Sarah Straitjacket

A significant portion of Dr. Smith's private practice comprised clients who had been referred to him from a psychiatric hospital. These included a former inpatient at the hospital, Ms. Sarah Straitjacket. During the initial 20 minutes of the intake session, Sarah reported that she was 15 years old and was in her sophomore year in high school. Sarah told Dr. Smith that her parents were divorced and that her mother had custody of her and her two younger sisters. The client reported that her mother repeatedly said that she was tired of taking care of her and her sisters and that she thought that her mother wanted the children out of the home. Sarah went on to say that she had been placed in the hospital because of her aggressive and defiant behavior toward her mother. In addition, Sarah stated that she thought that her mother had become involved with another man prior to the divorce and that her mother liked him more than she liked her children. Sarah expressed considerable anger toward her mother and the belief that her mother and was trying to "get rid of her."

Dr. Smith's case notes indicated that Sarah seemed agitated and felt persecuted by her mother. As he was conceptualizing the case, he recognized the similarity between this case and previous referrals from the hospital and recalled that the diagnoses in those cases had been paranoid schizophrenia. The case notes indicated that Sarah seemed to be functioning at an adequate level to be treated as an outpatient and that Dr. Smith regarded her as suffering from paranoid schizophrenia.

What do you think the diagnosis is?

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