UNDER
CONSTRUCTION
Rough Draft:
Writing a Case Study
A case study is a specialized type
of paper used in some social sciences and in medical, legal, and other fields.
It often is found especially in a clinical or social-services setting, it
describes the problem or illness of a patient or client, and it details a system
or therapy for helping that patient. Even though its specific use is in
such fields, it has a more general application of dealing logically and
rationally in a step-by-step manner with any kind of general problem in most
professional workplaces and in many personal difficulties. In so doing, it
follows a common critical-thinking pattern of examining the background of a
problem, the problem itself, a plan for solving the problem, the application of
the solution, and the result.
Though this assignment is in our
story-writing chapter, it is very unlike most story writing in this way: a case
study has a logical, sometimes even clinical tone, whereas a story often has a
more creative and personal tone. However, many of the same skills used in
major revision of a story also are used in developing a good case study: for
example, the five senses and five W’s, an eye for what the client/patient
looks, sounds, and feels like beneath the surface, a sense of the history of the
patient, and especially the classic story-writing focus on a plot: on a person,
a problem, and a solution.
Case studies usually are written
in the past tense—after the patient or client has already been seen and helped
and there is a result to the assistance. The tone should be quite logical;
in some settings, it also should be cool and distance, whereas in others a tone
of warmth is allowed or even encouraged. There is a group pre-writing
activity at the end of this assignment, and a complete case study sample paper
written by a student.
Case studies also have
organizational structures that are very different from stories. There are
many different versions of case studies in different disciplines and different
professions. However, here is a general pattern that is somewhat typical
for developing a case study:
Introduction: a very brief
introduction mentioning the client/patient, the clinic/organization handling
him/her, the person(s) in charge of providing the examinations and therapies or
other assistance, and the purpose of the case study (for medical records, a
research study, etc.).
Client/Patient: a thorough profile—a
description—of the client or patient, the aspect he/she presents at the first
meeting(s), and/or the general background. In this section, use such
devices as the five W’s of journalism (who is the patient; what is he/she;
where does she live, work, play, etc.; when; and how or why?); the five senses
(e.g., how a patient looks, sounds, smells, moves, eats/smokes, etc. is
important in psychological profiles); social and family relations, work and
personal history; etc. Do not yet discuss the problem or illness in this
section.
Problem(s)/Symptoms
& Diagnosis: a thorough discussion of the person’s problem, or a
set of symptoms and a diagnosis.
Plan: (A) COMPONENTS—a description
of the system of help, or of the therapeutic method, that you or your
organization chose for the person. Do this in the abstract, relatively or
completely: do not yet discuss how you or others applied the help or therapy.
(B) TREATMENT--a description of how the treatment was given and/or what happened
during (not after) the process of treatment.
(C) RESULT/PROGNOSIS—a description of the results after the primary treatment
cycle was completed, and/or what the prognosis--the long-range expectations--is.
Conclusion: a very brief conclusion
reiterating the name of the patient, his/her problem or illness, the assistance,
and the result.
Use these sections to break information about the client or patient into the
appropriate parts. Do not tell a story in a narrative form (i.e., don't
just go from event to event in an order of time). Instead, break up
whatever story materials you do have into subject materials--the sections
above--and, in each section, further break up the information by using a subject
system of delivering information. For example, in "Client/Patient"
you can use the five W's, then the five senses, then social and family history,
etc. as subject categories.
A sample case study follows, below.
Group Exercise to Introduce the Writing
of Case Studies
In
groups, create case history profiles. Choose
a made-up person and use either a psychology profile or a social work profile:
|
Person:
Problem:
Solution:
................................................
:
:
:
:
Psycho- : Physical/medi-
: Description :Treatment
:
logy, psy-: cal & 5 W's
: of mental and :
plan + :
chiatric : description
: emotional
: projected :
nursing/ : of patient.
: problems, + :
results. :
services: :
: diagnosis.
:
:
:
:
:
:
:..............:..............:...........:
:
:
:
:
Social :
Marital, work, : Description
: Plan for
:
work: :
financial, & : of
financial, :
various :
: support
: housing, food, : assistance:
: history of
: medical, &/or :
programs +:
: applicant.
: counseling
: projected :
:
: needs/problems.: results.
:
:................:................:............:
|
Describe
on paper the person, problem, and solution aspects of your profile (50-100 words
each); then present your profile to the whole class.
Sample: A Finished Case Study (unedited)
Note: This sample case study by a
third-year college student is modeled after an episode from a popular evening
television drama.
Laleh Yaghoubi
EngC 3014 - Jewell
Section 10
Case Study Draft III
4/19/99
Torture
by Laleh Yaghoubi
The following is a case study of a
male client, Mubilajeh, suffering from a sexual disorder (impotence).
