Case Presentation -Stuck. Help!!

[Phipps]

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Hi all:

I am stuck. I have to write up a case of a patient I worked with. I will present the patient as part of a panel discussion.

My problem: I have never presented a case at a conference before and would like some information on how to conceptualize a case, the outline that makes most sense, where to integrate theory and my own thoughts...

if anybody here on this forum could give me a hint where to find literature on how to structure on oral case presentation or has an idea how to write, I would really appreciate any hints, ideas, help!! I mainly need to know how to structure my case. Where do I start, what's next, etc.

I have about 20 minutes for the presentations. Thinking about it makes me nervous but what makes me really nervous is the uncertainty about how to prepare for the presentation...don't want to make a fool out of myself in front of professionals/experts...😱

Thanks for any and all help 🙂

Ms. Phipps

 

[cara susanna]

Have you asked your supervisor? In my program we have to give a case presentation and most people ask their supervisors for help putting it together.

 

[Doctor Eliza]

What theoretical orientation are you using? If you are using a dynamic or analytic conceptualization, Nancy McWilliam's book "Psychoanalytic Case Formulation" is amazing.

For a more general idea of what sections to include, you might do some reading in the journal "Clincial Case Studies."

Best,
Dr. Eliza

 

[kid16]

A format that I've used before from a psychodynamic perspective is as follows... Adapt and readjust as necessary for your patient.

Background Information
Family History
Medical History
Work/School History
Prior Psychotherapy Tx
Ethnicity, Gender, Sexual Orientation, Age
Primary Self-Identification
Initial Impressions at Intake

Transference and Metaphor
Transference Objects
Themes specific to Prior Therapists & Care-takers
Themes specific to Male/Female Figures
Opportunities for Corrective Experience

Erotic Transference
Prior Significant Others
Themes of Possession & Jealousy
Boundaries: Insistence on Hard/Flexible
Response to Perceived or Actual Abandonment

Disclosure of Prior Trauma
Compulsions to Repeat...
Choice of friends, partners, mentors

Resistance to Establishment of Therapeutic Relationship and Insight re: Prior Trauma
Defenses (primitive? or advanced?)
Perseveration
Minimization of Own Trauma
Splitting during Termination
Depersonalization of Therapeutic Process/Relationship

Counter-Transference Themes
Boredom / Excitement
Allowing Minimization
Personally Conflicted about Splitting (allow or challenge?)

Re-framing of Transference – Counselor as Parent/Re-parenting
Pt. Seeking Approval of Therapist
Anxiety/Panic over Potential Future Failures


Not all aspects are going to be relevant all the time with all patients, of course. Nonetheless, I hope this makes sense despite the fact that there are really no details here and this is just my rough outline to verbal case presentations.

 

[Therapist4Chnge]

What theoretical orientation are you using? If you are using a dynamic or analytic conceptualization, Nancy McWilliam's book "Psychoanalytic Case Formulation" is amazing.

For a more general idea of what sections to include, you might do some reading in the journal "Clincial Case Studies."

Best,
Dr. Eliza

Both great ideas. McWilliam's book is wonderful.

 

[kid16]

Both great ideas. McWilliam's book is wonderful.

Definitely.

And, with regard to Phipps' fears of being/feeling embarrassed in the process of presenting a case in front of other professionals, McWilliam highlights - in my opinion - the absolutely best thing about case presentations, especially when you can give in group settings them while still treating that particular patient......... that the other therapists will help you pick up on aspects that your own biases and subjectivity have led you to miss or potentially misinterpret.

Don't be afraid 😉 You will do well, and it should be a great experience for you and those in attendance.

 

[Therapist4Chnge]

In the beginning case presentations will seem scary, but eventually you'll learn to enjoy them. We did them frequently on internship, and they are routine on many post-docs/fellowships, often as part of the department case conference....that was admittedly a bit more nerve racking because of the # of people who typically attend.

Once you are out practicing being able to do a case presentation is a luxury, as many people don't have available time/colleagues to do it on any kind of regular basis.

 

[Phipps]

A format that I've used before from a psychodynamic perspective is as follows... Adapt and readjust as necessary for your patient.

Background Information
Family History
Medical History
Work/School History
Prior Psychotherapy Tx
Ethnicity, Gender, Sexual Orientation, Age
Primary Self-Identification
Initial Impressions at Intake

Transference and Metaphor
Transference Objects
Themes specific to Prior Therapists & Care-takers
Themes specific to Male/Female Figures
Opportunities for Corrective Experience

Erotic Transference
Prior Significant Others
Themes of Possession & Jealousy
Boundaries: Insistence on Hard/Flexible
Response to Perceived or Actual Abandonment

Disclosure of Prior Trauma
Compulsions to Repeat...
Choice of friends, partners, mentors

Resistance to Establishment of Therapeutic Relationship and Insight re: Prior Trauma
Defenses (primitive? or advanced?)
Perseveration
Minimization of Own Trauma
Splitting during Termination
Depersonalization of Therapeutic Process/Relationship

Counter-Transference Themes
Boredom / Excitement
Allowing Minimization
Personally Conflicted about Splitting (allow or challenge?)

Re-framing of Transference – Counselor as Parent/Re-parenting
Pt. Seeking Approval of Therapist
Anxiety/Panic over Potential Future Failures


Not all aspects are going to be relevant all the time with all patients, of course. Nonetheless, I hope this makes sense despite the fact that there are really no details here and this is just my rough outline to verbal case presentations.

This is very helpful since it gives me some guidance/orientation and feel for how to structure. I feel more confident now to develop my own format! 🙂

Thanks much, kid16

Phipps

 

[Phipps]

What theoretical orientation are you using? If you are using a dynamic or analytic conceptualization, Nancy McWilliam's book "Psychoanalytic Case Formulation" is amazing.

For a more general idea of what sections to include, you might do some reading in the journal "Clincial Case Studies."

Best,
Dr. Eliza

I'll get the book from the library and look into journals. So good to have this community of knowledgeable individuals! So rich 🙂

Phipps

 

[Phipps]

Have you asked your supervisor? In my program we have to give a case presentation and most people ask their supervisors for help putting it together.

My supervisor/advisor is a Gestalt Therapist and thus, her orientation is different. We did talk a lot about the case which was very helpful...even played parts of it but the case will be looked at from a more psycho-dynamically focused perspective since that is where I am headed. I thought I come up with the case formulation first and then talk it over with her. My situation is a little odd since I graduate in 5 weeks 😀 with a MS and start my doctoral studies in Fall. So, this presentation is somewhat between both even though I will still be a student in the MS program when presenting.

 

[Phipps]

In the beginning case presentations will seem scary, but eventually you'll learn to enjoy them. We did them frequently on internship, and they are routine on many post-docs/fellowships, often as part of the department case conference....that was admittedly a bit more nerve racking because of the # of people who typically attend.

Once you are out practicing being able to do a case presentation is a luxury, as many people don't have available time/colleagues to do it on any kind of regular basis.

...yep, pretty scary. At least, I got started - and stuck again!!

My question to the experienced ones among us 🙂:

while I am aware of the 'difficult-to-do' yet important and crucial piece of disguising information, I don't know how much and which pieces to disguise. Specifically, there is one piece of information that probably if mentioned would not jeopardize patient's anonymity. It would be important to mention since it is an important piece that led to other things I would want to include. Hard to exchange this particular piece of information with another one...but I am a little hesitant to reveal it.

Is that a normal feeling of a novice?? Or is it good to be that careful with revealing personal information about the patient??

I just don't know how much can be true info and how much has to be exchanged? Where is the line??

Phipps