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					Jodie #4

 Jodie is a 16-year-old female who lives with her biological parents and a younger
brother. The family gets along fairly well together. Eight months ago, Jodie began
experiencing hallucinations and developed a fear of people that has restricted her actions
tremendously. She is afraid to leave the home, and has been out of school for the last 4
months. Jodie rarely leaves home, and she takes antidepressants in conjunction with other
anti-psychotic medications in an effort to help her cope with her problems. Mrs. X has
had to quit her job in order to stay home with Jodie, and a counselor comes to their home
twice a week to help assist/counsel Jodie and her mom. Mrs. X is grateful for all the
support. Mrs. X expressed her belief that Jodie will be on medication and will need
counseling "for the rest of her life."


Jodie was in the 11th grade at the local high school and did well in school until 4 months
ago when she was no longer capable of being with people. In addition, Jodie’s
medications caused concentration problems at school as well as home. She also has
problems remembering things like she used to, simple things like math or spelling.


Jodie has great difficulty getting her chores done now. She also cannot be trusted to
observe safety rules anymore. For instance, she turns on the stove or the iron, and then
forgets what she is doing and wanders away. Mrs. X reported that she watches Jodie
"every minute" to be sure she is okay. Mrs. X states that she is prescribed medication for
depression and sometimes can barely watch or take care of Jodie. One time last month, it
took her two hours to find Jodie, who was hiding in her closet because she was afraid that
someone was in the house. Mrs. X had taken a nap due to her depression and did not
realize what was happening with Jodie.


Since Jodie does not leave home, she does not have any problems in the community.

Jodie is a gentle girl, but she no longer can function like she used to. She is afraid of
people, and is convinced that if she leaves home, someone is going to "get her." She
cannot be left alone for any period of time. She has developed odd mannerisms and
somewhat bizarre behavior, which make other kids feel very uncomfortable around her.

She has always tended to be shy and somewhat withdrawn and used to have several
friends that she hung out with. Since her problems started about eights months ago, her
friends gradually stopped coming over or calling.

When Jodie is feeling well, she looks forward to seeing her counselor.


Jodie is depressed, especially in the times when she realizes how her life is changing. She
"totally shuts down" and says that she wishes she had never been born. She does not like
to deal with people, and since she feels safe at home, she refuses to leave her house. Mrs.
X reports that Jodie thinks about death or suicide every day, and she is afraid that Jodie
will succeed in killing herself someday. Mrs. X reports that she has to hide her own
medication since Jodi presented Mrs. X with her pills two months ago and said that she
was going to use the pills to kill herself. Mrs. X added, “Jodie’s counselor knows her
situation and is trying to get her more help. We have a plan in place and numbers to call
if she tries to harm her self, but we still feel uncomfortable knowing she might try again
at anytime.


Jodie complains of constant headaches and feels tired all the time.


Jodie has told her mother that she would like to die, and that she would take lots of pills
to kill herself.


No problems with substance use were reported.

Mrs. X reports that Jodie has frequent visual hallucinations. She sees ghosts and people
standing near her. On two occasions in the last six weeks, Jodie attacked her brother
fearing he was an intruder. She is convinced that people will "get" her if she leaves
home, so she refuses to go out. Simple memory tasks such as household chores she used
to do are very infrequent, as Jodie cannot remember how to do them.


Even though Mrs. X has had to quit her job, Mr. X is able to support the family on his
salary alone. Although they had to cut corners and give up some of their favorite things,
they realize that Jodie needs her mother at home.


Mrs. X reports that her and Jody have extended family that live close by and often stay
with them.

Mrs. X reports that she has been depressed "all my life," and she worries that she might
not be able to take care of Jodie as well as she should. Sometimes she gets so depressed
that she has a hard time forcing herself to get up in the mornings, and she takes naps
during the days. Fortunately, these severe periods of depression only happen about once
every other month, and only last for a couple of days at a time. However, Mrs. X realizes
that her family is near-by to help when needed. Mrs. X indicates that she is able to watch
Jodie now, but is afraid if things don’t improve even with the help she receives now,
Jodie may succeed in killing or hurting herself.

Child ID:___Jodie #4_________ Date Assessed:____/____/______ Service Start Date:
Agency Case #:__________MaineCare #_______________ DOB: ___/____/_____ Gender ___M
Child’s County Residence: _________________ BDS Region: ____ I ____II ____ III
Rater Name:____________________ Agency/Program Name:_____________________________
Rater ID#:______________________
                                               Services Program (check of the following)
CAFAS Administration:                                  MH Case Management _____
 ____ Baseline____ Entry into Service                  Children’s Behavioral Health
Services(65H) ____
 ____ Annual ____ Exit
 ____ Other ___________________

                            Scale Scores for Youth’s Functioning
                                     DIMENSION                                                       DIMENSION
                                                                                                   Choose one rating option
                                                                                                    (30) (20) (10) (0)
 Role Performance

 Behavior Toward Others

    Self-Harmful Behavior

 Substance Abuse

                                                                     Total for Youth

 Levels of Overall Dysfunction based on Youth’s Total Score
 8-Scale Summary               Description
 0-10                     Youth exhibits no noteworthy impairment
 20-40                    Youth likely can be treated on an outpatient basis, provided that risk behaviors are not present
 50-90                    Youth may need additional services beyond outpatient care
 100-130                   Youth likely needs care which is more intensive than outpatient and/or which includes multiple
                            sources of supportive care
 140 & higher             Youth likely needs intensive treatment, the form of which would be shaped by the presence of
                            risk factors and the resources available within the family and the community

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