Seperation Anxiety Case Analysis

THE CASE OF KELSEY

The Case of Kelsey

Case Conceptualization

Kelsey is a single heterosexual female aged 18 years. She identifies as a Caucasian American of European descent. The client is currently a senior in high school, and she is part of the volleyball team. Kelsey’s school guidance counselor referred to her for assistance with her emotions connected to her romantic relationship. Kelsey has average weight, tall stature, good hygiene, well-groomed, casually dressed, and has no visual marks. During the initial exam, she was well-mannered in behavior and maintained an upright posture throughout. She seems attentive, cooperative, and friendly. When speaking, Kelsey has a rapid speech rate that is clear and is audible. She has a good memory of the past and immediate memory. She seems reliable though she sometimes has poor judgment.

Her major presenting complaint was that she feels like her boyfriend does not love her anymore. Anytime Kelsey calls her boyfriend and fails to answer or respond to her texts, she gets stressed. She wants her boyfriend’s life to revolve around her, which increases her stress as she prefers he spends all his time with her. Kelsey indicates her current problem began about a month ago. Kelsey does not have any past personal and family history of treatment for mental health problems, and she is not taking any medications apart from her birth control. There is no history of physical, emotional, sexual, or substance abuse.

Her mother primarily raised up the client since the parents divorced when she was in second grade. She spent time with her father every other weekend when she would go over to his house. However, she finds it difficult to visit her father over the weekends as she would in the past due to her other weekend commitments. Kelsey prefers to spend time with her friends, boyfriend, or sports over spending time with the father. Kelsey indicates she currently lives with her first cousin, whose parents are also divorced. She states the two have become close, and they both started dating cousins last year. Kelsey is searching and applying for colleges close by because she wants to be close to her boyfriend, who is a year younger than her.

Kelsey’s typical day revolves around school, friends, and her boyfriend. With the volleyball season over, she goes to school, eats lunch with her boyfriend and friends. After school, her boyfriend comes over to her house, where they hang out. He leaves to go home for dinner, which allows Kelsey to do her homework before watching TV. Kelsey texts and calls her boyfriend until she goes to bed. The client feels she is a good girlfriend, fun to be around, and intelligent. Her nervousness when she has to speak in public is her greatest weakness. Kelsey was obsessive about her boyfriend, and her thought process revolved around her romantic relationship.

The theoretical orientation used for this client is Gestalt’s empty chair method. The empty chair method will place the client across an empty chair where the client is asked to imagine that her boyfriend is sitting in the chair (Seen, Ahmad, & Khalid, 2021). Kelsey will be encouraged to hold a dialogue with the empty chair as a way of engaging their thoughts, behaviors, and emotions. The roles will be reversed at some point where Kelsey will be asked to assume the role of the boyfriend. The empty chair method will help Kelsey become aware of the whole situation and disengage with herself.

DSM-5 Diagnosis

The identified DSM-5 diagnosis is separation anxiety (DSM-5 309.21 (F93.0)). Separation anxiety is characterized by a person’s fear of leaving home or separating from certain people (Park & Kim, 2020). Their anxiety must exceed what is expected of individuals of his or her age and developmental level. For a separation anxiety disorder diagnosis to be made, the individual must experience fear or anxiety caused by separation from a person they are attached to. Our client demonstrated three of the applicable criteria for diagnosing her with separation anxiety. The first one is recurrent excessive distress when anticipating or experiencing separation from home or significant attachment figures (Shear, Jin, Ruscio, Walters, & Kessler, 2006). Kelsey states she gets stressed when her boyfriend fails to answer her calls and texts and when he prefers to do other activities besides spending time with Kelsey. Kelsey’s statement indicates she has excessive distress when her boyfriend detaches from her or when he is away from her. Kelsey is attached to her boyfriend so much that she insists he has to introduce her to his family, and she goes as far as calling his sister when he fails to answer her calls.

The second criterion is regular excessive worry about losing major attachment figures or possible harm to these individuals like injury, illness, disaster, or death (Shear et al., 2006). When Kelsey’s boyfriend fails to answer her calls, she worries he might have someone else. Kelsey fears losing her boyfriend, which causes her to call and text him repeatedly even when he is not responding to her texts or calls. She fears losing her major attachment figure, making her get in touch with his family when he fails to answer her calls. Kelsey is not worried about some har coming to her boyfriend as she did not state that in any of her interviews. Her primary worry has to do with the fact she is not aware of what he is doing when he fails to answer her calls, making her think he is seeing someone else.

The third criterion is the persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings (Shear et al., 2006). Kelsey gets stressed when her boyfriend does not want to spend time with her and instead prefers to do his own things. Kelsey fears being alone, and the only consolation she gets is when she is talking to her boyfriend on the phone.

The client’s fear, avoidance, or anxiety is persistent, lasting at least 4 weeks for children and adolescents and typically 6 months or more for adults (Park & Kim, 2020). Kelsey meets this criterion as she is 18 years old, making her an adolescent, and she has been experiencing this anxiety for the past 4 weeks, as she stated. The final criterion is the disturbance cannot be explained by another mental disorder (Park & Kim, 2020). There is not past personal and family history of treatment for mental health in Kelsey’s case.

Treatment Plan

The first thing would be letting Kelsey know what the diagnosis is. Separation anxiety will be explained to her to ensure she understands her diagnosis before delving further into treatment. Divorce of her parents will be the main focus as this could be the underlying reason she suffers from separation anxiety. By delving into her parents’ divorce, Kelsey can open up about how she feels regarding their divorce and the impact it has had on her life. There is trauma Kelsey is experiencing from the divorce of her parents, and if this trauma is not dealt with, it will not be possible for her to overcome her separation anxiety. Her current relationship is being affected by her parent’s divorce trauma, which causes her to fear losing her boyfriend as she lost one of her parents. The divorce of her cousin’s parents will also be discussed since there is a divorce pattern to those close to her. She might have registered in her mind that people separate, and she does not know how to handle separation in relationships. She might be working too hard to ensure she does not suffer the same fate as her parents and her cousin’s parents.