SCO 294
Rachel Bianca Mallari
Case Study
G.C. is a 48-year-old Hispanic male. His current marital status is separated. Prior
to admission in Manhattan Psychiatric Center (MPC), Mr. G.C. is said to be living
independently in his own apartment. According to the his chart, he denied having any
close friends and hobbies and tends to isolate himself. He stated, “I don’t remember ever
being happy” (Client‘s Chart, Summary of Clinical Findings).
The client has 5 sisters, 3 brothers and 1 half-brother who committed suicide. His
fathered died of liver cirrhosis. Mr. G.C. fathered a child but did not keep in contact with
the child neither with the child’s mother. The client is of Columbian descent. He speaks
both English and Spanish fluently. The client relates to his Hispanic culture as evidenced
by his fond of listening to Spanish music. Mr. G.C. is of Catholic faith. He values his
religion through reading the bible.
The client is assessed to benefit from a Sexual Offender’s Program and an after
care MICA program. The Client does not have a meaningful work history. He stated that
he was employed as an office file clerck and receives SSI payments to supplement his
income. Mr. G.C. mentioned that he dropped out of school in 7th grade and admits to be a
poor speller.
The client is diagnosed with the following:
AXIS I: Anxiety Disorder NOS 300.0, Alcohol Abuse 305.0, Paraphilia, Voyeurism
302.82.
AXIAS II: R/O Dependent Personality Disorder 301.6.
AXIS III: Asthma, Pituitary Adenoma, Hepatitis C.
AXIS IV: Incarceration, limited support system.
AXIS V: GAF 45.
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DSM IV Code 302.82 Voyeurism
DSM IV-Criteria
Mr. G.C.
A. Over a period of at least 6 months,
Pt. is stalking and harassing women. He
recurrent, intense sexually arousing
also sends letters to teenagers with sexual
fantasies, sexual urges, or behaviors
provocative content.
involving the act of observing an
unsuspecting person who is naked, in the
process of disrobing, or engaging in sexual
activity.
B. The person has acted on these sexual
urges, or the sexual urges or fantasies
caused marked distress or interpersonal
difficulty.
BEHAVIOR
Patients derive sexual gratification from
Nothing was noted in the pt’s chart
seeing sex organs and sexual acts.
regarding gratification from seeing sex
organs and sexual acts.
USUAL MEDICATIONS OR
INTERVENTION
A. GnRH analogues
Pt. doesn’t take any medications for
B. Psychotherapy
voyeurism. His current medications are as
follows: Seroquel (antipsychotic), Prozac
(antidepressant), Protonix, Albuterol and
Quetiapine.
SIDE EFFECTS
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Case Study
PROGNOSIS
Guarded
This writer thinks that the client fits the description for someone with this
diagnosis. The client is charged of stalking and aggravated harassment thus, suggests that
he has poor control of his sexual impulses. His chart stated that he is putting letters under
his neighbors apartment door containing sexual provocative messages. In addition, he has
a pathologically low self-esteem related to his sense of masculinity.
The client has no other medical conditions aside from the ones identified in AXIS III.
INTERVENTION FOCUS OF OTHER PROFESSIONALS:
Psychiatrist- The Psychiatrist prescribes medication to the client and decides whether the
patient can be on the discharge list. Also, educating the patient regarding medications and
target symptoms while emphasizing consistent compliance with medications to avoid
decompensation is part of the responsibility of the psychiatrist.
Psychologist- the Psychologist works with the client in providing information and
understanding regarding his illness and ways he can recover.
Social Worker- The Social Worker prepares the client for discharge and educates him on
how to avail various programs in the community and makes the arrangement in the type
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Rachel Bianca Mallari
Case Study
of residence the client will go to after being discharged. The Social Worker also helps the
client to manage his financial needs and contacts his family.
Nurse- The Nurse administers the client’s intake of medication and monitors side effects.
Vocational Counselor-
The Vocational Counselor is not involved in the client’s
treatment or rehabilitation.
School Teacher- The school teacher is not a part of the treatment team working with this
client.
Recreational Therapist (RT)- The RT is the primary treatment leader of Mr. G.C. The
treatment goals are established and addressed by the Recreational Therapist for this
particular client. He interacts with the client in the treatment mall and documents his
progress. The RT engages the client in meaningful and self-expressive form of therapy.
These health professionals work with each other as a team, in order to plan the
goals and intervention program for this client. They work collaborately to provide the
utmost care for the patients. In MPC, the treatment team works in tandem to establish the
goals, intervention and progress or lack thereof of the patient in the team meeting.
