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PCN-488 Case Study James

James 24 years old

African American

Active duty in the U.S. Navy – On medical leave for family illness

Symptoms:

​ ​Voices and flashbacks to battle in Afghanistan

​Feels that people are watching him

​Drinks two twelve-packs of beer every five days

High school education

Treatment History:

​Spoke with military counselors two times

​Fears having health issues listed on his military record

Family History:

​ ​Parents divorced when James was two years old ​ Older brother has a substance use disorder

​Father is an alcoholic

​Raised by his mother

Stressors:

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​James' mother is suffering from ovarian cancer and is not expected to live more than one month

Demographics: James is a 24-year-old African American male. He states that he enlisted in the Navy after graduating high school at the age of 19 years old. James is currently on an extended medical leave for family illness but states that he "intends to make the Navy my career."

Relationship history James is not married, but he has a girlfriend who he has been with for the past year and a half.

Family history James has an older brother who he is close to “but he is an addict.” James reports that his biological father is still alive, but he is an active alcoholic. His parents divorced when he was 2 years old. James was raised by his mother and reports “I was the man of the house.”

Presenting Issue: James states that "I came to your office because I have started hearing voices and having flashbacks to gun fights in Afghanistan." James reports that he has been using marijuana (mostly edibles) and drinking beer daily to “drown out the noise.” James reports that he drinks at least two twelve-packs every five days. Even with his self-medication, James reports that he has recently begun thinking “people are watching me” and James knows that he is not thinking rationally. James is afraid that his commanding officer will find out about his symptoms and he will be medically discharged. James is adamant that he will not consent to inpatient treatment and becomes upset when the topic is entertained.

Treatment History: James reports that he has spoken to a military counselor “a couple of times.” He reports that he did not find this helpful and he "fears having treatment issues on his military record so decided to seek private therapy."

Current Treatment: James is currently seeking treatment at your office to help him regain control of his life. He reports that he is not currently being treated anywhere else.

Current Medical: No significant medical history reported.

Stressors: James reports that he has been home for one month because his Mother has ovarian cancer and is not expected to live more than one month. James tearfully reports "I am fearful about losing my mother and my career in the Navy."

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