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Introduction (1/4 page)
Think of an ideal client who has:
Enough information
DSM 5 diagnosis
-Provided identifying information of client (fake name, age, ethnicity, etc)
-Provide a brief description of the presenting problem (symptoms, behaviors)
-Provide a brief description of client’s lack of respond to treatment/intervention
Bio/Psych/Social (2 pages)
This is a clinical assessment of functioning not a problem narrative. Please identify and apply each domain in separate paragraphs for flow and clarity.
This is the story of the client. Breakdown the domains (biological, psycho, sociological)
Use what applies.
-Biological domain
-Psychological domain (include DSM 5 diagnosis and criteria that meets diagnosis in this section)
-include the criteria of the DSM5, and code (cognition, behavior, etc)
-Social domain
-Conceptualization of the interplay between the three (as a whole person, the interplay is a ‘summary’)
FOR EXAMPLE, client has high ACE score (meaning they have high psych factors) and due to their exposure, they may have symptomatic factors or medical problems. (connect the three and how they influence each other)
(This section requires key clinical concepts, see list of biopsychosocial criteria)
McLean’s Triune Brain Theory (2 pages)
-From a neurobiological perspective, discuss the symptoms/behaviors of your client
-FOR EXAMPLE, what does Nuerobiology say about a person who has PTSD, how does it affect the brain and behavior, etc (depth about the brain)
-Identify, define and cite Mc Lean’s Triune Brain Theory
-Identify, define and cite the key concepts of the theory and apply to the client
-Analyze the reason why the prior intervention you used on patient did not work by applying the Triune Brain (WHY DIDN’T THE THERAPY NOT WORK BEFORE)
-Theory/neurobiological perspective and how your current assessment informs the new selected intervention (Do not apply the intervention in this section, only identify it…bottom up or top down intervention)
-Integrate literature to support your analysis
Sources that may help that are attached: Using Concepts from Interpersonal Neurobiology in Revisiting Psychodynamic Theory Judith R. Schore
Paul MacLean and the Triune Brain
Intervention: Bottom Up or Top Down (3 pages)
-Identify, define and cite a bottom up or top down intervention
-Apply the intervention to client problem/symptoms
-show me how you’d apply certain parts of the intervention to your client
-Integrate literature to support your discussion
If using the following interventions, the following sources are available. Use them and also add scholarly sources:
DBT (Top Down or Bottom Up) if using dbt be mindful if bottom up or top down.
-Linehan, M. M. (2015). DBT skills training handouts and worksheets (2nd ed.). Guilford Press.
CPT for PTSD (Top Down)
-Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. Guilford Press.
Chapter 1: The origins of cognitive processing therapy

Chapter 5: Overview of PTSD and CPT: Session 1
Yoga (Bottom Up)
⁃ Body keeps the score, Van Der Kolk
EMDR (Bottom Up) If using emdr include the only procedure MSW’s can perform due to no licensure.
⁃ A guide to the Standard EDMR ,etc Leeds,PHD
Conclusion (1 to 2 sentences)
Consolidating/Summary of paper


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