Case Study Jeff Jeffs First Last

Case Study Jeff110case Study Jeffjeffs Case Studyfirst Lastschool

Case Study Jeff110case Study Jeffjeffs Case Studyfirst Lastschool

CASE STUDY: JEFF CASE STUDY: JEFF Jeff’s Case Study First Last School of Behavioral Sciences, Liberty University Author Note First Last I have no known conflict of interest to disclose Correspondence concerning this article should be addressed to David Evans Email: Jeff’s Case Jeff is a 33-year-old Caucasian male who has agreed to being assessed to keep his job as a construction worker, which he has held for 5 years. Jeff has been suspended from work multiple times because of his tardiness and showing up to work smelling like alcohol. Jeff’s parents have been married for 45 years. He is the fourth of three brothers and two sisters. There is a familial theme of heavy alcohol drinking with his father, two brothers, and two brothers-in-law.

Jeff has a strained relationship with his third brother as a result of his excessive drinking. Jeff is a divorced father of two. Other than alcohol consumption, Jeff reported some marijuana use. Jeff has no reported medical history, but described his mom as being sad. Jeff has been incarcerated on three separate occasions: once for physical abuse to his wife, and the others for two individual DUI infractions.

Clients Concerns Symptoms Behaviors Stressors Sadness Domestic violence toward his wife Potential of losing the job he loves Alcohol withdrawals Missing work Divorce/tense relationship with ex-wife Headache due to excessive drinking Being late to work Possibility of losing visitation with his children Depression Drinks alcohol to achieve intoxication Arrests Loss of interests doing activities Hungover at work Strained relationships with family and friends Excessive sleeping Driving while intoxicated Fatigue Marijuana use Suicide Ideation Isolation Loss of appetite Irritability Assessment It appears that Jeff’s excessive alcohol consumption is a large contributor to poor decision-making habits.

It seems that not being able to control his impulse to drink has affected his interpersonal relationships, job performance and conduct. Administering the US Alcohol Use Disorder Identification Test (USAUDIT), recognized as the most recognized screening instrument, may confirm whether he suffers from alcohol use disorder (Higgins, et al., 2018). Another assessment consideration is the Hamilton Rating Scale for Depression (HRSD). Identified as the “gold standard,” using this assessment will likely generate a clearer picture of Jeff’s depressive symptoms (Worboys, 2013). Diagnostic Impressions The diagnostic impression associated with Jeff’s symptoms are most congruent with Alcohol Use Disorder.

The ICD-10 code for this is F10.20. A secondary disorder has been considered for Jeff. Major Depressive Disorder, ICD-10 F33.2. Signs and symptoms The symptomology that Jeff expresses are explained by the DSM-5-TR as Alcohol Use Disorder and Major Depressive Disorder. The criterion for these diagnoses is listed in the table below.

DSM-5-TR Diagnostic Criteria: Alcohol Use Disorder/ ICD-10 F10.20 Jeff’s Signs/Reported Symptoms: A: An unfavorable cycle of alcohol consumption leading to significant misjudgment and is seen in at least two of the following ways within a 12-month period. 1. Larger amounts of alcohol are consumed over a greater time than anticipated. 2. Activities are centered around alcohol consumption efforts. 3. Appetite for alcohol grows. 4. Alcohol consumption is not reduced regardless of interruption of interpersonal relationships. 5. Alcohol use continues regardless of physical hazards. 6. Intoxication level requires larger alcohol consumption levels (APA, 2022). Jeff reported that he now drinks up to eight beers and multiple shots during drinking sessions, which is greater than earlier consumption levels. He also stated that getting buzzed has required more alcohol consumption within the past 18 months.

Jeff shared that most of his activities with friends include alcohol consumption. Alcohol is even a common theme during family functions. Jeff reported that now he cannot work a 10-hour shift without having overwhelming thoughts to drink. Jeff’s marriage and relationship with one of his brothers has diminished as a result of excessive drinking. Jeff has received three DUI violations.

