Case Study

Case Study: Jacob Assignment

Jacob is a 21-year-old business major at a large local university. Over the past three months, his family and friends have noticed increasingly bizarre behaviors. On many occasions, they’ve overheard him whispering in an agitated voice, even though there is no one nearby. They have also heard him praying over and over, late into the night. Within the last couple of weeks, he has refused to answer or make calls on his cell phone, claiming that if he does it will activate a deadly chip that was implanted in his brain by evil aliens. He has all but stopped going to his courses at the university, claiming that he believes his professors are out to get him and plotting against him. He is now so far behind in his coursework that he will fail if something doesn’t change very soon.

His parents have tried to get him to go with them to a psychiatrist for an evaluation, but he refuses. He has accused them on several occasions of conspiring with the aliens to have him killed so they can remove his brain and put it inside one of their own. At this point he has not reported any suicidal ideations or homicidal ideations, but he has reported that he will do whatever he must to protect himself against those who are conspiring against him. He has also reported no manic, depressive, or mixed manic-depressive episodes.

Although Jacob occasionally has a few beers with his friends, he’s never been known to abuse alcohol. At the most he will drink three or four 12-ounce beers once a month. He did disclose to his parents that he has smoked marijuana once or twice, but the last time was more than two years ago. He has reported the use of no other substances.

In addition, socially Jacob has had girlfriends since he was an adolescent, but none of those relationships has lasted more than a few months. He is currently not involved in a relationship and reports that he does not desire being in a relationship. He also reported that he does not see this being likely in his current state, as he noted that most of his friends and acquaintances have drifted away due to his “bizarre behavior”—this was a direct quote from the client. At this time he reports that he doesn’t even desire a relationship with friends. