Mental Illness in the Movie "Silver Lining Playbook"
Learning Objectives:
Synthesize available information about a character from a movie who presents with mental illness
Create/Formulate a clinically defensible case conceptualization using a biopsychosocial diathesis-stress model
Develop a viable, clinically defensible treatment plan
Purpose:
The primary purpose of this assignment is to prepare a case conceptualization based on the character chosen. The case conceptualization will be developed using a biopsychosocial diathesis/stress model that takes into account predisposing factors (diatheses), precipitating factors (stressors), and perpetuating factors (maintaining). In addition, resiliency factors (strengths) should be considered.
Instructions
1. Select a character in a film who presents as suffering from a major mental disorder – as your client.
The following movies (and movies like these) present characters about whom a case study may be considered. This is not an exhaustive list, but one you can use and/or to generate ideas for other characters.
If you have another movie and character in mind, please let me know.
A Beautiful Mind
Apocalypse Now
Black Swan
Clockwork Orange
Fight Club
Girl, Interrupted
Good Will Hunting
Inception
Long Day’s Journey Into Night
One Flew Over the Cuckoo’s Nest
Ordinary People
Psycho
Silver Lining Playbook
The Lost Weekend
Vertigo
We Need to Talk About Kevin
2. Below are detailed instructions for the sections and sub-sections of the case study paper.
(N.B.: The case study outline herein is for this paper, only. Case study formats will likely vary at practicum sites, public facilities/clinics, and in private practice settings.)
Title Page
Include a Title page consistent with current APA style/formatting. Do not include an Abstract page – case study papers do not use Abstracts.
Introduction
Begin your case study with a one-paragraph introduction of the character that you will present, a brief description of the movie, and the purpose of the paper, i.e., a case study examination of the character.
Presenting Problem/s
Provide a brief narrative statement describing the specific problem/s the client presents: his/her/their symptoms, reported issues, concerns, struggles, etc. This section is explicitly descriptive, based on client’s self-report (and/or collateral information, if applicable); it is not analytical, explanatory, conceptual, therapist-observational, evaluative, or diagnostic, etc.
You can certainly report here if the client has been previously diagnosed with schizophrenia, for example, but rather than discuss the overall characteristics of this disorder, detail instead, the client's specific presenting symptom/s.
A prior diagnosis can be noted in this section, if the character is diagnosed in the movie. But, as the author of the case study, you must render a defensible diagnosis (that may or may not be the same as a prior one), based on the information available to you (from the movie). The diagnosis/es you provide should be placed in the Diagnostic Formulation subsection of Case Formulation (not in this Presenting Problems section).
Background/Historical Information
This section is also descriptive; that is, what is reported, claimed, or alleged by the client, significant collaterals, records, etc. and/or the evaluator’s observations; not, what you currently diagnose, assess, or hypothesize. This section is comprised of two components: (1) Life Domains (with sub-section headings, per below) and (2) Critical Incidents.
Life domains: Provide cursory, relevant, available information regarding each life domain, including:
Present Living Situation/Family Constellation and SES status, including composition of the client’s present family, socioeconomic status, if available
Quality of Relationships with Parents and Siblings (past and present)
Current Friendship and Romantic Relations
Mental Health Issues in the Family
Mental Health Issues of the Client
Educational and Occupational History
Problems with Substance Use and/or Legal Problems
Cultural Considerations
Information reported in this section should be based only on the film. Avoid creative license, speculation, made-up information, or facts available from other sources to fill in gaps. If no information is available for a particular life-domain, then say so.
Demarcate life-domain sub-sections with sub-headings (e.g., Present Living Situation, Relationships with Parents and Siblings, etc.)
Critical Incidents from the Film: Describe two to four ‘critical incidents’ that will support your case formulation. Critical incidents typically include major, life-affecting and/or life-changing predispositional circumstances and precipitant events.
