Case #1 A woman with personality disorder SUBJECTIVE Rhonda is a 32-year-old Hispanic female who presents to your office for her initial appointment. When you ask what brought her to your office, she states: “I’m at the end of my rope, I don’t know what else to do.” She then bursts into tears. Rhonda explains that she has very few friends left, and everyone seems to have “abandoned” her. Rhonda explains that she goes out of her way to help other people, and to be nice to them, but this does not seem to help. Rhonda then stands up and begins to pace around your office at times using wild hand gestures to explain the circumstances that led up to her making the appointment with you. She describes the recent breakup with her boyfriend as traumatic and explains “when we first met, he was the best guy in the world. He treated me really well. But he just became a complete monster! Even though he broke off the relationship with me, I was glad to see it end. I hate his guts!” Rhonda explains that her current financial situation is also precarious. She states that she recently purchased an automobile, and is not certain how she is going to pay for it. She states that she had a car that was repossessed last year at that time, and that she borrowed some money from a friend to help pay for the car; the friend later turned around and accused her of theft. “It was my friend’s fault. She told me she would loan me the money and then backed out. I only took the money because she said she would loan it to me … people just can’t go back on their word like that when other people are counting on them.”  Rhonda reports that she was “always in trouble” as a kid. She states that people were always picking on her, to which she adds: “the other kids my age were just stupid. They didn’t know how to have fun.” She says “I have always been impulsive, but it’s fun. Sometimes people can be such prudes … you only go around life once, so you have to make the best of it.”  OBJECTIVE Rhonda is currently single. She has no children. Educationally, she had completed two semesters toward her bachelor of arts degree in fine arts. Rhonda currently works as a waitress at a local restaurant. She has held this job for about 2 weeks. Prior to this, Rhonda worked as a housekeeper for a local hotel chain. She states that she was fired from this job because her coworkers were jealous of her and “planted” evidence of her stealing from hotel patrons. She was also arrested for cashing checks under an alias, for which she spent 120 days in jail.  Rhonda has a history of multiple incarcerations for offences ranging from larceny to possession of controlled substances to possession of an illegal firearm. She was also arrested several times for fighting and on at least one occasion, used a baseball bat to beat up a girl who she thought was trying to “set her up” with the police.  MENTAL STATUS EXAM Rhonda is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, an.

1. Case #1 A woman with personality disorder
SUBJECTIVE
Rhonda is a 32-year-old Hispanic female who presents to your
office for her initial appointment. When you ask what brought
her to your office, she states: “I’m at the end of my rope, I
don’t know what else to do.” She then bursts into tears. Rhonda
explains that she has very few friends left, and everyone seems
to have “abandoned” her. Rhonda explains that she goes out of
her way to help other people, and to be nice to them, but this
does not seem to help.
Rhonda then stands up and begins to pace around your office at
times using wild hand gestures to explain the circumstances that
led up to her making the appointment with you. She describes
the recent breakup with her boyfriend as traumatic and explains
“when we first met, he was the best guy in the world. He treated
me really well. But he just became a complete monster! Even
though he broke off the relationship with me, I was glad to see
it end. I hate his guts!”
Rhonda explains that her current financial situation is also
precarious. She states that she recently purchased an
automobile, and is not certain how she is going to pay for it.
She states that she had a car that was repossessed last year at
that time, and that she borrowed some money from a friend to
help pay for the car; the friend later turned around and accused
her of theft. “It was my friend’s fault. She told me she would
loan me the money and then backed out. I only took the money
because she said she would loan it to me … people just can’t go
back on their word like that when other people are counting on
them.”
Rhonda reports that she was “always in trouble” as a kid. She

2. states that people were always picking on her, to which she
adds: “the other kids my age were just stupid. They didn’t know
how to have fun.” She says “I have always been impulsive, but
it’s fun. Sometimes people can be such prudes … you only go
around life once, so you have to make the best of it.”
OBJECTIVE
Rhonda is currently single. She has no children. Educationally,
she had completed two semesters toward her bachelor of arts
degree in fine arts. Rhonda currently works as a waitress at a
local restaurant. She has held this job for about 2 weeks. Prior
to this, Rhonda worked as a housekeeper for a local hotel chain.
She states that she was fired from this job because her
coworkers were jealous of her and “planted” evidence of her
stealing from hotel patrons. She was also arrested for cashing
checks under an alias, for which she spent 120 days in jail.
Rhonda has a history of multiple incarcerations for offences
ranging from larceny to possession of controlled substances to
possession of an illegal firearm. She was also arrested several
times for fighting and on at least one occasion, used a baseball
bat to beat up a girl who she thought was trying to “set her up”
with the police.
MENTAL STATUS EXAM
Rhonda is alert and oriented × 4 spheres. Her speech is clear,
coherent, goal directed, and spontaneous. She reports her mood
as “terrible!” Affect is labile and seems to change rapidly with
the subject being discussed. Her eye contact is normal, but at
times, she appears to stare at you. Rhonda is oriented to person,
place, and time. She denies visual/auditory hallucinations, no
overt paranoia or delusional thought processes noted. Rhonda
denies any suicidal or homicidal ideation.

3. Examine Case 1
: You will be asked to make three decisions concerning the
diagnosis and treatment for this client. Be sure to consider co-
morbid physical as well as mental factors that might impact the
client’s diagnosis and treatment.
At each Decision Point, stop to complete the following:
Decision #1: Differential Diagnosis
Which Decision did you select?
Why did you select this Decision? Support your response with
evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision?
Support your response with evidence and references to the
Learning Resources.
Explain any difference between what you expected to achieve
with Decision #1 and the results of the Decision. Why were they
different?
Decision #2: Treatment Plan for Psychotherapy
Why did you select this Decision? Support your response with
evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision?

4. Support your response with evidence and references to the
Learning Resources.
Explain any difference between what you expected to achieve
with Decision #2 and the results of the Decision. Why were they
different?
Decision #3: Treatment Plan for Psychopharmacology
Why did you select this Decision? Support your response with
evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision?
Support your response with evidence and references to the
Learning Resources.
Explain any difference between what you expected to achieve
with Decision #3 and the results of the decision. Why were they
different?
Also include how ethical considerations might impact your
treatment plan and communication with clients and their family.
Note:
Support your rationale with a minimum of three academic
resources. While you may use the course text to support your
rationale, it will not count toward the resource requirement.