A 25-year-old male presents to your clinic because he is having difficulty his new job. He works at a consulting firm. He states it is hard for him to give presentations due to concerns that he will embarrass himself and his peers will think less of him. To avoid being put on the spot, he has passed up multiple lead roles and potential promotion as a result. He says this is frustrating because he doesn't have an issue interacting with peers in small groups or friends and in no work settings.
Summarize the clinical case.
Create a list of the patients problems and prioritize them.
Which diagnosis should be considered
What is your rationale for the diagnosis
What differential diagnosis should be considered
What test or screening tools should be considered to help identify the correct diagnosis
What treatment would you prescribe and what is the rationale (consider psychopharmacology, diagnostics tests, referrals, psychotherapy, psychoeducation)
What standard guidelines would you use to assess or treat this patient
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the students position.
Clinical Case Summary
A 25-year-old male, working at a consulting firm, presents with difficulty in giving presentations due to fear of embarrassment and concerns about peers' opinions. He avoids lead roles and promotions due to this fear while having no issues in other social settings.
Patient's Problems and Prioritization
1. Social Anxiety Disorder affecting work performance.
2. Imposter Syndrome leading to self-doubt and avoidance of opportunities.
3. Fear of failure impacting career growth.
Diagnosis
Social Anxiety Disorder should be considered as the primary diagnosis.
Rationale for Diagnosis
The patient's fear of negative evaluation in social situations, avoidance behavior, and impairment in occupational functioning align with the criteria for Social Anxiety Disorder (American Psychiatric Association, 2013).
Differential Diagnosis
Differential diagnoses may include Generalized Anxiety Disorder, Avoidant Personality Disorder, or Performance Anxiety.
Test/Screening Tools
Consider using standardized tools like the Liebowitz Social Anxiety Scale (LSAS) or the Social Phobia Inventory (SPIN) to assess the severity of social anxiety symptoms.
Treatment Plan
1. Psychotherapy: Cognitive-Behavioral Therapy (CBT) to challenge negative thought patterns and improve coping strategies.
2. Pharmacotherapy: Selective Serotonin Reuptake Inhibitors (SSRIs) like sertraline may be prescribed for symptom management.
3. Referral: Refer to a psychologist or psychiatrist for ongoing therapy and medication management.
4. Psychoeducation: Educate the patient on social anxiety, its impact, and coping mechanisms.
Standard Guidelines
Adhere to guidelines from the American Psychiatric Association (APA) Practice Guidelines for the Treatment of Patients with Social Anxiety Disorder. Regularly assess treatment response, adjust interventions as needed, and monitor for side effects of medications (Bandelow et al., 2014).
In conclusion,
addressing the patient's Social Anxiety Disorder through a comprehensive treatment plan involving psychotherapy, pharmacotherapy, and psychoeducation, based on standard guidelines, can significantly improve his work performance and quality of life.
References:
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
- Bandelow, B., et al. (2014). Efficacy of treatments for anxiety disorders: International guidelines. International Journal of Psychiatry in Clinical Practice.