Ingram (2012) describes the problem identification process as involving two key tasks: defining “the presenting problem…[and developing a] comprehensive problem list” (p43). The BASIC SID comprehensive problem framework involves assessing the following areas: “behavior, affect, sensation, imagery, cognitive, spiritual, interpersonal, [and medical]” (p43). Developed by Arnold Lazarus in the 1980’s, this assessment method allows a holistic assessment of clients, without the influence of theoretical conceptualization in the process (Ingram, 2012).
I begin by providing a brief description of the components of a “BASIC SID” Framework
BEHAVIOR – what the person is doing / not doing / what others observe / quality of skills presented
AFFECT – internal emotional experience and overt verbal/nonverbal expression of feelings.
SENSATION – awareness of body, use of senses with degree of cognitive filtering of information.
IMAGERY – nature of r/t past/present/future/ dream vs. reality
COGNITION – meaning, self-talk, belief, schemas, etc….
SPIRITUAL – religion/non-religion
INTERPERSONAL/SOCIAL/CULTURAL = relationships with others, family context, social/cultural groups, acculturation levels.
DRUG / ALCOHOL / MEDICAL HISTORY
Next, I provide a brief list of issues present in Illana’s case study (as assigned) then conclude with my impressions of this tool.
Ilana’s Preliminary Problems
Little is provided in the case history that describes Ilana’s specific behaviors during the therapy session. At the same time, it is important that she is described as “significantly underweight” (Author, 2015), and appears depressed. Additionally, it should be noted that she is resistant to therapy and only sought counseling after “the doctor threatened to call child protective services” (Author, 2015).
Affect – Ilana is described as depressed and describes a history of suicidal behavior and cutting behavior (Author, 2015). She describes feelings of worthlessness and states “I’m a terrible wife and mother” (Author, 2015). Additionally, Ilana, describes herself as lonely and “unhappy all the time” (Author, 2015).
Ilana describes a history of cutting behaviors and presents with cuts on her thighs and arms (Author, 2015). She states her cutting helps her cope because it makes her feel better afterwards (Author, 2015). Additionally, she also describes a complex history of eating disorders and states she “always felt better when…hungry” (Author, 2015).
The “mental imagery” (Author, 2015), in Ilana’s case is rich in information on her life history. It provides a useful context with which to understand many underlying issues. Ilana describes her early childhood as idyllic (Author, 2015). She describes memories of her extended family and summer vacations at her grandparents’ lake house (Author, 2015). She describes details of an incident when she was five, of being fondled by an uncle, although states her memory of this incident is vague (Author, 2015). Regarding her eating disorder history, she reports the positive comments from family that encouraged her to maintain these weight loss efforts (Author, 2015). Finally, the early years of her marriage are filled with memories of loneliness and isolation (Author, 2015). She describes a difficulty pregnancy, while her husband is away at basic training, and then an extended assignment in Spain during this time (Author, 2015).
Ilana describes an extended history of depression, self-harm, and anorexia. Her self-talk reflects feelings of self-doubt as she describes her inadequacies as a mother, wife. Distant memories of her childhood with older sister Reyana also reflect this pattern, particularly when she describes herself as “the ugly duckling” (Author, 2015). Ilana’s cognitive skills do not currently reflect a great deal of self-awareness. Instead, Illana is highly resistant to therapy, and has only sought counseling upon her doctor’s assistance. Additionally, she doesn’t display a high degree awareness or self-responsibility regarding her eating disorder, cutting behavior, and suicidal thoughts. Her current mindset is overwhelmed by feelings of depression, loneliness, and inadequacy.
Not much is mentioned about Ilana’s spiritual and religious background. While her early childhood is described as idyllic and involving an extended family with “rich cultural traditions” (Author, 2015), nothing is known about religious aspects of her background.
Interpersonal, Social & Cultural
Ilana is a 28-year-old married mother of two young children ages five and three. (Author, 2015) She is of Hispanic descent and grew up in the Midwest with an older sister in a multigenerational setting. (Author, 2015) She graduated with a Bachelor’s degree in psychology and met her husband, David, in College (Author, 2015). According to the case study she was raised in a large family that is “rich with cultural traditions” (Author, 2015).
Drug & Biological
Ilana describes a history of cutting and is grossly underweight (Author, 2015). Additionally, it appears she has an extensive eating disorder and self-harming history (Author, 2015). In addition to being prescribed antidepressants, she has been hospitalized several times for suicidal behavior (Author, 2015). Finally it is important to note she was unwilling to contract for safety while visiting with her base doctor recently (Author, 2015)
Is This List Comprehensive?
The final part of this discussion board assignment requires us to comment on how comprehensive the BASIS SID assessment is. Firstly, regarding the case study above, the BASIS SID assessment provides a good preliminary overview of presenting issues. Further assessments are naturally critical to define the specific nature of her issues. I would like to assess her eating disorder and depression more closely. Finally, her history of self-harm is also quite concerning and requires closer examination. However, when utilized to develop a “comprehensive problem list”, this assessment method is quite useful. The one caveat I might include, is that the level of experience of its user determines the effectiveness of this tool.