Case Study:Case Vignette

Topic: Case Study
Paper instructions:
Case Vignette
Current Offense:
Genevieve was arrested and jailed for the crime of Aggravated Mayhem —
an act causing permanent disability or disfigurement and is done with the
specific intent of causing injury and with indifference to the well-being
of another person.
Genevieve is a 36 year old, ethnic Samoan Polynesian police officer, a
lieutenant, who has been on work-related disability leave (Workman’s
Compensation) for the past nineteen months. This injury occurred after
she was pushed off a second story roof by an armed robbery suspect whom
she was chasing and attempting to apprehend. She suffered a dislocation
of two lumbar vertebrae and developed a chronic pain syndrome for which
she has been prescribed massive dosages of Vicodin. Her physicians have
considered installing a morphine drip for her pain. Additionally, she
has been prescribed the MAO Inhibitor, Nardil, for intractable dysphoric
symptoms that emerged four months after her work-related accident.
On the day of her arrest Genevieve was being driven in her personal
vehicle to her medical and psychiatric appointments by her spouse,
Elizabeth, who is the 62 year old African American, County Sheriff, when
a car of youth drove by and yelled at Genevieve and Elizabeth, “Get off
the road, you (bleep)ing dykes!” Elizabeth drove up the youth’s car to
get the license number. The youth’s car then slammed on its brakes
leading Elizabeth to rear-end the car. The driver, a young Hispanic male,
jumped out of his car and ran to Elizabeth’s driver’s window. Genevieve
hit her head hard on the side window; then she jumped out of her car,
screaming “Get away from me, you devil!!” Next, she ran around her car,
kicked the youth in the groin, pulled out her penknife and sliced across
both eyes of the youth causing him severe and permanent damage.
Elizabeth called the local police, and Genevieve was arrested and taken
to the local jail.
When she arrived at the jail and was processed, Genevieve manifested
pressured speech and flight of ideas, – shouting nonsense statements,
whirling around, hugging and kissing the jail staff, and trying to walk
on her hands. She was subdued, restrained and transported to the county
hospital locked forensic inpatient unit where she was medicated with
neuroleptics and has remained in partial remission until this date.

Psychosocial History:
Genevieve was born and reared in American Samoa in a moderately large
village composed entirely of her family and extended family. She was the
youngest of eleven children. Genevieve immigrated as a U.S. National to
the U.S. mainland when she was 16 with her two next older brothers, the
youngest of whom had been accepted to a Big 12 university on a football
scholarship. The older brother of the two, 28, set up household for the
brother and Genevieve. The younger brother entered the local university
and Genevieve entered high school. The older brother has a PhD in nuclear
engineering from Oxford University and teaches at the local university.
Genevieve’s early childhood was chaotic and rife with violence. Her
father was a late-stage alcoholic and perpetrated severe battery upon his
wife and his sons for many years. He was killed in an auto accident when
Genevieve was eight years old. Her mother, currently 68, is in recovery
as an alcoholic and developed a Bipolar II disorder and a chronic
concussion syndrome from her husband’s beatings when she was 36. After
several years of untreated and unmanageable manic episodes, the mother is
finally on medication and living with her oldest daughter.
Genevieve was “protected” by her mother and siblings from most of her
father’s violent behavior although she was very withdrawn until her
father’s death after which time she began to excel at school and strongly
engage with her friends. She was an excellent track and field athlete
specializing in field events of the javelin and shot put.
When Genevieve moved to the US at age 16 with her brothers she entered
high school as a sophomore, older than most of her classmates. As the
sole Samoan in her school, she was treated with both awe and trepidation
by her schoolmates. She again became withdrawn yet overcame them by her
athletic abilities. She won the state championship in the shot put as a
junior and senior. She began dating a member of the school’s football
team, a Hispanic fullback, but that yearlong relationship broke up after
her unreported and unshared with anyone “date rape” experience. This
boyfriend was the only intimate relationship in Genevieve’s life to this
point. Genevieve graduated from high school at 19 and entered a local
state college with a criminal justice major in which she excelled.
As a senior, Genevieve participated in a field placement in the local
county sheriff’s office where she met Elizabeth, a deputy sheriff and 26
years Genevieve’s senior. The two began dating when Genevieve graduated
from college. Elizabeth was divorced with three children and had always
considered herself bisexual; Genevieve came out as a Lesbian. The two
moved in together and lived as partners until they were married in
Massachusetts two years ago. The two have experienced a moderate
intensity of homophobia at their workplaces and local communities.
Genevieve applied to the local police department and was hired as a
patrolwoman and quickly moved up the ladder to her current rank of
lieutenant that she has held for the past six years. Genevieve enjoyed
law enforcement “in the field”.
Task Identification:
You are being asked to conduct a pre-trial psycholegal evaluation of
Genevieve for the court to which Genevieve is initially assigned. You are
to act as a forensic mental health evaluator and produce a written report
addressing the questions, below. The report will be submitted to the
appropriate supervisor and presented to the court.

