I’m trying to learn for my Psychology class and I’m stuck. Can you help?
Mary is a 58-year-old physician who had a very busy private family practice for the past 19 years before she had to close down her office due to medical issues. She was the sole provider in her practice and was working anywhere from 60 to 70 hours a work, which included face to face patient hours as well as administrative duties associated with running her practice. She also managed a staff of six individuals.
Prior to her first visit with you, Mary had encountered a lot of personal problems and stressors. Both of her parents became quite ill and she was trying to manage her practice while also intervening and assisting with their needs. It was quite a challenge for her to manage both her work responsibilities along with the unpredictable aspects of caring for her aging mother and father, who eventually required placement to an assisted living facility. On top of all of these responsibilities, she also was the single mother of a 15 year old, who had been shuttling back and forth between her home and her ex-husband’s. Over the past year, her son has also gotten into trouble at school a few times for truancy and was caught once by the police at the local mall for underage drinking with a friend. As she was trying to handle all of these issues, she began to make mistakes at work in writing out prescriptions for her patients. Fortunately, her staff caught the errors and no patient harm occurred, but Mary was quite upset and alarmed about these mistakes and sought consultation with one of her peers. She was advised to cut back her hours.
Several months passed and Mary began to notice changes in her physical and cognitive functioning. She complained of great fatigue, muscle pain and weakness, and decreased energy. She also started experiencing significant problems with memory, which she felt was worsening over time. She began to have problems managing her own personal finances that included missing or making double payments on bills. One evening she put a pot of tea on the stove and forgot that it was there until she smelled the pot burning. She was most upset by an incident of getting lost while driving in an area that she had been before in the remote past. These incidences were quite worrisome to her and she sought out the assistance of her primary care physician who eventually suggested that she might benefit from a therapist and perhaps down the line a memory evaluation. In the midst of all of these changes, Mary felt that she could no longer maintain her private practice and she began to consider the possibility of closing her private practice after dedicating most of her life to get it up and running.
After reviewing the case study, share with us your initial impressions of Mary and then respond to the following:
1) Based solely on Mary’s report, what are your initial impressions of what is going on in her life? Does she have a problem that warrants formal treatment? What are some preliminary or working diagnoses that you might consider for her? How might a thorough assessment help her?
2) Mary is forthcoming about what is going in her life, but what other questions do you have about her background that she has not mentioned and why?
Please be reassured that there are no right or wrong answers for this discussion board so share with us your thoughts about this case. Include any personal reactions that you have about Mary and how you think this might impact your interactions with her.