DO A CLIENT MAP (Seligman, 1990)

Diagnosis

Emphasis of Treatment

Objectives of Treatment

Nature of Treatment

Assessments as Needed

Timing

Clinician Characteristics viewed as therapeutic

Medications needed

Location of treatment

Adjunct services

Interventions to be used

Prognosis

Diagnosis:
Major Depressive Disorder, Single Episode, Moderate Severity (F32.1)
Persistent Depressive Disorder (Dysthymia), Early Onset, With Persistent Major Depressive Episode, Moderate
Severity (F34.1)
Posttraumatic Stress Disorder (F43.10)
Objectives of Treatment:
There are four primary objectives of treatment, based around the clients primary concerns. The main
objective is to continue to reduce and monitor suicidal thoughts and keep the client safe. The second is to
continue to reduce symptoms of depression. The primary symptoms that have been reduced are feelings of
emotional numbness and anhedonia. The third objective is to identify relationship patterns and make
relationships more positive. And the fourth objective is to reduce symptoms related to posttraumatic stress
disorder, particularly recurrent thoughts related to the trauma and intense psychological distress related to the
trauma.

Assessments as Needed:
The initial assessment consisted of the National Depression Screening Day Adult Screening Form.
This form consists of the following assessments: The HANDS Depression Screening Tool, the Mood Disorder
Questionnaire, the Carroll-Davidson Generalized Anxiety Disorder Screen, and the Modified SPRINT
(SPRINT-4) PTSD Screen. Because the clients stated purpose for coming to counseling was depression, this
assessment assessed the severity of depression, as well as identify any other potential disorders that would not
be apparent from an informal assessment.
Because of the clients potentially high risk of suicidal ideation during the initial session there was also
be an informal suicide assessment administered by both Jay Key and Ednalyn Hurley, LPC.
A third assessment is to informally assess for what level of change the client is at for each of the
objectives of treatment. The client is at a higher level of change for his suicidal ideation and depression than for
his PTSD and relationship issues.
Clinicians Characteristics Viewed as Therapeutic:
The first clinician characteristic that has been therapeutic with this client is [c]ommunicating empathy
and understanding to this client (Seligman & Reichenberg, 2014, p. 15). This client has suffered some intense
trauma in their life and are reluctant to talk about some aspects of their life. They also have strained
relationships with many of those close to them. Because of that having someone who can convey empathy and
caring to them has helped create a positive relationship with this client within which change can be enacted.
The second clinician characteristic is [h]aving strong interpersonal skills and being able to model them
(2014, p. 15). This client has difficulty identifying and accepting their feelings. By working with me, a

counselor who can and has modeled those feelings and how they might affect the client, this client can
hopefully continue to achieve greater understanding about themselves.
The third clinician characteristic that has been beneficial is [h]aving appropriate emotion-handling
skills, asking emotion-seeking queries, focusing emotion. (2014, p. 15). Because of the clients difficulties with
emotions, having someone who can model them has been beneficial.
Location of Treatment:
Treatment takes place in the counseling office at the GTCC Counseling Center located on Jamestown
Campus, Room 107.
Interventions to Be Used:
The primary intervention has been emotion psychoeducation. This has be accomplished through
practicing identifying feelings, such as with immediacy activities involving I am feeling _________
statements and emotion lists.
The second intervention strategy has been identifying past coping mechanisms. This allows the client to
explore what has worked in the past and ways that they can integrate those past strategies into the present.
Emphasis of Treatment:
The primary emphasis of treatment has revolved around keeping the client safe and alive.
The second emphasis has been exploring feelings with the client. This exploration has involved feelings
that were both positive and negative. Furthermore an emphasis has been on healthy coping strategies to deal
with those feelings.

A third emphasis on treatment would be on modeling what positive relationships can look like. This has
been touched on so far but seems related to the PTSD and lack of emotion and does not appear important to the
client.
A fourth emphasis has been on the level of change that the client is at for his various presenting
concerns.
Nature of the Treatment:
The nature of this treatment has been individual counseling.
Timing:
The client would ideally meet with me once per week for one year, with less meetings as necessary.
Medications needed:
The medication needed are an antidepressant to reduce symptoms of depression.
Adjunct services:
The adjunct services for this client currently consist of depression medication and a depression therapy
group at RHA Behavioral Health.
Future adjunct services might consist of family therapy and a trauma related therapy such as EMDR or
brainspotting. Both would address the students past trauma.

Prognosis:
I believe that the client has a positive prognosis of reducing symptoms related to depression and suicide.
The medication and therapy have be effective at reducing those to this point. However it is unclear whether the
client can reduce symptoms of PTSD due to a lack of willingness to change related to this. The memories
associated with the trauma seem painful enough that the client does not appear to want to deal with those
memories, making any attempt at working with them ineffective. And I believe that the client can improve on
their relationship with their family if their negative symptoms associated with depression and PTSD subside.

References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Washington, DC: Author.
Seligman, L., & Reichenberg, L. W. (2014). Selecting Effective Treatments - A Comprehensive, Systematic
Guide to Treating Mental Disorders (4th, revised). Hoboken, NJ: John Wiley & Sons, Inc.