Erectile disorder, the inability to have an erection or maintain one, is
currently the most common sexual disorder among men (Hyde 468). One result
of erectile disorder is that the man cannot engage in sexual intercourse.
For many men, including this individual, psychological reactions to erectile
disorder may be severe: embarrassment, depression, and anxiety. The client
was diagnosed and given an assessment with the goal of determining the factors.
Through a process of discovery, the client's history finally revealed that the
impotence was actually a result of Posttraumatic Stress Disorder (PTSD) caused
by a past experience. People with PTSD fear re-experiencing a traumatic
event and sometimes are unable to remember certain aspects (Barlow 138).
However, through psychoanalytic therapy, this client illustrates a successful
recovery.
Client
This section presents at brief
client assessment and a case history of the client considered in the study.
Mubilajeh, thin proportioned and nearly seven feet tall, is a thirty-year-old
African male who is originally from
Nigeria. Mubilajeh is a peaceful and proud African man. He has been married
to his wife, Zhane, for nine years, and they hope to have children very soon.
At the age of fourteen,
Mubilajeh's father passed away, which left his mother alone to raise six
children. Mubilajeh was the oldest of the six children. After his
father's death, Mubilajeh felt obligated as "man of the house" to
financially support his family. These difficult times forced him to quit
school, and he found a full-time job at a neighborhood library. Mubilajeh
had always been an excellent student in school; he especially missed writing his
creative stories. Mubilajeh found his job extremely boring; therefore, he
kept himself occupied reading anything he found interesting in the library to
pass time. Mubilajeh returned back to school when his brothers were old
enough to work and help financially support the rest of the family. This
allowed all three of them to work and attend school. Mubilajeh eagerly
continued and completed his education at a local university.
In
Nigeria, Mubilajeh became a well-known professional writer and an engineer. He
later published a story that was very controversial, and as a result stirred up
a lot of political debate. The Nigerian government felt that it was a
cause for starting a revolution. Hence, he and his wife escaped to the
United States. They moved to
Philadelphia
approximately four years ago and live in a one-bedroom apartment a mile from
Mubilajeh's place of employment. Mubilajeh is a hard working janitor in
the emergency room section of
St. John's
hospital.
Diagnosis
This section presents a
description of the client’s problems and a diagnosis of the client
under study. Mubilaieh's complaints presented a list of symptoms
associated with a particular kind of sexual disorder, erectile dysfunction
(impotence). This has been a very embarrassing and stressful problem for
him and has put a strain on his relationship with his wife, Zhane. Zhane
has been sympathetic but she is very worried about him.
Mubilajeh was feeling sharp pains
in his lower back and proceeded to see a doctor at his place of work.
During his medical office examination, the attending physician, Dr. Dahl, noticed twenty enormous burn scars all over Mubilajeh's back. Though
healed through time, the scars still felt rough like the bark of a tree.
Dr. Dahl asked Mubilajeh, "How did you get those?" However,
Mubilajeh didn't want to talk about it. 'We don't have to talk about it,
but I am rather concerned about that possible hernia," replied Dr. Dahl.
After x-rays and further tests Dr. Dahl revisited with Mubilajeh and determined
that surgery was urgently necessary.
After Mubilajeh's surgery, Dr.
Dahl reported the successful results to Zhane. Dr. Dahl, concerned about
further possible problems with Mubilajeh's health, asked Zhane how Mubilajeh got
the severe scars on his back. Zhane explained that due to the
controversial story that Mubilajeh published, a group of soldiers came to their
house and captured him. That same night, the soldiers returned and raped
Zhane. After several weeks the soldiers released Mubilajeh. Barely
alive, he finally returned home. He had broken bones, severe burns, and
bruises. Zhane explained that she never told Mubilajeh of her rape by the
soldiers. Also, Zhane volunteered to share that she and Mubilajeh had been
experiencing intimacy problems. During his routine patient check-up, Dr. Dahl
consulted with Mubilajeh about the information Zhane had shared with him.
Mubilajeh confessed that he had been experiencing impotency.
During a standard room
check/preparation one day, Nurse Elliot walked in and found Mubilajeh in the
comer of an examination room. The room was in disarray. Mubilajeh had
blood all over his hands and shirt. Nurse Elliot not only found surgical
scissors in his hands, but also saw Zhane lying unconscious on the floor in
front of him. Security was called and Mubilajeh was arrested. When
Zhane finally became conscious from her coma, she explained that after
shamefully confessing to Mubilajeh of her rape, she repeatedly struck herself
with the surgical scissors. Mubilajeh was only trying to stop her.
"He felt responsible for what happened to me. I felt ashamed, like I
could never please him again," stated Zhane. Mubilajeh was temporarily
released.
