WassonB_C-PAD

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American Military University *

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COUC604

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Psychology

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Dec 6, 2023

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C-PAD 1 Case Presentation Assessment and Diagnosis (C-PAD) Jack Student Name School of Behavioral Sciences, Liberty University

C-PAD 2 Basic Case Summary Identifying Information Date of initial assessment – July, 5 th 2023 Client’s name – Jack Employment status – Employed School status – Graduate school Age – 43 years old Gender – Male Presenting Concern Jack was mandated to attend counseling by his work superior due to concerns of “volatility. Emotional exhaustion and imminent burnout”. Jack denies these claims and states that his behavior, “exhaustion, physical and emotional stress, exposure to threats and loss is a routine part of his job description.” Jack was not interested in counseling and did not do so willingly, he was just “following orders.” Background, Family Information, and Relevant History Jack is a 43-year-old white male, who works as a field agent in a life-threatening, high stakes environment. He was born in California, the oldest of two children of parents who separated when he was an infant. Jack has a brother, Graem, his father, Phillip (an industrialist), and a daughter, Kim. Jack’s mother has not been in his life since the divorce of his parents, he was raised by his father. He has a distant relationship with his father, with minimal contact. Jack and his brother do not have a relationship due to his father, who he states “fostered competitiveness” between the two of them. Jack attended college at UCLA, and later went on to study at the University of California, Berkley, where he was earning his master’s degree in criminology and law. During this time, he met his wife, Terri, the mother to his daughter, Kim. Before finishing his degree, Jack joined the military. His time in the military helped him develop many skills and abilities, his records indicate that he was well respected and excelled in his career. He was successful and seen as

C-PAD 3 “being fiercely intelligent, yet lethal, combatant who stopped at nothing to accomplish his missions.” Jack has had many difficulties in his work and personal life. He witnessed the death of his wife, who was killed by a trusted coworker. After this incident, he and his daughter were estranged. His daughter was not able to maintain a relationship with him following the tragedy of his wife, her mother. Jack became apprehensive of those around him due to his fear of being betrayed. Jack has lost many coworkers and those he needed to protect. He is now living with guilt due to his inability to save the president from assassination. He has isolated himself at work and has been avoiding certain job duties. Jack has had difficulties falling and remaining asleep due to graphic and disruptive dreams. He also suffers from intrusive, random themed images while he is awake. There is no religious or spiritual information to provide at this time. Problem and Counseling History During Jack’s time with his employer, CTU, he has had annual mandatory evaluations by staff psychologists. These professionals have habitually recommended that he participates in ongoing counseling. Jack was not interested in counseling, and only attended counseling because he was “following orders.” His participation in counseling has shown that he is not interested in being there. He has given short responses to questions, minimal eye contact, and unprompted information. The short responses occur when asking questions about his feelings, his job and the difficulties he has faced and those he has lost. Due to Jack’s reluctance to be in counseling and his attempt to just try check the boxes in order to portray that he was “alright,” he said whatever he needed to say in order to do so. He was well oriented during the session, although visibly fatigued, irritable, and impatient, he was

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C-PAD 4 able to convey remote and recent events. When expressing his thoughts and feelings on his terms, he was comprehensible. He visibly displayed his anger at his mandated referral and unwillingness to be there. He often used profanity with the examiner when he felt he was not being understood. Jack mentioned that was “self-reliant” and that he “Has learned the hard wat that it is wise neither to trust nor get close to others.” He has opened up about having issues falling and remaining asleep due to graphic and disruptive dreams, he also experiences similar themed images while awake. He had moments where he expressed remorse due to the losses he has encountered in his job, including his wife, displaying visual sadness at this time. He has expressed that “sometimes I just don’t care what the future holds.” He does not have regrets for things he has done in his job, including the killings he has committed. He questioned if he would ever have a normal relationship with his daughter or new grandson. Diagnostic Impression F43.10 Posttraumatic Stress Disorder (principal diagnosis) Z65.5 Exposure to disaster, war, or other hostilities Z91.82 Personal history of military deployment Z65.4 Victim of Terrorism or Torture Discussion of Diagnostic Impression Jack meets the DSM-5-TR diagnostic criteria for posttraumatic stress disorder. The client has been exposed to death or threatened death/serious injury. He has been captured and tortured and exposed to life threatening situations (Criteria A.1). He has witnessed the death of many of his colleagues (Criteria A.2). He also directly witnessed the traumatic killing of his wife (Criteria

C-PAD 5 A.3). He has been exposed to numerous traumatic events throughout his military and current career, witnessing assassinations and death (Criteria A.4). Jack struggles with falling and remaining asleep due to graphic and disruptive dreams (Criterion B.1), while he also experiences similar images while awake (Criterion B.2). When the topic of his capture and torture are brought up, jack has been observed avoiding these conversations and isolating himself (Criteria C.2 & Criteria D.6). Jack believes that is wise to not get close to or trust others (Criteria D.2). Jack has feelings of remorse over the job-related losses and the death of his wife (Criteria D.3). Jack’s superior state that he was concerned with his “volatility.” Jack also displayed irritability and impatience in his session (Criteria E.1). Jack trouble falling and remaining asleep due to disruptive dreams and images (Criteria E.6). Jack’s superior states that since his last mission several months ago, he has been “different” (Criteria F). Jack has been isolating himself at work and avoiding or leaving meetings related to his capture and has also been less able to rally around his subordinates (Criteria G). Jack has no substance abuse issues nor are there any medications that have been reported to attribute to his difficulties (Criteria H). Jack served in the military and was a part of a series of covert affiliations and operations. He was known as a lethal combatant and would stop at nothing to accomplish his missions (Z91.82). His current employment, he works in a challenging field that involves thwarting domestic and international terrorist plots and has stated that “exposure to threats were a routine part of his job description” (Z65.5). Jack was captured and tortured in his last mission and has seemed different since then (Z65.4).

C-PAD 6 References American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

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