This writer would like to know if Ms. Barr takes any other drugs or medication in order to sleep or make her feel better and if so how much, and how often. Mental Health Symptoms:

Mental Status: This writer would like to ask Ms. Barr if she ever thought of harming herself or someone else. If yes, did she have a plan and when was the last time she thought about harming herself or someone else? This writer would like to know if she has ever harmed anyone intentionally. If yes, does she have a plan and when was the last time she harmed someone else. This writer would observe if Ms. Barr's physical characteristics such as clothing, hair color, eye color, mannerisims, interaction with her and include general observations about the person appearance, behavior and social interaction. This writer would describe Ms. Barr's motor activity. This writer would describe Ms. Barr's mood. This writer would describe Ms. Barr's affect. This writer would describe Ms. Barr's self-concept. This writer would describe Ms. Barr's speech. This writer would describe Ms. Barr's thought process. This writer would describe Ms. Barr's thought content. This writer would ask questions to test the Intellectual Functions: Sensorium - Orientation to determine if Ms. Barr's intellectual functions with sensorium in person, place, time, and situation. This writer would then test Ms. Barr's cognitive functions, evaluate her intelligence and insight, and then determine what level of self-control Ms. Barr exhibits through various standard tests. This writer would ask if Ms. Barr has difficulty remembering things in the remote past. This writer would ask Ms. Barr if she has experienced hallucinations, delusions, or other apparent thought disorders.

Initial Impression:

Disposition:

This writer in completing the Mini Mental Status Exam (MMSE) with Ms.

Barr found that she had scored "No Apparent Impairment" according to the vignette.

Ms. Barr has experience symptoms related to a stressful event which is one criteria for...

Ms. Barr has development of emotional and behavioral symptoms in response to an identifiable stressor her promotion which occurred within 3 months of the onset. Ms. Barr has distress in excess of what would be expected from the exposure to the stressor, significant impairment in social, occupational functioning, and the symptoms are not caused by bereavement. Ms. Barr displays symptoms of having difficulties adjusting to starting a new position. As a result she has experienced difficulty with her mood and behavior for several months after the announcement of her new position. She is more irritable than usual. The primary goals of treatment related to the Adjustment Disorder are to relieve these symptoms and assist with achieving a level of adaptation that is comparable to Ms. Barr's level of functioning before the new position.
Ms. Barr has not provided enough information for this writer to determine if she meets criteria for Alcohol Dependence, Alcohol Abuse, or other alcohol induced disorders.

Ms. Barr displays symptoms of Type A Personality. She has an insatiable desire to achieve goals. She has a strong desire for advancement and recognition. She has a desire to multitask under time constraints, a perfectionist in completing task, and always concerned about the work that needs to be completed.

Ms. Barr reports that she has difficulty sleeping and uses alcohol to help her sleep. Ms. Barr reports no other medical problems.

It is recommended that Ms. Barr participate in a minimum of one, one-hour weekly mental health individual counseling sessions for 16 weeks to address her mental health issues. In these sessions, Ms. Barr will be reinforced about the need to identify triggers which exacerbate her stress levels, develop alternative coping strategies, and work toward reducing her anxiety symptoms. In addition this writer recommends that Ms. Barr participates in MAST and SASSI-3 to gather data for this writer to evaluate if Ms. Barr needs additional treatment for substance abuse. This writer also recommends that Ms. Barr participate in a psychiatric evaluation to determine if medications would be clinically appropriate at this time. If a psychiatric evaluation is unable to determine appropriate clinical diagnosis, further psychological testing may be required.