I. Practice Setting This agency is a large nonprofit providing services to vulnerable groups such as at -risk youth, the elderly, homeless individuals, people with disabilities, those recovering with addictions and men and women returning from prison. For many years, I have the pleasure to serve individuals with mental health diagnosis in an urban community. Noticeably, most of my case load of clients were living below the federal poverty line. The community was moderately diverse represented by African Americans, Latinos, Asian and Caucasian. Much of the respective populations subsidized their incomes by utilizing supportive services such as SNAP, food pantries and utility assistance. Often Social Security Income (SSI) benefits were my …show more content…
Case Summary
A. Presenting Problem
Susan was referred to my agency in September 2014 by her case manager for mental health services. The case manager expressed a need for more intense services such as compliance with medication, assistance with individual therapy appointments, and addressing the amount of material items in Susan’s residence.
My initial appointment with Susan resulted in two cancellations, due to her forgetting and scheduling another appointment. Eventually, we were able to meet in the community and completed the necessary paperwork. During this unusual lengthy initial meeting Susan talked excessively. Our conversation resembled “old friends catching up.” Since than Susan meet with me bi-weekly in the community for about two months, never wanting to meet at her residence. Eventually, Susan allowed me to visit at her home. During this meeting she stated she must vacate the property in three weeks due to failing inspections and Susan’s inability to make the apartment safe to live in. About a month later, Susan moved to a new residence in a neighboring …show more content…
Literature Review There is a great deal of evidence based literature on many of the symptoms associated with the term hoarding and its relation to trauma. The Diagnostic and Statistical Manual of Mental Disorders, DSM IV, listed hoarding as a symptom of obsessive compulsive disorder (OCD), known as “compulsive hoarding” (American Psychiatric Association, 2000). However, throughout the years research has shown “compulsive hoarding” did not respond to OCD treatments, thus redefining hoarding in the [DSM-V-TR] as a psychiatric disorder (American Psychiatric Association, 2013).
Until more recently hoarding was a very secretive and shameful disorder. Research suggest that 3-5% of the U.S. population suffers from a hoarding disorder. To put this into perspective, the state of Delaware has 900, 000 residences, 3-5% have hoarding disorder, which amounts to 18, 000- 45, 000 individuals. There are 300 million people in the United States, of that population 6-15 million people are affected by a hoarding disorder. (Cohn, 2012). To address and conceptualize Susan’s co-morbidities of her psychopathological mental distress and manifestations of behaviors I will use three evidence-based theoretical frameworks as