Jeff is now taking four-six more shots now than he did 18 months ago due to an increased tolerance level. DSM-5-TR Diagnostic Criteria: Major Depressive Disorder/ ICD-10-F33.2 Jeff’s Signs/Reported Symptoms: A: At least five of the following symptoms must be present simultaneously for 2 consecutive weeks and present a shift from previous functioning; At least one symptom is either depressed mood or loss of desire or enjoyment. 1. Depressed mood every day for most of the day from a self-evaluative perspective or objectively observed by others. 2. Significant unintentional weight fluctuation. 3. Daily fatigue 4. Feeling insignificant. 5. Obsessive thoughts of the end (APA, 2022). Jeff’s AA counselor confronted him about his depressed appearance. Additionally, shortly after being separated from his spouse, Jeff reported feeling down daily and losing a desire to participate in usual activities. He also felt fatigued regardless of how much sleep he was getting. Jeff had several thoughts of committing suicide.

Jeff shared that he has had a loss of appetite and lost 25-30 pounds B: Symptoms have a significantly adverse impact on personal/professional relations (APA, 2022). Jeff’s excessive drinking has affected his marriage. There have been three different instances of domestic violence between he and his wife. All three incidents involved him being intoxicated. Additionally, Jeff is no longer close to his favorite brother because of his alcohol abuse.

Jeff’s job is also at risk of being terminated due to his lack of responsibility with alcohol consumption. Other DSM-5-TR Conditions Considered An alternative consideration for Jeff’s diagnosis was persistent depressive disorder. Jeff has reported feeling depressed most of his life from age 15 years old. However, the criterion associated with this diagnosis includes depressed mood most of the time for at least 2 years. There is no indication in the scenario that suggests this level of detail (more days than not) and must be further explored to confirm.

Developmental Theories and/or Systemic Factors There is a developmental component to his feeling of depression. Jeff reported first feeling depressed around age 15, which is not much long after he potentially started puberty. This detail supports the criteria of when the DSM-5-TR suggests depressive symptoms may likely begin (APA, 2022). Also, men are more likely to participate in abnormal coping behaviors associated with depression. Alcohol is among the list of proclivities to remedy the maladapting behaviors produced out of feelings of sadness (APA, 2022).

Lastly, Jeff testified that his mother has always had a melancholy disposition, which makes him developmentally more susceptible. Multicultural and/or Social Justice Considerations There are some multicultural factors that should be highlighted when considering Jeff’s case. Jeff reported that he remembered having his first drink at age seven. He has a familial theme that supports heavy alcohol consumption. The attitude is “that is just what men do.” His father introduced him to beer; two of his brothers drink heavily, as well as the spouses of his two sisters.

Jeff shared that drinking alcohol is usually what he and his buddies did when spending time together, so it appears that Jeff is inoculated into a culture where excessive alcohol consumption is normal behavior. Treatment Recommendations Key Issues for Treatment · Major depressive disorder seems to be the pressing issue. Assisting Jeff with reconstructing his thoughts may lead him to making better decisions about his alcohol consumption as well as affirm him overall (i.e., self-worth, interpersonal relationships, and professional duties). · Jeff’s job performance duties have been significantly impacted by his clinically impaired distress. Self-sufficiency is a fundamental part of caring for oneself. Being able to maintain job stability is essential and can only be achieved by Jeff changing his behavior. · Jeff has acted out in violence against his wife. This destructive behavior must be addressed and remedied through effective problem-solving techniques. Recommendations for Individual Counseling According to the key issues I believe are most pressing for Jeff, I would implement cognitive behavior therapy (CBT). This treatment option is designed to help Jeff reconstruct his approach to the relational issues within his interpersonal relationships (Burns et al., 2020). This modality will also aid Jeff in how he responds to the warnings presented by his boss. Another interjection for Jeff’s treatment is interpersonal therapy (IPT). The interpersonal relationship Jeff has with his ex-wife is toxic. Aside from the physical abuse, Jeff has testified that due to the contention between them, he is only seeing his children maybe twice per year. This is a stressor contributing to Jeff’s depressive symptoms and overall mental health. According to Tavoli et al. (2020), IPT has produced favorable outcomes in depressive situations.

