Case Study Undergraduate 1,459 words

Separation Anxiety Disorder: Case Conceptualization & Treatment

~8 min read

Abstract

This paper presents a clinical case conceptualization, DSM-5 diagnosis, and treatment plan for an 18-year-old female high school student referred for emotional distress related to her romantic relationship. The client exhibits recurrent excessive distress, fear of losing her attachment figure, and persistent anxiety about being alone — meeting three core criteria for Separation Anxiety Disorder (DSM-5 309.21/F93.0). The paper explores potential underlying causes rooted in parental divorce and attachment disruption. The proposed treatment integrates Gestalt therapy's empty chair technique to help the client access and process unexpressed emotions, ultimately fostering greater self-awareness and healthier relational functioning.

Key Takeaways

Client Overview and Presenting Concerns: Client background, history, daily routine, and referral reason
DSM-5 Diagnosis: Separation Anxiety Disorder: Identification of separation anxiety disorder diagnosis
Diagnostic Criteria Applied to the Client: Three DSM-5 criteria matched to client behaviors
Treatment Plan and Therapeutic Approach: Gestalt empty chair therapy and trauma exploration plan

Separation Anxiety DSM-5 Diagnosis Empty Chair Technique Gestalt Therapy Attachment Figure Parental Divorce Adolescent Anxiety Case Conceptualization Treatment Planning Romantic Relationships

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What makes this paper effective

The case conceptualization is thorough and methodical, establishing a clear picture of the client's background, presenting concerns, and behavioral patterns before moving to diagnosis.
Each DSM-5 diagnostic criterion is directly mapped to specific client behaviors and statements, demonstrating evidence-based clinical reasoning rather than broad generalizations.
The treatment plan connects the chosen therapeutic modality — Gestalt's empty chair technique — back to the identified root causes (parental divorce, attachment disruption), showing coherent clinical logic.

Key academic technique demonstrated

The paper models criterion-by-criterion diagnostic reasoning: for each DSM-5 separation anxiety criterion, the author cites the relevant standard (Shear et al., 2006; Park & Kim, 2020), then applies it directly to the client's reported behaviors. This structure-to-evidence mapping is a core skill in clinical psychology writing and makes the diagnostic argument transparent and auditable.

Structure breakdown

The paper follows a standard clinical case report format in three sections: (1) Case Conceptualization — client demographics, presenting complaint, social history, and daily routine; (2) DSM-5 Diagnosis — identification of the disorder and systematic application of five diagnostic criteria; and (3) Treatment Plan — psychoeducation, exploration of trauma history, and application of Gestalt empty chair therapy. This progression from observation to diagnosis to intervention mirrors real clinical documentation practice.

Client Overview and Presenting Concerns

The client is a single heterosexual female aged 18 years who identifies as a Caucasian American of European descent. She is currently a senior in high school and is a member of the volleyball team. Her school guidance counselor referred her for assistance with emotions connected to her romantic relationship. The client presents with average weight, a tall stature, good hygiene, is well-groomed, and is casually dressed with no visible marks. During the initial examination, she was well-mannered and maintained an upright posture throughout. She appears attentive, cooperative, and friendly. Her speech rate is rapid but clear and audible. She demonstrates good recall of both past and immediate events, and she seems reliable, though she sometimes shows poor judgment.

Her major presenting complaint is the feeling that her boyfriend no longer loves her. Whenever she calls her boyfriend and he fails to answer, or when he does not respond to her texts, she becomes stressed. She wants her boyfriend's life to revolve around her and prefers he spend all his time with her, which increases her stress. The client indicates her current problem began approximately one month ago. She has no past personal or family history of mental health treatment and is not taking any medications other than birth control. There is no history of physical, emotional, sexual, or substance abuse.

The client was raised primarily by her mother after her parents divorced when she was in second grade. She spent time with her father every other weekend at his home; however, she now finds it difficult to maintain those visits due to other weekend commitments. She prefers to spend her time with friends, her boyfriend, or participating in sports rather than visiting her father. She currently lives with her first cousin, whose parents are also divorced. The two have grown close, and both began dating cousins last year. The client is searching for and applying to colleges nearby because she wants to remain close to her boyfriend, who is a year younger than her.

Her typical day revolves around school, friends, and her boyfriend. With the volleyball season over, she goes to school and eats lunch with her boyfriend and friends. After school, her boyfriend comes to her house, where they spend time together. He leaves to go home for dinner, which allows her to complete her homework before watching television. She texts and calls her boyfriend until she goes to bed. The client considers herself a good girlfriend, fun to be around, and intelligent. Her greatest weakness, she reports, is nervousness when speaking in public. Her thought process is predominantly focused on her romantic relationship, and she exhibits obsessive thinking about her boyfriend.

DSM-5 Diagnosis: Separation Anxiety Disorder

The theoretical orientation selected for this client is Gestalt therapy, specifically the empty chair method. This technique places the client across from an empty chair and asks her to imagine that her boyfriend is seated there (Seen, Ahmad, & Khalid, 2021). The client is encouraged to hold a dialogue with the empty chair as a way of engaging her thoughts, behaviors, and emotions. At some point, the roles are reversed: the client is asked to assume the role of the boyfriend. The empty chair method is intended to help the client become more aware of the full situation and develop the ability to disengage from her self-focused perspective.

The identified DSM-5 diagnosis is Separation Anxiety Disorder (DSM-5 309.21 / F93.0). Separation anxiety disorder is characterized by a person's excessive fear of leaving home or separating from certain people (Park & Kim, 2020). The anxiety must exceed what is developmentally expected for the individual's age and developmental level. For a diagnosis to be made, the individual must experience fear or anxiety caused by separation from a person to whom they are attached. The client demonstrated three of the applicable diagnostic criteria that support this diagnosis, as outlined below.

2 Locked Sections · 590 words remaining

44% of this paper shown

Diagnostic Criteria Applied to the Client · 310 words

"Three DSM-5 criteria matched to client behaviors"

Treatment Plan and Therapeutic Approach · 280 words

"Gestalt empty chair therapy and trauma exploration plan"

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Key Concepts in This Paper

Separation Anxiety DSM-5 Diagnosis Empty Chair Technique Gestalt Therapy Attachment Figure Parental Divorce Adolescent Anxiety Case Conceptualization Treatment Planning Romantic Relationships