Work Examples

Each work example may include elements of consultation, intervention, and assessment. Please note which competencies you believe your two work examples are highlighting, and make sure that all three competencies are addressed within the two work examples.

Contextual Statement:
I am presenting the case of Mr. J, an 81-year-old, White, never-married, post-Korean era Army veteran who was referred for evaluation of decision-making capacity regarding discharge planning in the context of possible elder neglect/abuse in his group home environment. He was referred to our sub-acute rehab unit for strengthening following a fall at his group home. He had a medical history that included: Type II Diabetes, Hyperlipidemia, COPD, Peripheral Neuropathy, amputation of big toe last year, and Chronic Schizophrenia. While in our care several incidents raised concerns about Mr. J returning to his previous living environment where he has been a resident for 25 years.

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Contextual Statement:
I am presenting the case of an 86-year-old Caucasian divorced WWII veteran who was referred for evaluation of his medical decision-making and independent living capacities. He was referred to our Home-Based Primary Care team by his VA PCP to provide services as he had difficulty attending clinic appointments. He had a medical history that included stage III kidney disease, cerebrovascular disease, dementia NOS, hypertension, and B12 deficiency. This veteran had been screened for admission to the HBPC program about six months earlier, and the nurse who saw him at home at that time had been concerned for his well-being in that environment. She felt that the home was in deplorable conditions and after speaking with the veteran’s daughter, she arranged to have him undergo a social admission to the hospital for further evaluation. He had been evaluated by the consultation psychiatry service who felt that he had diminished capacity to care for himself and recommended he return home with services.

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Contextual Statement:
I have chosen to present the assessment case of Mr. X, an 84-year-old, married, Caucasian, non-service connected (NSC) veteran of the Army who was initially referred to the Geriatric Mental Health Clinic by his Geriatrics provider in the context of difficulty adjusting to discontinuing his driving. My work with him has included an initial psychodiagnostic assessment, a brief course of individual therapy after which he transitioned to a support group for veterans with dementia I facilitate, an evaluation of his capacity to discontinue his medications, and a related adult protective filing. For the sake of brevity, I will focus primarily on the capacity evaluation, but I will describe our previous interactions to provide contextual information. I have also included a final individual therapy note/termination summary below for this purpose.

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Contextual Statement:
I am presenting the case of Mr. S, an 85-year-old, White, male, widowed, 10% service-connected, WWII-era Army veteran who was referred to Mental Health on 9/16/12 by the physician for behavior management in the context of increased yelling, cursing, code green (behavioral emergency), and threatening remarks to the nursing staff. He was initially referred to our sub-acute rehab unit on 12/8/11 status-post appendix perforation with drain placement and failure at an outside rehab facility.

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Contextual Statement:
I have chosen to present the intervention case of Mr. Z, a 68-year-old, single Vietnam era veteran who was originally referred to the Geriatric Mental Health Clinic by his VA Primary Care Provider after he called the Patient Call Center requesting anger management services. At our initial session, it was clear that his treatment needs extended beyond anger management. From a period of December 2011-August 2013, I followed the veteran for 38 sessions of individual therapy, an 8-session coping with bereavement group, and a 6-session cognitive behavioral therapy for insomnia group. I started working with this veteran during my fellowship year and continued after I transitioned to my staff psychologist position.

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