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Case Study

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1. Client map
Diagnosis: Obsessive Compulsive Disorder, 300.3 (F42)
Objectives of treatment: bring symptoms of disorder under control, so that they do not rule
patients daily life.
Clinicians characteristics viewed as Therapeutic:

Therapist's personal attributes like, for

example, being friendly and motivating are necessary. Moreover, he should be persistent to
that patient would deal with the object of obsession.
Location of Treatment: patients everyday circumstances and therapists office.
Interventions to be used: hypnosis, yoga, exposure and response prevention (ERP),
medications, cognitive behavioral therapy.
Emphasis of Treatment: emphasis on keeping a job and developing of interpersonal skills
Nature of treatment: individual and group sessions. Pharmaceutical treatment is also to be
provided.
Timing: 3 months once or a few times a week.
Medications needed: Serotonin Reuptake Inhibitor (SRI) or another antidepressants
Adjunct services: N/A
Prognosis: The treatment is going to be effective, but our patient has spent much time on this
obsession, that is why it can take a time. (Mayoclinic.org, 2016)
Diagnosis: Obsessive Compulsive Disorder, 300.3 (F42)
Provisional diagnosis: Social Anxiety disorder 300.23 (F40.10)
Rule out: Obsessive Compulsive Disorder, 300.3 (F42) is to be treated in different ways. Two of
them is psychotherapy and medications. The first step should be a doctor to try to determine
whether the patient is faking his symptoms, or because he has something to gain as to avoid
responsibility. The next step is to determine drug or substance related causes. And after all, it is
very important to understand the real nature of the disorder and to determine the precise
diagnosis of this syndrome.
2. Diagnosis
Diagnostic and Statistical Manual -5 defines obsessive-compulsive personal disorder (OCD)
(300.3 (F42)) by at least four of the following signs:
The person is concerned in lists, rules, procedures and organizational aspects, which
can even lead to loss of the main essence of the problem.

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Detects perfectionism that interferes in the execution of a task

Excessively works, can even sacrifice vacation and friendly or family relations.
Not flexible and has strong views on issues of morality, ethics values.
Unable to get rid of unneeded items, even when they have significant value.
Reluctantly cooperates with others, because, in his opinion, they are doing things and

tasks wrong.
Detects excessive firmness and perseverance.
Compulsions are repetitive behaviors or mental acts that an individual feels driven to
perform in response to an obsession or according to rules that must be strongly applied. (DSM-V,
2013)
3. Provisional diagnosis
The extensive and abnormal work regime must lead to Social disorders, that are
misunderstanding of the requirements of the society.
In social anxiety disorder (social phobia) 300.23 (F40.10) , the individual is
anxious about or scared of or avoidant of social interactions and situations that involve
the possibility of being analyzed. This includes social interactions such as meeting
unknown people. There is a fear of being evaluated by others in a negative way, by being
humiliated, or ignored, or offending others. In panic disorder, the individual experiences
recurrent unexpected panic attacks. This is a provisional diagnosis. Nevertheless, our
patient is likely to develop this kind of disorders through his lifestyle and habits.
4. Rule out.
There are some certain steps in ruling out the right disorder to provide a necessary
medication and treatment.

Determine malingering and factitious disorder

Check drug-related causes

Determine any general medical conditions

Understand the precise primary disorder

Differentiate adjustment disorders from unspecified categories

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Determine boundaries with no mental disorder ( Schimelpfening, N. 2016)

Our diagnosis is likely not to be drug-related. This disorder is very broad and of high
quantity all around the world.

5. Discussion
Our patient, John, during last years, became more and more aware that he spends much
time on his studying and working. When he graduated, he got a job in a big company, so that he
tried to do his best. Within weeks, firm had second thoughts on John, because he was doing his
commitments for a long period and with excessive persistence. He knew that it took for him too
long for his job, but he felt compelled to continue checking the lists. After the probation period,
the organization let him go.
This history is a perfect example of the Obsessive Compulsive Disorder. In this
case, there are different groups of disorders: some of them are with compulsions, some of
them are with obsessions. This disorder is likely to be genetic and inherited, but there are
several scientific studies, that prove, that OCD is to be changed in the circumstances of
society.
This disorder is guided by compulsions or obsessions. Our patient is likely to be
compulsive, because he spends much time doing the same work. Our mind is using
psychological defense mechanism get rid of accumulating tension, stress, that is why patients
are guided by the compulsions.
There are several ways to get rid of it. One of them is exposure and response
prevention (ERP), which is the therapy of confronting with your fears. Our patient should try,

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by the help of the doctor, to avoid his compulsion and to make his consciousness understand,
that there is no use in these repeatable actions.
The next way is the use of medications, which can help to create new habits and
help to confront with the patients fears. These medications are most of all antidepressants or
the one of the hormone nature.
Conclusion
The obsessive-compulsive disorder is vast spread all around the world. This
disorder is more common among the men. Even if such a problem weighs years and decades,
it is possible to cope with. That is why there is no use in fears of failure of medications. The
first thing for patient is to believe in the strength of this procedure and in the strength of his
mind, because the best factor of treatment is our brain.
There are several ways to help our mind to meet the requirements of the
specialists. Some of them are hypnosis and yoga. Moreover, these skills are not only
important in treatment, but also in everyday life. It happens that regular meetings with the
therapist in a patient with OCD are stretched for several months, but it takes time fruitfully.
Negative comments and criticism may worsen OCD and calm, supportive
environment are likely to help improve treatment outcomes. It makes no sense to swear or
scold person with OCD to stop the execution of rituals. He can not do it, and the pressure will
make it worse. The best way to help cope with OCD loved to be with him kind and patient.
Praise each successful attempt to resist OCD, and focus on the positive things in life

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References

Diagnostic And Statistical Manual Of Mental Disorders, Dsm - 5. (2013).

.Available at: http://psy-gradaran.narod.ru/lib/clinical/DSM5.pdf

Schimelpfening, N. (2016). What Is a Provisional Diagnosis Vs. a Differential

Diagnosis?. [online] About.com Health. Available at:
http://depression.about.com/od/majordepressivedisorder/fl/What-Is-a-ProvisionalDiagnosis-Vs-a-Differential-Diagnosis.htm [Accessed 28 Jan. 2016].
Mayoclinic.org, (2016). Obsessive-compulsive disorder (OCD) Treatments and
drugs - Mayo Clinic. [online] Available at: http://www.mayoclinic.org/diseasesconditions/ocd/basics/treatment/con-20027827 [Accessed 28 Jan. 2016].