Pt score 5

MDQ- negative

ISI- negative

PHQ-9- Pt score 22

Other Pertinent Information

NKDA

Current Daily meds- multivitamin gummy when he remembers to take it (most days 5/7)

Past Psych History- Denies

What appropriate next steps would you take? (Select all that apply)*

A.

Perform the C-SSRS

B.

Initiate and document a safety plan

C.

Call the client’s Emergency Contact to take them to the hospital

D.

Initiate treatment plan with appropriate medication and/or therapy

E.

Call 911

QUESTION C

Tell me about the most complex behavioral health client you have taken care of. Include your assessment and treatment plan including any prescribed medication and collaboration you required/utilized. Include rationale for treatment choices.

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