Case Formulation
Provide a brief overview of the diathesis stress model, followed by a detailed discussion of the four factors that help us understand and explain the deeper nature of the client’s problems. Finally, hypothesize about the subject’s presumed DSM-5 diagnosis/es with substantiating criteria.
Overview of the Diathesis Stress Model: Present a brief (one paragraph), introductory explanation of the biopsychosocial diathesis stress model being applied in this case study. This identifies the theoretical framework within which the case formulation is developed.
Case Formulation: For this section, demarcate sub-sections with headings (e.g., Predisposing Factors, Precipitating Factors, etc.
Predisposing Factors: Major diatheses and stressors that contributed to the development of the character’s disorder
Precipitating Factors: Major event/s that, inferentially, triggered the disorder
Perpetuating Factors: Circumstances that, inferentially, serve to maintain the disorder
Positive/Protective Factors: The client’s strengths and resources that are likely to be useful in treatment and/or augur a more favorable prognosis
Then, present your diagnostic formulation.
Diagnostic Formulation: Integrating the background information with your analysis of the four Ps, present your DSM-5 diagnosis/es. Summarize the DSM-5 criteria to substantiate your diagnosis/es. Address alternative and/or any other diagnoses that you considered and ruled-out.
Treatment Plan
Based on your case formulation and diagnosis, present a recommended treatment plan that is responsive to the client’s mental disorder/psychological challenges, social, cultural (if applicable) situation/resources, and/or personality.
Be sure to detail how you will address any risk factors. For example, if the subject has a history of suicide ideation/attempts, state how your treatment plan will address this.
When preparing a case study, a common clinical practice standard is to consider any strengths and/or limitations of the treatment approach you recommend. If another concurrent and/or subsequent treatment approach would seem to benefit the client, you can add a brief discussion of that approach as well.
You can consider any responsible, ethical, clinically defensible treatment approach; including CBT, DBT, transdiagnostic models, psychodynamic, Adlerian, behavioral, existential, Rogerian therapies, etc., and their contemporary derivative approaches.
Be sure to identify treatment goals, difficulties that may be encountered with this specific client, and possible limitations to the recommended treatment approach.
Conclusion
Finally, add a brief (one-paragraph) conclusion/summary (one paragraph) of your work on this assignment.
References
Lastly, provide an APA-styled list of references that you used and cited for this paper.
Structure
Required components: An outline for this project is as follows (see below for detailed considerations):
Title page
Introduction (brief description of the movie and purpose of the paper)
Presenting problem (description of the client’s reported symptoms)
Background/Historical Information (as only revealed in the film)
Case formulation (based on the biopsychosocial diathesis/stress model)
Treatment Plan (a treatment approach if the client were to enter treatment.
Conclusion (brief summation of the case study paper)
References
Length of Assignment: The text body of paper (i.e., not including references or title page) should consist of approximately 2200 +/- words, (i.e., 10-pages double-spaced typed pages, Times New Roman font size: 12).
Format: Please, format your assignment in Word (files with extension .doc or .docx), or Rich Text Format (files with extension .rtf).
References: 5 scholarly sources
Considerations
Do not make up or fabricate information – the movie is the only source of information, even for non-fictional characters about whom other sources of information may be available.
Sub-sections for which no reported or observed information is available should be noted as such. Do not over-tell the movie’s story or plot-line. Follow the formatted outline.
Note that this assignment is not a theory paper, literature review paper, or research paper; it is, rather, a case study paper. A case study, by definition, provides a concise clinically defensible conceptualization about a client.
In the case formulation section, the DSM-5 may be used to substantiate your assessed diagnosis; however, do not list out the diagnostic criteria, in a bulleted-like or tabular fashion, in your paper. You can assume that the reader (me) is familiar with diagnostic criteria. Instead, summarize the salient criteria that, in your clinical opinion, warrants the diagnosis.
Sources published within the past ten years should be used. One or two older seminal sources are acceptable, provided that they are necessary and relevant to this assignment. Sources can be used in the diagnostic case formulation section and/or to support treatment recommendations and planning.
