Case of Mary

This chapter highlights Mary, a 55-year-old European-American woman referred due to depression and anxiety following the death of her husband. How clearly and comprehensively a diagnosis of Major Depressive Disorder fits her case, in comparison in comparison to other DSM-V-TR^TM Diagnoses, and if there is an appropriate ICD-10-CM code for her, are considered. Diagnostic exercises challenge clinical reasoning concerning whether symptoms might be a realistic response to environmental issues, including racism or the impact of violence and trauma, during development rather than reflecting personal or family dynamics. In addition, diagnostic decisions are challenged as to whether they accurately reflect a balance between client resilience and/or factors supporting resilience in comparison to the factors supporting risk in the client’s life. The interviewing skills highlighted in the chapter include empathetic comments, nonverbal attending, open-ended and closed questions, reflective listening, and summarizing. Thought questions challenge professionals to consider their own and their clients’ possible thoughts, feelings, and actions when they first meet, and what steps they must take to develop the most effective working relationship with the client. Thought issues for building clinical reasoning skills using this client include bereavement, religion, sexual orientation, and suicide risk.