Addiction Case Conceptualization Template

Alejandra

Alejandra is a 23-year-old who identi�es as a heterosexual female from a family with strong

connections to their Mexican heritage and their Catholic faith. She prefers to be called “Alex.” She

has been working full time for a large �nancial institution for over 2 years, enjoys her job, and has

several “good” relationships with co-workers. She has been in a monogamous relationship with her

boyfriend for 3 years.

Alex was referred to you by a peer after she discovered she is pregnant. She is “very concerned”

about telling her boyfriend and her family about the pregnancy, citing her parents’ and her

boyfriend’s parents’ religious beliefs and her fear they will “force us to get married.” She does not

believe that her boyfriend wants children, and she has been experiencing “panic attacks” when she

thinks about telling him. She explains that she has always been “a little worrier,” stating she was

“obsessive” about her grades in school. Alex’s supervisor praises her for her high standards and

quality work, but she always worries about being �red if her performance does not continue to

improve. She is also concerned that motherhood will, “slow me down, and I won’t be able to keep a

job and pay her bills.”

Alex reports during your initial visit that she has been using prescription pain medication to treat a

knee injury she developed playing soccer 2 years ago when she was in college. She is aware that she

has become physically dependent on opioids, disclosing that she recently tried to quit taking them

but experienced “intense withdrawal symptoms.” She is worried that she is harming herself and the

fetus by continuing to take the prescription medication.