Appendices, tables, and figures are not acceptable for this assignment.
Since you are one author, use of first-person singular ("I," "me," "my") is acceptable - and preferred, consistent with current APA style.
Final Paper - Case Study - Literature Review
Student Name
Institutional Affiliation Date
Final Paper - Case Study - Literature Review
Introduction
An individual’s relationship with a significant other is an integral aspect of their overall psychosocial and mental wellbeing. Such relationships often activate an innate psychobiological system prompting one of the parties or both parties to develop close ties or dependency on each other for protection from specific threats. In essence, people tend to develop a sense of attachment security based on the support, care, and habitual sensitive responses to their needs from their significant others or those with whom they share very close ties (Ein-Dor, 2016). It suffices, therefore, that individuals tend to activate behavioral attachment systems that motivate them to maintain close ties to their attachment figures for protection against perceived threats whenever they arise. Failure to receive the appropriate or expected response from the attachment figures results in many attachment-related anxiety disorders such as generalized anxiety disorder, panic, and social phobia (Ein-Dor, 2016). Pat Solatano, a character in the movie Silver Lining Playbook, presents an excellent depiction of the role played by attachment as a transdiagnostic factor enhancing individuals’ psychological and biological vulnerabilities that expose them to the outlined forms of anxiety disorders. The film Silver Lining Playbook features Bradley Cooper playing Pat Solatano as the main character who suffers from a mental health disorder triggered by his violent reaction to his wife’s cheating (Russel, 2012). After an altercation with his wife’s lover, Pat lost his job and was sent to a mental health facility for bipolar disorder (Russel, 2012). He goes back to living with his parents, Pat Senior and Dolores, upon his release from the mental health institution (Russel, 2012). He is determined to get his life together by overcoming his mental health problem and winning back his estranged wife. The journey to recovery is characteristic of his desperate attempts to reconnect with his ex-wife, which draws him to a young widow, Tiffany, with whom they make a mutually beneficial agreement (Russel, 2012). Pat has to be Tiffany’s dance partner in an upcoming dancing competition, with the latter delivering Pat’s letters to his ex-wife (Russel, 2012). Pat’s attachment to his ex-wife and its subsequent implications for his mental health problem play out in the movie's unfolding events. Provided herein is a case study of Pat Solatano’s mental health problem toward formulating a defensible treatment plan using a biopsychosocial diathesis-stress model. Problem Presentation Pat Solatano is a middle-aged man placed in a mental health institution in Maryland after beating up his wife’s lover (Russel, 2012). Pat finds his wife, Nikki, cheating on him with her lover in their matrimonial home and goes into a frenzy beating up the man who had taken advantage of his wife (Russel, 2012). He avoids jail for his violent behavior as he is diagnosed with bipolar disorder and placed in a mental health facility for eight months (Russel, 2012). Dolores Solatano, Pat’s mother, discharges her son from the institution after eight months with an additional condition that Pat moves back to living with his parents (Russel, 2012). Pat’s wife, Nikki, has already left him and got a restraining order against her former husband (Russel, 2012). Pat refuses to take medication for his bipolar condition because of the way it makes him feel but attends the mandatory therapy sessions with Dr. Patel (Russel, 2012). Pat further believes that he only needs to live a healthy life and look for his life’s silver linings to manage change on the outside (Russel, 2012). Pat’s main focus is to reunite with his wife by getting back his old job as a substitute teacher (Russel, 2012). He finds it challenging to cope well in some circumstances, as witnessed in one of the scenes where he joins his best friend’s family for dinner (Russel, 2012). He fails to resonate with Tiffany’s loss of her husband. Pat also portrays a low perception of others, as witnessed by his low opinion of Tiffany based on his high expectations from their newly formed relationship. Background/Historical Information Life Domains
- Present Living Situation
- Quality of Relationship with Parents and Siblings
- Current Friendship and Romantic Relations
- Mental Health Issues in the Family
- Mental Health Issues of the Client
- Cultural Considerations