With an assessment strategy established:
- Analyze how the DSM and ICD may augment guidance for working with families from a systemic perspective.
- Describe the Z code or codes that apply, noting the limitations and risks of using these codes for Annie and her family.
Annie is a 13-year-old Asian American girl; the youngest child in a family of four older siblings. Her parents are both high school teachers and came to United States from India to attend college and stayed to raise a family together. They travel as a family to India several weeks of every year to be with extended family. Annie understands some phrases in the dialect spoken by her extended family, but she and her sisters consistently speak to their parents in English. When Annie was 5 years old, she was hospitalized for three weeks for a serious illness. Since that time, she has been in good health, but has struggled with her fears and anxiety.
Annie is extremely shy and avoids situations in which she needs to interact with new people or large groups. She worries about making mistakes in her schoolwork and becomes extremely anxious when taking tests. Sometimes, she becomes so nervous that her heart races; she begins to tremble and has difficulty breathing. Annie is also afraid of the dark and does not want to be alone in her room at night. She often requires the presence of one of her parents or older sisters until she falls asleep. As her oldest three sisters have left home to pursue their education and careers, the family is finding Annie’s need for reassurance more burdensome.