Psychological Evaluation for Homer Brine).

Click here to read the second case study (Psychological Evaluation for Homer Brine).

Once you read the case, complete the following tasks:

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Identify a principal and secondary diagnosis for the assigned case study with rationale for each diagnosis.
Describe multiple elements of the etiology for the principal and secondary diagnoses. Explain how the etiology contributed to each (principal and secondary) diagnosis.
Identify a specific therapeutic modality for each principal and secondary diagnosis.
Apply therapeutic modality to treat each of the principal and secondary diagnoses in the case study.
Identify at least one differential (alternate) diagnosis for the principal and secondary diagnoses.

Assignment 2: Etiology and Treatment
In this assignment, you will discuss the etiology and treatment of your principal and secondary diagnoses for the following case study using a minimum of eight peer-reviewed sources on etiology and a minimum of eight peer-reviewed sources on treatment. Your paper should have separate sections for the etiology of each principal and secondary diagnosis, therapeutic modalities for each principal and secondary diagnosis, justification of the selected therapeutic modalities for the disorders, application of the treatment for the disorders, and a reference page for your sources. Your citations and references should be in APA style, and your paper should be 8–10 pages in length.
Once you read the case, complete the following tasks:
• Identify a principal and secondary diagnosis for the assigned case study with rationale for each diagnosis.
• Describe multiple elements of the etiology for the principal and secondary diagnoses. Explain how the etiology contributed to each (principal and secondary) diagnosis.
• Identify a specific therapeutic modality for each principal and secondary diagnosis.
• Apply therapeutic modality to treat each of the principal and secondary diagnoses in the case study.
• Identify at least one differential (alternate) diagnosis for the principal and secondary diagnoses.
• Discuss key cultural factors that may influence diagnosis and treatment.
Write in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources; and display accurate spelling, grammar, and punctuation. Include citations in text and at the end of the document in the correct APA format. The case for study is below.

Please only use sources dated after the year 2013, and make all diagnosis according to the DSM-5.
Psychological Evaluation

Confidential: For Professional Use Only
Name:
Date of Birth:
Date of Evaluation: Clinician:

Homer Brine
1-11-65
7-30-08
A. Adler, Phd
Reason for Referral

Brine was referred by the Division of Family Services for a psychological evaluation to assess his current level of cognitive, behavioral, and emotional functioning and to provide recommendations for outpatient mental health services and family reunification.

Background History

The following background information was obtained from an interview with Brine and a review of available records.

Brine is a forty-three-year-old Caucasian male who was referred for a psychological evaluation by the Division of Family Services to assist with providing recommendations for outpatient mental health services and family reunification. He became involved with the Division of Family Services after he was arrested for sexually abusing his daughter. Brine was informed that the results of the evaluation would be utilized to develop opinions and conclusions regarding the likelihood that he would revictimize his daughter. In addition, he was told that the report or the examiner might appear at his court proceedings to give evidence regarding his past, present, or potential future mental state. Brine chose to participate in the evaluation recognizing the nature of the evaluation and its purpose.

Brine was born in York County, Pennsylvania, in a rural farming community near the Maryland state line. He was the older of two children raised in a “traditional Christian home.” When Brine was a young boy, his family moved to Wheeling, West Virginia, due to his father’s employment with a mining company. Brine’s mother was a “stay-at-home mom” who was actively involved in her sons’ school-related activities. Brine described his parents as hardworking people who always supported him. He reported that he had begun having school learning problems in middle school related to comprehending and retaining learned
materials. Brine described himself as a “quiet” child who “always had difficulty in school.” He described being involved with special educational services throughout his secondary education (middle school and high school). He received small group instruction and individualized assistance with learning arithmetic skills, developing memory skills, and improving his comprehension. Brine was an impulsive, distractible, and active boy who had difficulty completing school assignments and interacting with peers in the classroom. He obtained part-time employment after school and during summer vacations and worked for the Natural Services Department cleaning campgrounds. Although Brine enjoyed working for the Natural Services Department, he was unable to obtain full-time employment after his high school graduation due to his learning problems.

Brine continued to live with his parents after he graduated from high school, moving back to York County, Pennsylvania, with his family after his father lost his job (was laid off). He reported having felt awkward in social situations throughout his teenage years, choosing not to date due to a fear of being rejected by his female peers. Brine’s difficulty with social skills not only affected his interactions with others but also interfered with his ability to communicate with his coworkers and supervisors in a work-related environment. He has had difficulty maintaining employment as evidenced by his history of losing jobs due to poor attendance and insubordination. After many failed vocational pursuits, Brine and his family began working with the Office of Vocational Rehabilitation (OVR) to assist him with job training and social skills development. He described having participated along with several work crews doing janitorial work at local schools, office buildings, and small businesses. Brine stated that he enjoyed working independently due to the difficulties he faced in relating to his coworkers. He often needed assistance with handling interpersonal conflicts and managing his anger (negative mood).

While at OVR, Brine met his wife, Kelda Brine, after an introduction by mutual friends. Their relationship progressed rapidly and within months, they began living together. Brine described his wife as a “mentally retarded” and “slow” woman who “needs a lot of guidance.” She reportedly has difficulty with decision making and lacks appropriate parenting skills. Brine and his wife argue frequently due to her irresponsibility and irritable mood. They have a history of verbal and physical aggression toward one another, which has included pushing, saying hurtful things, and threatening to kill each other. Brine acknowledged having made statements that he did not mean and feeling remorseful after their arguments. Brine acknowledged that he was unable to set appropriate boundaries or create a structured environment at home. Although his parents often attempted to help him with establishing limits in his home, his wife would refuse. Brine’s mother and wife have a strained relationship due to their inability to communicate and their differences in parenting styles. Consequently, his wife has refused to accept help from her in-laws due to the fear that they “would take her daughter away.” After the Division of Family Services became involved with his family, his wife’s biggest fear came true-their daughter was removed from the home and placed with his parents.

Brine stated that he was incarcerated because he sexually molested his kid-he was in the closet naked with her. He described having had a pornographic magazine that he showed to his daughter and reportedly touched her inappropriately. Brine stated that he did “not remember” touching his daughter at that time; however, he admitted to having his daughter touch him in his private area in the past. He spoke of their sexual relationship beginning when his daughter was seven years old. Brine had told his daughter “not to talk about it” to anyone. He reported that his wife had walked in on them two years ago, saw what was happening, and didn’t say anything. He stated that his wife probably did not understand what was happening or did not want to know about it. Brine described the abuse as including both contact and noncontact acts. The sexual abuse involved multiple incidents over time as the activity progressed from less invasive to more invasive (began with exposure and fondling and had moved to digital and oral penetration). Although Brine denied having engaged in sexual intercourse with his daughter, he stated that she “would be able to describe what it is” due to having walked into their (her parents’) bedroom without their knowledge.

Brine and his wife have been referred counseling for marital therapy and assistance with parenting. He described having difficulty setting limits for his daughter and struggling with decision making. He reported that his daughter “is in charge at home,” often ignoring her parents when she is told that she cannot do something. He has disciplined his daughter by taking something away from her, making her sit in her room, yelling at her, or thumping her on the head. The two household rules that are enforced include not going out of the yard without permission and going to bed at 8:00 p.m.

Brine denied recent alcohol or drug use, stating that he only experimented with alcohol and marijuana as a teenager. Legal history is significant for a previous charge of Arson (1990) that resulted in a ten-day jail sentence and a year of supervised probation and his current charge of incest.

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