The interaction among these health professionals certainly have an effect on the
patient. They were able to dicuss the effect of the client’s medication in relation to his
behavior and make adjustments. Thus, the treatment team are aware that the behavior of
the client may have to do with the side effects of his medications. Also, in the team
meeting they can decide whether the patient is ready for discharge or refer the client in
the appropriate program that is suitable for him.
OCCUPATIONAL THERAPY OR ACTIVITY THERAPY EVALUATION
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Rachel Bianca Mallari
Case Study
A. Problems experienced using the assessment:
Since this writer was instructed by her supervisor not to write in front of the
patient during the interview, one believes that the assessment was long thus, all of the
patient’s comments may have not been remembered.
B. Summary of the information obtained:
Although, the client is compliant with the treatment regimen and motivated to be
discharged, the client shows deficits in areas such as social/psychosocial, communication
and recreational interest. Furthermore, he has no insight regarding his illness. During the
assessment interview, the client said that he still doesn’t know his diagnosis; the reason
why he was admitted to MPC was because of a misunderstanding.
C. Supervisor’s comments:
See attached Rehabilitation Services Assessment.
AREA OF OCCUPATION
ASSESSMENT USED
SUMMARAZE THE
FOR THIS AREA
EVALUATION
RESULTS
Psychosocial/Interpersonal
Occupational Therapy
Pt. states he doesn’t have
(Self-concept/Self-esteem)
Questionnaire
any achievements. He
prefers to be alone.
However, he
acknowledges the need to
socialize with peers.
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Rachel Bianca Mallari
Case Study
Communication
Occupational Therapy
Pt. mentioned having a
Questionnaire
hard time verbalizing his
feelings. Thus, he prefers
writing letters. He admits
to be a poor speller. Pt.’s
speech was somehow
pressured especially when
anxious.
Leisure (Recreational
Occupational Therapy
Pt. expressed not having
Interest)
Questionnaire
any hobbies and does not
play any board games.
However, he enjoys
watching t.v., reading the
bible and listening to
music. He also indicated
interest in playing bowling
when discharged.
Occupational Performance Intervention area #1: Social Interaction/Participation
Problem: Mr. G.C. is often times withdrawn and tends to isolate himself.
Goal: Client will initiate and sustain conversation with 3 peers twice a week during the
group sessions by one month with minimal prompting.
Method: (Be sure to include the specific tasks, how they will be used, any adaptations to
the task and/or the environment, and how you will approach the person).
The client will attend Social Skills and Relationship group 2x a week for 1 hr
session in the treatment mall. The client will be prompted to seat next to the person who
is active and would likely engage him in a conversation. Mr. G.C. will also be directly
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Rachel Bianca Mallari
Case Study
asked open-ended questions and respond to the comments of other patients in the group.
The group will engage in activities such as social skills for life, social bingo, friendship
quilt and my play which will build up the client’s social skills. Also, the client will be
encourage by the group leader to communicate and interact with fellow patients or staff
in the day room.
This approach is chosen to develop the client’s ability to relate with peers and
increase his ability to express thoughts and ideas.
Occupational Performance Intervention Area # 2: Interpersonal Skills
Problem: Mr. G.C. declared to have low self-esteem.
Goal: Client will state one positive thing about himself in the beginning of the group
sessions twice a week by 2 weeks with minimal cuing.
Method: (Be sure to include the specific tasks, how they will be used, any adaptations to
the task and/or the environment, and how you will approach the person).
Client will attend Interpersonal Skills once a week in the treatment mall.
Activities such as Woulda Shoulda Coulda and Self-Disclosure will develop the client’s
ability to reframe self-defeating statements and increase self-confidence. In addition,
Self-Disclosure will increase and enhance understanding of oneself.
This procedure is chosen to improve client’s view of oneself and selfunderstanding. Through self-awareness activities, the client may be able to strengthen his
relationship with others.
Occupational Performance Intervention Area # 3: Leisure
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Rachel Bianca Mallari
Case Study
Problem: Client states not having any hobbies. However, he enjoys watching t.v., reading
the bible and listening to music.
Goal: Client will choose one of the two preplanned leisure activity (e.g., exercising
routine or dancing) and initiate it twice a week with minimal cuing for 3 weeks.
Method: (Be sure to include the specific tasks, how they will be used, any adaptations to
the task and/or the environment, and how you will approach the person).
Client will attend Leisure Education twice a week for 1 hour in the treatment
mall. Mr. G.C. will be encourage to discuss and plan alternative leisure activities. He will
be asked to select one new leisure activity and reports to the group about the activity
selected. The client may demonstrate ,or if possible teach the group on how it is done.
This method is chosen for the client to explore and open up possibilities to have a
positive and productive use of leisure time. This may also increased his social
participation. Thus, avoiding depression and suicidal ideation.
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Rachel Bianca Mallari
Case Study
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