Case of Mark

This chapter highlights Mark, an 18-year-old male European-American college student who is referred due to his survival guilt and career issues. How clearly and comprehensively a diagnosis of Post-Traumatic Stress Disorder fits his case, in comparison to other DSM-V-TR^TM Diagnoses, and if there is an appropriate ICD-10-CM code for him, 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, reflective listening, supportive redirecting, 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 substance abuse and social isolation.