Summative Assessment Scenarios

Summative Assessment Scenarios
A CAMHS Case Study- Molly
Molly is a 13 year old girl who lives at home with her Mum (Lucy) and her pet dog (Frank). Molly has never met her Dad. Molly’s Mum works as a care assistant in the
nursing home in the next village, and also works three evenings a week in the local pub in order to make ends meet, leaving Molly to do the majority of the cooking,
the shopping and the house work.
Molly often eats a lot of take away food as she does not enjoy cooking, and has around 4 take away meals a week. She struggles with her sleep as she misses her Mum and
worries that her Mum will be cross with her if she has not managed to do the house hold chores. Molly is struggling at school as she is always feeling tired, and all
but two of her friends have slipped away from her as she does not have time to socialise with them after school.
Last year, Molly’s maths teacher asked the students to take their height and weight, and then manually calculate their BMI. He then wrote all the BMI results on the
board. Molly’s BMI was the highest in the class (she scored 33), and a gang of girls have been teasing her relentlessly as a result. They shout “fatty” at her in the
corridor, throw food at her, and recently weakened the legs on her science stool, so that when she sat down the stool collapsed. Molly has not spoken to anyone about
this; she is worried about burdening her remaining friends, she is not close with her teachers and does not want to worry her Mum.
Molly has started spending her break times sitting in a toilet cubicle as she wants to avoid the bullies. Six months ago, Molly scratched herself with her nails when
she was feeling particularly stressed, cutting her arm. She was surprised to find that this made her feel better, as it helped her forget her problems for a moment.
She then began experimenting with cutting, using her maths compass to cut her arms and legs when she felt upset or helpless. Molly is now finding that she has to cut
deeper and deeper in order for cutting to help her, and has recently began using razors as they are sharper, and the cuts are more precise.
Molly is ashamed of the cuts on her arms and her legs. she has begun wearing long sleeve tops to hide the scars, even though it is summer. The gang of girls have also
been teasing her about this. Molly wants the scars to go away, but does not know how to stop cutting herself. Last week, one of the girls tried to pull up Molly’s
sleeves, and Molly hit out, striking her in the face. Molly has been suspended as a result.
Lucy is aware that Molly has been suspended from school, she is very angry with Molly and has forbidden her from leaving the house during the day.
Molly is spending all day alone in the house, watching TV. She is starting to wonder about the purpose of her life, and feels that no one would miss her if she was no
longer around. She has hidden an old kitchen knife under her bed ‘just in case’ things become worse.
Molly finds that she spends most of her day thinking about death, and has been keeping a diary about her thoughts and her worries. She is beginning to worry that
there is something seriously wrong with her.
Molly decides to talk to her Mum about how she is feeling, and shows her Mum her diary. Molly’s Mum is very upset and worried about Molly, and takes her to the GP the
next day. The GP immediately refers Molly to the adolescent CMHT, and you have been asked to meet Molly and complete the initial assessment.
2. Abdul has moderate learning disabilities and complex needs. He is 26 years old and lives in his family home with his parents and a younger brother and sister.
Abdul has spastic quadriplegia and is demonstrating the characteristic signs of arthritis and tendonitis.
Abdul is unable to walk, sit up unaided or control the movements of his limbs or hands. He experiences muscle spasms resulting from the pain and/or stress of the
tightness experienced by his spasticity. Abdul spends his day in a wheelchair which he is reliant upon others to maneuver.
He is also reliant upon others to maintain his continence, wash, dress and feed him.
Abdul has some intentional language. He speaks in short sentences of about 3-4 words. Sometimes his communication will be a mixture of English and Urdu. Abdul’s
parents family first language is Urdu, and his Mother, who is his main carer speaks little English.
Abdul experiences a number of physical health needs, including:

• Epilepsy: Abdul typically has absences as well as myoclonic seizures. Within the last 12 weeks he has had two episodes of tonic clonic seizures that have
progressed to status epilepticus for which he was hospitalised as an emergency on each occasion.
• Abdul has a BMI of 16.5, and this has been decreasing across the last 14 months.
• Abdul suffers constipation. Although a bulk-forming laxative is indicated , Abdul is unable to take this due to swallowing difficulties
• Abdul suffers frequent occurrences of bronchitis, and twice in the last 12 months had bronchial pneumonia.
• Abdul has a history of pressure sores on his ankles, with the sore taking a very long time to heal. Currently one of his ankles is beginning to show
characteristic signs of redness prior to breaking down.
Abdul has been admitted to hospital because of a bronchitis. You have been asked to meet with Abdul and complete the initial assessment.
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