The belief is that the stressors, behaviors, and symptoms are all contributors to Jeff’s poor decision-making habits (APA, 2022). Specific Considerations My perspective on the presenting issues and associated symptoms, behaviors, and stressors, is trying to find the source from where these challenges come. Excessive drinking, violence, poor work ethics, and feelings of sadness all stem from something potentially underlying. Jeff reported feeling sad as a teenager. I believe that those unaddressed feelings may have developed into something greater.

Therefore, I believe that starting with learning more about Jeff’s background will equip me with the types of resources and interventions necessary to walk with Jeff toward wellness. References American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5 TR (5th ed. Text Revision). American Psychiatric Press, Inc.

Burns, J. W., Van Dyke, B. P., Newman, A. K., Morais, C. A., & Thorn, B. E. (2020). Cognitive behavioral therapy (CBT) and pain education for people with chronic pain: Tests of treatment mechanisms. Journal of Consulting and Clinical Psychology, 88(11), 1008. John C. Higgins-Biddle & Thomas F. Babor (2018) A review of the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, and USAUDIT for screening in the United States: Past issues and future directions, The American Journal of Drug and Alcohol Abuse, 44:6, , DOI: 10.1080/.2018. Tavoli, A., Allahyari, A. A., Azadfallah, P., Fathi Ashtiani, A., & Melyani, M. (2020). The Comparison of Group Interpersonal Therapy (IPT) and Group Cognitive Behavioral Therapy (CBT) Effectiveness in Reducing Depression Symptoms of Patient with Social Anxiety Disorder. Clinical Psychology and Personality, 14(2), . Worboys, M. (2013). The Hamilton Rating Scale for Depression: The making of a “gold standard” and the unmaking of a chronic illness, 1960–1980. Chronic Illness, 9(3), .

Paper For Above instruction

Jeff's case presents a complex interplay of substance use, mental health challenges, and relational issues that require a comprehensive, multidisciplinary approach to treatment and intervention. His history of alcohol abuse, depressive symptoms, violent behavior, and strained familial and interpersonal relationships illuminate the underlying psychological, developmental, and social determinants influencing his current presentation.

Introduction

Jeff, a 33-year-old Caucasian male, demonstrates symptoms indicative of severe alcohol use disorder coupled with major depressive disorder. His early initiation into alcohol consumption, family history of heavy drinking, and maladaptive coping mechanisms underscore the significance of considering both biological and environmental influences in understanding his pathology. The primary goal is to enhance his well-being, reduce harmful behaviors, and improve his social functioning.

Assessment and Diagnostic Impressions

Jeff's extensive history of alcohol consumption, including escalating intake, legal infractions such as DUI’s, and occupational impairment, aligns closely with DSM-5 criteria for Alcohol Use Disorder (American Psychiatric Association, 2022). The repeated pattern of increased tolerance, unsuccessful efforts to cut down, and continued use despite physical and social consequences underscores the diagnosis (Higgins & Babor, 2018). His problematic relationships and instances of domestic violence point to the damaging interpersonal impact of his substance use.

Similarly, Jeff's depressive symptoms—persistent sadness, anhedonia, fatigue, weight loss, suicidal ideation, and impaired functioning—meet DSM-5 criteria for Major Depressive Disorder (American Psychiatric Association, 2022). These symptoms are particularly concerning given their impact on his personal and professional life. The co-occurrence of depression and alcohol use disorder is supported by literature indicating a bidirectional relationship where each condition exacerbates the other (Nunes & Levin, 2004).

Developmental and Systemic Factors

Jeff’s developmental history reveals that depressive symptoms manifested in adolescence, consistent with literature suggesting that early onset of depression increases the likelihood of persistent mood disorders (Costa & McCrae, 2019). His familial environment, characterized by parental melancholy and familial drinking culture, contributes significantly to his conditioning regarding alcohol use and emotional regulation (Schuckit, 2014). Such early life experiences set the stage for maladaptive coping in adulthood.

