CASE CONCEPTUALIZATION

Ben is a 26-year-old who identifies as a gay male of European descent. He is currently working full time as a pipe fitter’s apprentice and attending school three nights a week as part of his union contract. He reports a history of Major Depressive Disorder, recurrent, but has not had any symptoms of depression in over 2 years. Recently, he has noticed that he has had low energy, doesn’t find his job as interesting as he once did, and is experiencing hopelessness about his future. Ben reports during adolescence he had some thoughts about death and dying, but he does not believe he has ever been truly “suicidal,” stating, “I know someone who died like that, and I don’t want my friends and family to suffer like that, so it’s never an option for me.”

Ben moved back home with his parents 4 months ago, as they are concerned about his depression and level of isolation.

While he does enjoy being home with his family, he has begun to feel like “a loser who can’t get out of my parents’ house.” Three months ago, he began going to the casino that is less than 10 miles from his home. He has found that he enjoys the challenge of playing poker. Ben reports when he is playing at the casino, his mood is “incredible,” and he feels like he is “on top of the world” when he wins. However, when he loses, his depression seems to get worse. In the past month, he has lost approximately $2,500. He reports he has started playing online gambling games at work to try to win back some of the money he has lost. At first, he was winning, but once he was “up,” he found he had difficulties stopping, and ultimately has lost an additional $200 through his online games.

Lesson 4 - 

Case Study 4: Kevin