Rick is a 37-year-old male who presented for outpatient treatment stating, “I never feel happy.” Rick has diabetes (which he manages) and a profound hearing loss. He reports that things seem to have “gone badly” shortly after he got married a few years ago. Prior to his marriage, Rick had a very close relationship with his family, particularly his mother and grandmother. He was highly involved in his church community as well as the deaf community. Despite his limitation Rick excelled at playing the piano and seemed to have a natural gift with computer technology. He had a job working for a community newspaper where he formatted the pages of each edition prior to publication. Since his marriage, he reports that “things have to go her way.” Rick is no longer involved in most of the things that once brought him much joy. His wife convinced him to quit his job at the newspaper in order to move to her hometown, which is a three-hour drive from the community Rick was connected to and where all his friends and family live. They have recently been forced to declare bankruptcy and have moved in with her father until they can get back on their feet. Rick is now stocking shelves at the local grocery store. His wife visits him there often. He has gotten into trouble on more than one occasion for his wife’s frequent visits. Rick’s wife allows him very limited contact with his family. Rick and his wife have a strained relationship and he reports spending much of his time and energy trying to keep her from getting mad. Since he has no other supports here, he depends on his wife which makes him feel embarrassed and bothered. Even though they spend most of their time together, he misses the companionship of his friends and family members. Rick reports that he has not been able to feel at home in his new community although he is beginning to reach out to co-workers at work. He has no deaf friends or connection with that culture with which he strongly identifies, and no access to deaf gatherings or TV or movies with adaptations for the hearing-impaired. Rick has difficulty communicating with others due to his deafness and limited verbal abilities. Rick reports that all of his free time is spent either with his wife’s family or doing whatever she wants. Rick’s mother and grandmother worry about him constantly and describe his wife as controlling. His family would love to be involved in his life more but are only able to have limited contact with him. Rick has a history of becoming explosive when he is angry and even though he has not had such an outburst in quite some time his family worries that his stress will reach a point where this will become an issue again.