Case Study: Client Profile the Client's Name

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¶ … Client Profile

The client's name is Alyssa Capolitto. She's 25 years old and never married, raised in a Caucasian, Irish- Catholic/Italian-Catholic family. Her family is a primarily English-speaking household, though her grandparents live at home and they speak both English and Italian. The family is firmly middle class: Alyssa's mother works in a bakery the family has owned for 50 years which was started by the grandparents. The father also works in the bakery and brings in extra income as an independent contractor for repair work and home renovations.

The reason the client was referred to me was she was strongly urged by her parents and her primary care provider to seek help for what they describe as her condition which they label to be depression and anxiety. None of the reasons for her referral are legal reasons. The client is aware of her symptoms and she is aware of why her parents are quite so upset however, she dismisses the meaning and the severity of her symptoms. For example, she's stopped showering and changing her clothes, though she describes this as "not a big deal." When asked why she doesn't shower or change her clothes anymore, she explains simply that she doesn't "feel like it." The symptoms that she expresses also appear to radiate from a fundamental eating disorder, but it's too soon to tell with the first intake appointment. For example, her weight loss is extreme; while the client has not been weighed, she appears to be 15 pounds underweight for her height (5'5"). She wears baggy, layered clothing though this clothing does not conceal the boniness of her limbs. She has deep circles under eyes which appear to indicate inadequate sleep. She trails off a lot during conversation and stares out the window, often losing her train of thought, and asking "what were we talking about?" Her pupils are dilated and suggest drug usage. Alyssa confesses to smoking marijuana daily. She also drinks alcohol daily, but she refuses to disclose the amount that she drinks. She also appears to suffer from low self-esteem, using the phrase "I f*cked up" in many sentences.

The current situation presents a conundrum. The client appears to suffer from severe symptoms of a serious underlying disorder. The client's denial that anything is wrong simply worsens the situation and makes treating it more of a challenge. However, one of the benefits to the client is that she has a strong family support system of concerned members. It still remains to be seen if the client has any support outside of the family, such as a group of friends.

Previous assessment and counseling experiences: according to the client's file, the client has received drug and alcohol counseling two years ago, but stopped because she claimed she didn't have a problem. According to the notes made by this counselor, the client had a "borderline" use and abuse of marijuana and alcohol and was dangerously close to substance abuse. This counselor also diagnosed the client with depression and anxiety. However, the client, after working with this drug and alcohol counselor has become even more suspicious of anyone who wants to discuss her drug and alcohol issues with her and gets extremely defensive when talking about it. She was offered anti-depressants but refused to take them, claiming that she didn't want "to be anyone's pharmaceutical guinea pig."

According to the client's parents, her birth and development history were extremely normal. As her mother explained, she was born right on time and gave her mother an easy labor and delivery. On second thought, the mother did recall that she was unable to breast feed during the first two weeks of Alyssa's life, as she was suffering from a staph infection. There was some difficulty in finding Alyssa the type of formula that she would tolerate, and they finally settled on goat's milk as being suitable and something she would tolerate. Alyssa's parents never worried about this issue as they felt that it never impacted their child in a developmental way, as she reached all developmental milestones on schedule, and generally seemed like a happy child. However, on second thought, the father added that she had been a happy child, but a moody child. And that as a child she was given to dark moods that she would fall into for hours or even days. She had been a turbulent teenager and that was something which had stayed with her into adulthood.

As stated earlier, the family unit is intact: the parents are still married and Alyssa has an older brother and a younger sister. The grandparents live in the same house with them and Alyssa's aunts, uncles and cousins live nearby. They describe themselves as a close knit family that abides by a set of rules of acceptable and unacceptable behavior. For example, all members go to church together on Sundays and all make sure they are free for lunch after church. Two of Alyssa's uncles gave up drinking, as did Alyssa's father but none of them believe they are alcoholics: they just feel they are better off without alcohol in their lives. Alyssa's parents make reference to the "Cappolito Temper" which they refer to as a hot-blooded temper that runs in their family. They don't describe what this temper consists of, such as fiery outbursts or actual violence to people or objects, just that many members of the family have it. Alyssa does not, however, they describe. She's much more passive, they assert.

When it comes to Alyssa's medical history, there were no major injuries or accidents aside from the DUI she got two years ago, which forced her to seek drug and alcohol counseling. However, she left the counseling because she said that her blood alcohol level had just been slightly over the legal limit and that the police department had been bullying her. Eventually, her family attorney got the charges dropped to reckless driving. However, Alyssa had smashed up the family car and suffered several contusions and cuts.

Regarding Alyssa's educational history, she has a four-year degree from a local community college where she majoring in advertising and marketing. The job that she just lost was a position as assistant manager at a clothing store. It was her first job ever and she said that she lost the job because "I'm a f*ck-up." However, it's unclear what the exact details of why she was fired exactly are. She said that her difficulties with that job were that, "I got bored a lot" though its unclear how this boredom manifested and what the problems were.

Diagnosis

The client appears to suffer from alcoholism and drug abuse along with an eating disorder. "Numerous studies suggest that eating disorders (EDs) and alcohol and other drug use disorders (referred to throughout this paper as substance use disorders [SUDs]) frequently co -- occur and often co -- occur in the presence of other psychiatric and personality disorders" (Grilo et al., 2002). The fact that Alyssa confesses to drinking every day but refuses to disclose the amount demonstrates a red flag of alcohol abuse. Getting high from marijuana every day indicates drug abuse. Together, the two indicate substance abuse. It also appears as though substance abuse runs in the Alyssa's family, though her parents seem to be in denial about it. "Observations that addiction runs in families… have been supported by formal family studies that indicate a clustering of addiction in families, with higher rates in parents of affected individuals and their relatives [3,4]. Indeed, one's risk of developing alcohol-related problems increases with both the proximity and number of affected relatives" (Ball, 2008). While, it's not of any interest as to whether Alyssa inherited this addiction through her gene pool or through mimicking behaviors learned within the family, it's safe to conclude that addiction does run in families and it runs in her family.

Alyssa also clearly appears to be suffering from depression and anxiety as demonstrated in her dress and appearance: she looks unclean and unkempt. As stated earlier, she has all the physical signs of an eating disorder, including severe weight loss, refusal to eat, and a denial that anything is wrong. She also is extremely avoidant with eye contact, something which has been known to be representative of social anxiety (Cuming, 2009). Furthermore, I wouldn't describe the client as cooperative; she frequently repeats that she doesn't have a problem and that this is a waste of time. While all her fine motor skills appear to be intact, there appears to be a mental issue with attention and concentration, as she often drifts her attention away from the conversation at hand. She also appears to suffer from low self-esteem which appears to fuel her depression. Furthermore, it's been found that individuals with low self-esteem sometimes generate high-stress events through their own behavior, which in turn, only contributes to their depression (Orth et al., 2009). One of the remarkable aspects about the patient's symptoms of depression is that… [END OF PREVIEW]

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