Choose a case study from this week's required text readings (Chapters 6 and 9 of Contemporary Clinical Psychology).

• Write a 1,050- to 1,400-word analysis of your selected case, in which you demonstrate an application of clinical psychology in a real-world situation.Address the following items:
  • Provide a brief overview of your selected case.
  • Discuss the biological, psychological, and social factors involved in your selected case.
  • Use your selected case study to explain which interventions would be appropriate in the field of clinical psychology. For each intervention you select, provide the following:
    • The rationale for selecting the intervention
    • What would be done
    • Who would be involved
    • In what setting the intervention would occur
    • Which area the intervention is targeting, such as biological, psychological, or social factors

  Use information from at least three peer-reviewed publications to support your points.Format your analysis consistent with APA guidelines

ONLY DO BULLET 2 (Discuss the biological, psychological, and social factors involved in your selected case) AROUND 350 WORDS ONE PEER REVIEW SOURCE

CASE STUDY

Case Study: Nicole Experiences School Phobia (Biopsychosocial)

PLEASE USE THE TEXT BOOK P 158

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Biological Factors: Nicole has always been

an anxious child who had difficulty with

separation and new experiences. While her

mother is unaware of any family history

of anxiety disorders, she claims that Nicole

has seemed ‘‘edgy’’ and ‘‘fearful’’ from ‘‘day

one.’’ Nicole’s diet is significant for her

lack of appetite—excessive consumption of

caffeine-rich cola beverages (approximately

6 cans per day)—and she also complains of

sleep difficulties.

Psychological Factors: Nicole is deeply

attached to her mother who works full

time. Her mother finds it challenging to

parent such a needy child. Nicole is beset

by ongoing anxiety, particularly in response

to separation experiences such as going to

school and sleepovers at friends’ homes. She

has numerous strengths, such as her high

intellect, loving nature, and artistic skill. She

has poor self-esteem, and is riddled with

feelings of inadequacy.

Social Factors: Nicole lives and attends

school in an urban environment. Having

moved to the city only recently, Nicole and

her mother feel relatively isolated and feel

tentative in a big city with significant crime

and hustle-bustle. Nicole’s relatives all live

in distant cities, and her mother’s work

demands have limited their ability to make

social or community connections.

Biopsychosocial Formulation and Plan:

Nicole, who may or may not have a biological

tendency toward anxiety, is certainly

not benefiting from the high levels of caffeine

she is consuming. Caffeine may be

contributing to some degree to her sleeplessness,

low appetite, and possibly even

her anxiety. Most prominent, however, appears

to be Nicole’s sense of isolation in a

new and intimidating environment and her

necessary dependence on her single, fulltime

working mother. By staying home from

school, Nicole (perhaps unconsciously) succeeds

in securing her mother’s presence, or

at least the attention of a neighbor. Nicole’s

school refusal may be inadvertently reinforced

by the companionship and attention

of her mother and neighbors, as well as by

relief from the more challenging aspects of

getting to school on public transportation

and contending with school demands. The

lack of a secure social support network appears

to be enhancing her dependency on

her mother and generating fearfulness and

school refusal.

Treatment should progress in a number of

ways. First, a behavioral program should

be instituted whereby shaping is utilized

to gradually reinforce Nicole’s reentry to

school. For example, Nicole’s mother could

spend the first hour of her school day during

her first week back at school, then only

Integrative and Biopsychosocial Approaches in Contemporary Clinical Psychology 159

Case Study (Continued)

the first 30 minutes, then merely accompany

her to school, and so forth. Nicole’s successes

could be reinforced by special time with her

mother, enjoyable experiences with friends,

or other desirable incentives. This behavioral

plan should be augmented by some supportive

psychotherapy to help Nicole express her

fears and dependency needs, both verbally

and through nonverbal means such as play

and drawing. Efforts should also be encouraged

for the family to extend their social

network, and consultation could be provided

to determine available resources and strategies.

Nicole’s participation in activities (such

as group art projects), which can enhance

her sense of esteem and competence, would

also be beneficial. Finally, all caffeine should

be eliminated from Nicole’s diet.

Cardiovascular Disease

Photo: Courtesy Zach Plante.

In addition to common mental health problems

such as obsessive-compulsive disorder,

anxiety and depressive disorders, and

schizophrenia, the use of the biopsychosocial

perspective in clinical psychology has been

effectively extended to understand and treat

major medical diseases. Thus, clinical psychologists

are now involved in disorders that

fall directly under the purview of medicine.

Cardiovascular disease provides an excellent

example of the biopsychosocial perspective’s

utility for clinical psychology in better understanding,

preventing, and treating this problem.

Cardiovascular disease (CVD) is the nation’s

number-one killer, resulting in 40% of

all deaths and having been the leading cause

of premature death in the United States since

the 1930s (American Heart Association, 2009).

As mentioned earlier, it has been estimated

that 50%