Due to illegal entry into
the
United States
, the immigration office demanded to hear Mubilajeh's whole story in court.
Otherwise, Mubilajeh and his wife would be forced to leave the country.
However, Mubilajeh could not remember anything from the incident. It was
diagnosed that Mubilajeh was suffering from a posttraumatic stress disorder.
Plan
This section presents the
treatment plan that was used for dealing with the client's problem. Also,
this section will describe the results and outcome of how that process was
applied. This plan took into consideration the severity of Mubilajeh's
disorder with regard to his resistance to treatment.
COMPONENTS [Type of Therapy
Chosen
]
From a psychological point of
view, most clinicians agree that victims of PTSD should face the original trauma
in order to develop effective coping procedures and thus overcome the
debilitating effects of the disorder. In psychoanalytic therapy, reliving
emotional trauma to relieve emotional suffering is called catharsis
(Barlow 144). The trick, of course, is in arranging the re-exposure so
that it will be therapeutic rather than traumatic once again. A traumatic
event is difficult to recreate, and very few therapists want to try.
Therefore, imaginal exposure, in which the content of the trauma and the
emotions involved with it are worked through systematically, may be used.
Another complication is that
trauma victims often repress their memories of the event. This happens
automatically and unconsciously. On occasion, with treatment, the memories
flood back and the patient very dramatically relives the episode. Although
this may be very frightening to both patient and therapist, it is therapeutic if
handled appropriately.
APPLICATION [of Therapy to This Patient]
Given Mubilajeh's resistance to
seek professional help, Dr. Dahl attempted to find another strategy for
treatment. Mubilajeh was still reluctant to seek psychological therapy,
but he was beginning to feel more comfortable discussing his problems with Dr.
Dahl. As a result, Dr. Dahl spontaneously decided to share a personal
experience with Mubilajeh in which he suffered memory loss caused by PTSD from a
traumatic incident.
He explained the gruesome details
of a viscous attack. "Afterwards, all I could think of was 'why
didn't I do anything?"' explained Dr. Dahl. "You can't . . .you can't
do anything. You're helpless," replied Mubilajeh. All of a
sudden, Mubilajeh remembered what happened to him. He recalled his eyes
tightly blindfolded, the unbearable smell of smoke, the excruciating pain of
being hung by his hands, and the metal irons burning into his skin. He
hopelessly wondered if he would ever taste Zhane's sweet lips again or smell the
scent of her perfume.
Results/Outcome
This section presents the results
of the treatment plan used in the study. After hearing all of the details,
the courts agreed to allow Mubilajeh and Zhane to remain in the
United States
. Due to the psychoanalytic therapy process used by Dr. Dahl, our
diagnosis of Mubilajeh's PTSD showed itself to be valid. Dr. Dahl's strategy was
successful and Mubilajeh was able to remember the details of his traumatic
experience.
Cognitive, Behavioral and Couple
Therapy later used in the treatment process also provided successful results.
Mubilajeh learned to overcome the fear and horror of his past traumatic
experience. The anxiety caused by these emotions was gradually overcome,
as was the sexual disorder.
Conclusion
The author hopes that the case
study presented here has communicated some of the issues and concerns associated
with Posttraumatic Stress Disorder. The author also hopes to show the
damaging effects that patients may suffer as a result of this disorder.
Such individuals are often doubly handicapped. Our hypothesis that
Mubilajeh's sexual disorder was actually a result of PTSD caused by a past
experience proved to be valid. Mubilajeh was not only suffering from severe
psychological problems caused by PTSD, but psychological problems from his
sexual disorder as well. With a helpful, caring doctor and a therapeutic
treatment program he was able successfully recover.
-----
Sub-headers to
incorporate:
Fix
the page-view display.
ALSO SEE THE FOLLOWING:
(1)
Samples of .
(2)
Samples of essay tests at C.
Return to beginning.
Return
to beginning.
----------
| NEW COLOR SCHEMES
|
1. new
gold (for highest levels)
Hex={FF,B9,35}
|
2. new gold moved to nearby hexagon
(secondary levels) Hex={FF,CC,00}
|
3. light
match to new gold and new brown (tertiary levels)
Hex={FF,C2,53}
|
4. lighter match to new gold and new brown (quaternary)
Hex={FF,CF,75}
|
| new brown (for top brown
bars) Hex={E8,97,00}
|
new gold moved directly left to
red-gold, and
lightened (OK)
(5th level?) Hex={FF,88,66}
|
lighter
version of "...red-gold"
(Ann hasn't seen it, yet.)
(5th level?) Hex={FF,A3,88} |
old brown
(OK)
Hex={FF,8F,20}
|
light version of old brown (OK)
Hex={FF,B8,71}
|
CASE STUDY: link
pic within each chapter
table
of contents page: 