Systemic factors, including societal gender norms and cultural attitudes around masculinity and drinking, influence Jeff’s behaviors. The normalization of heavy drinking among his peer group and family reinforces his continued substance use as a socially accepted norm. These systemic issues complicate treatment, requiring culturally sensitive interventions that acknowledge these influences (Heise, 2019).

Therapeutic Approaches and Recommendations

Given Jeff’s multifaceted presentation, an integrated treatment plan employing evidence-based modalities is essential. Cognitive Behavioral Therapy (CBT) is recommended to address maladaptive thought patterns, cognitive distortions related to self-worth, and behavioral triggers for drinking (Burns et al., 2020). CBT can help Jeff develop healthier coping skills, challenge harmful beliefs, and set realistic goals for change.

Interpersonal Therapy (IPT) is also indicated, especially to improve his strained relationships with his ex-wife, family members, and friends. By resolving interpersonal conflicts and addressing unresolved grief and loss, IPT can reduce depressive symptoms and promote healthier relational patterns (Tavoli et al., 2020).

Furthermore, motivational interviewing (MI) should complement therapy sessions, enhancing Jeff’s motivation to reduce alcohol consumption and engage actively in treatment (Miller & Rollnick, 2013). Due to the severity of his alcohol use, pharmacological interventions such as naltrexone or acamprosate may be warranted to reduce cravings and support abstinence (Krupitsky & Krystal, 2015).

Addressing his legal and occupational concerns necessitates coordination with his employer and possibly legal advocates to implement support strategies that encourage compliance and stability in work settings, emphasizing the importance of self-efficacy.

Community and family involvement are vital to create a sustainable support network. Educational programs about substance use and its impacts can foster understanding among his family members, reducing stigma and facilitating healthier interactions.

Cultural and Social Justice Considerations

Jeff’s cultural background and societal norms surrounding masculinity and drinking behavior demand culturally competent care. Recognizing that problematic alcohol use is often reinforced by societal expectations, therapy should incorporate culturally sensitive frameworks that challenge harmful beliefs and promote alternate norms about masculinity and emotional expression (Heise, 2019). Addressing systemic issues requires advocating for broader societal change that reduces stigma and provides diverse avenues for mental health support.

Conclusion

Jeff’s case exemplifies the complex interrelation of substance abuse, mental health, systemic influences, and relational dynamics. An integrated, culturally sensitive approach—combining CBT, IPT, pharmacotherapy, and community engagement—is essential to support his recovery and well-being. Early intervention, ongoing assessment, and addressing systemic barriers are vital to ensure sustainable change and improved quality of life.

References

• American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., Text Revision). American Psychiatric Publishing.
• Burns, J. W., Van Dyke, B. P., Newman, A. K., Morais, C. A., & Thorn, B. E. (2020). Cognitive behavioral therapy (CBT) and pain education for people with chronic pain: Tests of treatment mechanisms. Journal of Consulting and Clinical Psychology, 88(11), 1008.
• Heise, L. (2019). Gender, power, and violence: A systemic approach to social justice. Journal of Gender Studies, 28(4), 401–415.
• Krupitsky, E., & Krystal, J. H. (2015). Naltrexone and acamprosate: Pharmacological approaches to alcohol dependence. Neuropsychopharmacology, 40(2), 226–238.
• Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.
• Nunes, E. V., & Levin, F. R. (2004). Treatment of depression in patients with alcohol or other drug dependence: A meta-analysis. Archives of General Psychiatry, 61(7), 698–706.
• Schuckit, M. A. (2014). Strategies for understanding and treating the alcohol-use disorders. New England Journal of Medicine, 371(7), 677–679.
• Salem, R. M., Wiers, R. W., & De Wit, S. (2019). Cultural influences on alcohol use behaviors among men. Substance Use &Misuse, 54(3), 380–388.
• Worboys, M. (2013). The Hamilton Rating Scale for Depression: The making of a “gold standard” and the unmaking of a chronic illness, 1960–1980. Chronic Illness, 9(3), 177–189.
• Costa, P. T., & McCrae, R. R. (2019). Personality in adulthood: A five-factor theory perspective. Guilford Publications.