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Capella University *

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5802

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Psychology

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Feb 20, 2024

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Uploaded by CoachDiscoverySheep23

Case Scenario: Thomas is a 39-year-old business owner. He has built his commercial construction company from the start and three years ago had a multimillion- dollar budget. He is married and has three young children, ages 1, 3, and 4; his wife stays at home to care for the children so Thomas can focus on his business. Three years ago, a recession hit and there was a significant loss of work within his community. Thomas reports he is working here and there, but that he can no longer pay his business's or family's bills. Thomas reports that he feels a significant sense of loss, has no motivation to get out of bed, and feels like a failure. He reports that he knows the only way to fix the problem is to do something different or to find motivation to go out and find work, but he just cannot seem to do it. He reports that, to cope with his feelings of incompetence, he started to go to the neighborhood bar. He feels guilty when he goes because he tells his wife he is looking for work. As a result of his increase in drinking, he was arrested for driving under the influence a month ago and was referred to counseling. In addition, Thomas states that his wife wants to get a job to wait tables, as she has never really worked outside of the house but wants to help with the household finances. Thomas does not support this plan because he does not want his wife to be away from the children and states that it makes him feel like less of a man if his wife has to feed his kids when he cannot. Thomas also reports an inability to sleep at night because he is worried about his family, his business, and his failure as a man to provide for his family. Due to Thomas's struggles stemming from employment and the ability to provide for his family the Adlerian Theory would be most appropriate. This type of therapy is short termed (20 sessions or less) is direct and focuses on past and present concerns (Gehart, 2015). With an emphasis on people striving to be successful and transforming from inferiority to motivation this theory would assist Thomas in creating achievable goals and focusing on changing the way he thinks about his ability to provide for his family forming motivation and drive instead. To further assess this scenario, I would start with a PHQ9, this evidence- based assessment too with provide an indication of the severity of Thomas's depression. It appears from the case study that Thomas is struggling with Major Depressive Disorder. The DSM-5 Criteria that Thomas is displaying includes, depressed mood most of the day, diminished interest or pleasure in activities, insomnia, loss of energy, and feelings of worthlessness or guilt (APA, 2013). 1. I would start by working with Thomas to create a treatment plan that is not only achievable but centered on his own personal goals. We could discuss the use of medication and his thoughts and

feelings around Pharmacotherapy. I would then provide him with a referral to a psychiatrist if needed. 2. Thomas will work toward developing coping skills that can be utilized during times where he is noticing his symptoms of depression. During check points of our 4 month treatment plan I would reconduct the PHQ9 to see how his symptoms have changed. In addition, I would check in on any suicidal ideation at every visit and develop an emergency plan for Thomas should those thoughts arise in between sessions. 3. When the final sessions are concluding Thomas and I would discuss the effectiveness of therapy and review the coping skills and other takeaways he has had from our sessions. We would then come up with a plan should he start to feel the depression resurfacing and how he can manage his symptoms on his own or who to contact if he feel he cannot. American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revised DSM-5-TR. Washington D.C.: American Psychiatric Association. Gehart, D. R. (2015). Theory and Treatment Planning in Counseling and Psychotherapy. Cengage Learning.

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