Based on the vignette provided, please compose a well-written and
organized response to each of the following questions. When writing your
responses, please:
• Use APA (6th edition, 2nd printing) Style, with 1-inch margins,
double-spaced, 12 font, with a reference list at the end of each section.
• Write clearly and concisely.
• Cite appropriate, and especially current, literature (empirical
and/or theoretical).
• Avoid all sexist idioms and allusions.
• Remember to demonstrate your multicultural competence where
Psychological Theory and Practice
A. What assessment would you conduct to enhance your understanding of
the client’s problems and how would they direct your diagnostic
formation? In addition, what formal assessment procedures (conducted
either by you or by someone you would refer to) would enhance your
understanding of the problems and direct your treatment planning? Why?
B. Provide a possible multi-axial diagnosis (based on all five (5)
axes of the DSM-IV-TR) for this individual. In narrative form, describe
the differential diagnostic thought process that you used to reach your
hypotheses. What additional information would you need for each of the
possible diagnoses in order to confirm your diagnoses and rule out the
Legal Theory and Application
A. Describe the background, current presentation, and behavior of the
client from a perspective that takes into consideration theories of
offender and/or victim psychology and personality/psychopathology
theories to support your position. (Do not simply restate the client’s
presentation from the vignette. Provide a theoretical-based discussion
of the client that will later help guide your suggested treatment
approach. For example, if you were going to recommend Gestalt treatment,
you would provide a theoretical formulation from a Gestalt perspective in
this section).
B. Describe the psycho-legal standards and/or definitions for each of
the following: competence to stand trial, risk of dangerousness, and
insanity. Identify and describe one or more landmark case(s) for each
standard (at least three cases total). Describe the elements or issues
that a mental health professional usually focuses on when assessing a
person’s adjudicative competence, risk and insanity, and any additional
items that might be especially important to focus on in the provided
Research and Evaluation
A. Describe tests or assessment procedures you would employ to address
these forensic issues (competence to stand trial, risk of dangerousness,
and insanity) (you may refer to these from the Psychological Theory and
Assessment Section A. if you already covered them there), and discuss
what your anticipated conclusions would be based upon information
provided in the vignette.
B. Develop one empirically supported therapeutic treatment plan for
the client in the vignette. Please make sure you identify the name of
the theory your treatment plan is based on and summarize the empirical
evidence with appropriate citations to support your treatment choice in
working with this client. Be sure to discuss the effectiveness and
limitations in working with this particular client (including
effectiveness/limitations in working with this particular client’s
background using the above theories and treatment plans)
Interpersonal Effectiveness
A. What factors or cultural considerations would you take into account
in rendering diagnoses, case conceptualization, and treatment planning?
What other cultural factors may be salient for this client?
B. Your writing, use of citations, and proper APA Style will be
evaluated as a measure of your interpersonal effectiveness. No response
is required for B.
Leadership, Consultation, and Ethics
C. Describe how you would work within a professional team to consult,
triage, and/or treat this case. Include a description of the various
members of the professional team with which you would be likely to
D. What are the ethical and legal dilemmas this vignette introduced?
What would be your immediate steps and the rationale for implementing
those steps? Please be specific and make sure that you describe your
process of ethical decision making and the solutions/consequences this
process might lead to.
Additional materials: not defined