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How to overcome conquer and struggles

    People are more alike than many people are aware of or would admit to. Perhaps is this no more clearly evident than in overcoming struggles that people are faced with. Some struggles that people conquer and overcome are common to most people while others are encountered and dealt with by a proportionally smaller group of individuals. No matter how miniscule or monumental these struggles are, things can and often do change for the better. People have the ability to overcome challenges at all stages of life, enabling them to move on to lead healthy, happy, and fulfilling lives. Often difficulties can be eased by an individual making a conscious effort to change things for the better for himself or herself, while others may ease their struggles with the emotional, physical, or financial assistance offered by friends or family, and there are also those who rely, willingly or unwillingly, on assistance from mental health professionals to find the road to a brighter tomorrow. Children, unfortunately, as made evidently clear by the story of a four year-old girl named Clara, are no exception to encountering tragic struggles that require professional assistance from mental and behavioral health professionals. Given what is known about Clara, as provided by her adoptive mother and father to Dr. Mason, a psychiatrist, there is still a tremendous amount of relevant knowledge and background information needed to create a truly accurate clinical assessment.

    Given that information gathering is vitally important to making a complete and accurate assessment, many questions must be asked of the Lawsons by Dr. Mason. To begin with, Dr. Mason must inquire about Clara's biological mother's and father's background and the circumstances regarding Clara's birth. Understanding the specifics of Clara's biological parents will help Dr. Mason begin to assess and better understand the magnitude of the concerns that have been raised about Clara's recent behavioral changes. For instance, if Clara's biological parents were involved in drugs, this may have affected Clara's brain development which may be only now starting to surface. In addition, Dr. Mason must question the Lawsons about their level of involvement in Clara's life since she became their daughter. Understanding such an important aspect of Clara's development and the extent of how she is nurtured is vital in creating an assessment. Beyond providing financially for Clara, to what degree do the Lawson's provide emotional, mental, and physical support for Clara? All this is truly important to be able to gain a fuller picture of what this little girl is battling at the tender age of four. Questions could be asked of Clara also to see where her mind is at. Though she is so young, she may be able to express what, or how she is feeling.

    In attempting to gain more information for the purpose of an assessment for Clara, there are a couple of projective tests which may be helpful in gaining further information. The Thematic Apperception Test (TAT) is one and asking Clara to draw is another. The TAT is a projective test which asks Clara to tell a story about two individuals drawn on a card (Comer, 2005). The idea behind this test is that Clara will identify with one of the characters or develop a story about the two characters that represent what she may be feeling. Along the same line of thinking, having Clara identify or explain what she may be feeling, or who she is feeling a certain way about, may be achieved by simply handing her a blank sheet of paper and a pencil. With these tools in hand, Dr. Mason could ask her to draw people, tell who they are, and what they are doing. This may also create a glimpse of what she is thinking and outline her thought process. Conducting a naturalistic observation of Clara in school and at home may also serve as useful tools to gain information about Clara. In assessing the information and factors surrounding making an assessment for Clara, other considerations are necessary to be able to create an effective intervention for Clara's family. For instance, the adoptive parents' level of care that they provide for Clara should be considered. Obviously they have brought Clara to visit Dr. Mason, so they must care deeply for Clara and want what is best for her. With that said, are they willing and able to provide the time, energy, and effort needed for to help Clara successfully overcome these concerns that they now have about the behavior she is exhibiting? Another factor that must be considered is the amount of financing that they are able to provide for treating Clara. Different designs of programs require different levels of financial backing. Dr. Mason would not want to design a program to treat Clara that Mr. and Mrs. Lawson could not conceivably afford.

    In preparation for making a diagnosis for Clara, Dr. Mason must factor in many elements to the DSM-IV classification system. The first axis is used to measure clinical syndromes that cause considerable impairment. For instance, Dr. Mason could recognize signs in Clara that indicate she is suffering from major depressive disorder. The second axis is there to assess if the individual suffers from a disorder which has been overlooked because of signs of a syndrome on axis one. Perhaps Dr. Mason realizes that Clara suffers from antisocial personality disorder. The next axis, axis three, is present to list any medical conditions that may be of relevance to the diagnosis on the upper two axes. Axis four was created to assess psychosocial or environmental concerns of the patient. Finally, the fifth axis is present to ultimately make the "global assessment of functioning" (Comer, 2005). This axis is where the determination could be made, weighing all considerations, about the current status of Clara's classification.

    In the final consideration regarding Clara, Dr. Mason must decide to make a diagnosis or to not make a diagnosis. Diagnosing Clara with a disorder is not recommended unless Dr. Mason is absolutely certain that Clara has a certain psychological disorder. If Clara were to receive an improper diagnosis, this could lead to nothing but harmful effects. Given that Dr. Mason is an imperfect being, the opportunity presents itself for him to misdiagnose Clara. This could stem from any number of variables that goes into making a diagnosis, but the opportunity for misdiagnosis is definitely a possibility. Should Clara receive the wrong diagnosis, she could potentially be faced with monumental challenges in life. For instance, Clara could receive unfair treatment from friends and family members that now assign a certain label to her, rather than just treating her as they would any other girl or woman her age. Additionally, Clara, if misdiagnosed could suffer a huge blow to her confidence and or self-esteem and therefore may only progress to certain point of expectation for herself and those around her; to be wrongly diagnosed may prevent her from achieving all that she would otherwise be fully capable of achieving throughout her lifetime.

    With all these questions answered, the assessment can be done, and perhaps the diagnosis can be made so that treatment can be devised and implemented. Clara's future may be swayed by what is ultimately revealed from this assessment's findings. Either way, whatever happens and is revealed should serve as the beginning point on which a fulfilling and happy future can begin to take shape.