The case study focused on a client who presented symptoms of depressive and avoidant/ restrictive food intake disorders. The main symptoms included reduced food intake, weight loss, fatigue, depressed mood, and loss of appetite. However, the customer did not meet the full criteria for avoidant/ restrictive food intake disorder. The symptoms negatively affect the client’s relationship with her family and friends. The ethical issues that should be addressed during the assessment of the client’s problem are obtaining informed consent and ensuring privacy over the client’s information. Furthermore, the client is likely to experience stigma and discrimination due to diagnostic labels.
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In this paper, a case study of a client suffering from feeding and eating disorders will be presented. The paper will begin with a detailed description of the client in terms of her problem, demographics, relevant history, and significant relationships. This will be followed by an evaluation of the influence of social-cultural factors on the ways in which the client presents the symptoms of the disorder. The last part of the paper will discuss the ethical issues that are likely to arise in the process of assessing the client’s problem.
The client is a female adult in her mid-thirties. She is a single African American who was born and raised in the US. In addition, she is a Christian who belongs to the Catholic Church. The client has a degree in marketing and is currently working in the retail industry as a customer relationship manager.
The client was raised in a single-parent family. Currently, she is a mother of two children who are under the age of ten years. Raising the children is a serious challenge to the client due to her work commitments. Although the client is not married, she is in a romantic relationship. The relationship has been a source of stress due to misunderstandings and disagreements between the client and her partner.
During her childhood, the client did not experience any serious mental/ psychological disorders. However, she often experienced high levels of stress because of excessive drinking and smoking during adolescence. The customer had a habit of avoiding food during childhood due to a lack of appetite. Nonetheless, she was not diagnosed with poor biological development. During adolescence, she restricted her food intake in order to control her body weight.
Currently, the client presents the following symptoms. First, she persistently avoids or restricts her food intake. This symptom has been observed for nearly three months. Second, the client has significantly lost weight. However, she has not been diagnosed with significant nutritional deficiencies. Thus, she does not depend on oral nutritional supplements. Third, the client shows symptoms of depression, such as loss of appetite, depressed mood, fatigue, poor concentration, and insomnia. However, her appetite often increases moderately when her mood improves. This enables the client to increase her food intake occasionally. Currently, the client is seeking counseling to improve her health by eliminating the symptoms associated with depression. Since the customer has not met the full criteria for avoidant/ restrictive food intake disorder, she is likely to be suffering from a major depressive disorder (“Feeding and eating disorders,” 2014).
The challenges being faced by the client has significantly affected her relationship with her children. In particular, she has a reduced capacity to participate in child-rearing activities such as cooking and helping the children with their homework due to fatigue and withdrawal. The challenges have also had a negative effect on the relationship between the client and her boyfriend. For instance, she lacks interest in activities such as going out for dinner and chatting with her boyfriend.
Client social-cultural Factors
Relationship problems and substance abuse are among the major causes of depression (Kearney & Trull, 2011). Thus, the client’s history of excessive drinking and disagreements with her boyfriend is likely to worsen her depressive disorder symptoms. Moreover, the client’s desire to maintain low body weight is likely to motivate her to reduce food intake (“Feeding and eating disorders,” 2014). The current environment also influences the way the client presents the symptoms. Child-rearing responsibilities, coupled with work-related challenges, are likely to increase her stress and anxiety. This increases the severity of symptoms such as loss of appetite and body weight.
Counselor Social-cultural Factors
One of the major differences between my socio-cultural background and that of the client is that I was raised by both parents. In this respect, a lack of experience in a single-parent family limits my ability to assess the client’s problem. Specifically, I may not accurately establish a link between the client’s family background and her current symptoms. However, I have a history of interacting with several individuals with symptoms that are associated with avoidant/ restrictive food intake disorder and depression. This experience will enable me to identify and recommend the best therapy to the client.
DSM-5 Cultural Limitations
First, the criteria lack predictive validity in a multicultural society. For instance, in some African cultures having a high body weight, especially, among men is a symbol of social status. Thus, increased food intake among men can easily be mistaken for bulimia. Second, cultural changes make the diagnostic systems unreliable. For instance, in most developed countries, people are increasingly shifting to the eating of small quantities of food regularly rather than eating large quantities at specific times of the day. In this case, detecting increased or decreased food intake becomes difficult and can lead to incorrect diagnosis (Kearney & Trull, 2011). Finally, cultural background often influences counselors’ conclusions about the client’s condition. Thus, a group of behaviors perceived to be a disorder by a given counselor might be considered normal by another counselor.
First, it will be necessary to obtain informed consent from the client before the assessment (ACA, 2014). This will facilitate the collection of personal and confidential information about the client. Second, the client’s information will be handled with confidentiality to prevent any damages or harm that might arise because of sharing the information with third parties (AAMFT, 2012). Finally, decisions concerning the client’s condition will be based on assessment results. This will help in preventing biases that might arise due to personal values and experiences.
Diagnostic labels may lead to stigmatization and discrimination. The client is likely to experience the negative effects of stigmatization, such as rejection and discrimination, if her relatives and friends know about her health condition. Furthermore, the client is likely to be stereotyped. Generally, individuals suffering from depressive disorders are often considered to be incompetent and dangerous (Kearney & Trull, 2011). These stereotypes are likely to have a negative effect on the client’s self-esteem and health condition.
Stigma and stereotypes might have a negative effect on the relationship that I have formed with the client. For example, the client might be ashamed of attending more counseling sessions. Similarly, the client is likely to fail to participate fully in the therapeutic process in order to avoid stigma.
AAMFT. (2012). Code of ethics. Alexandria, VA: American Association for Marriage and Family Therapy.
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ACA. (2014). ACA code of ethics. Alexandria, VA: American Counseling Association.
Feeding and eating disorders. (2014). Lifelong Learning in Psychiatry, 1(1), 1-25.
Kearney, C., & Trull, T. (2011). Abnormal psychology and life: A dimensional approach. Belmont, CA: Cengage Learning.