Preparing Case Summaries

Instructions:
Think of this part of the application as preparation for a case conference. You should prepare
brief summaries of two cases of patients you have evaluated or treated (one assessment case and
one treatment case) following the outlines presented below. Each of the summaries should be
no more than two pages in length. Submitting summaries of more than two pages will
adversely affect your application. We recognize that your existing records and reports probably
do not follow these outlines and that you will need to reorganize material for this presentation.

Outline for Assessment Case

1. Identifying Information
2. Referral Question
3. Sources of Data Used in Assessment
4. Summary of Data Relevant to Referral Question(s)
5. Dynamic and/or Behavioral Formulation
6. Diagnosis (DSM IV)
7. Answer(s) to Referral Question(s) and Treatment Recommendation(s)

Outline for Treatment Case

1. Identifying Information and Presenting Problem

2. Description of Problem(s) or Behavior(s) Treated
3. Brief Description of History Relevant to Treatment
4. Identification of Conceptual/Theoretical Approach Used
5. Brief Description of Process of Treatment
6. Outcome of Treatment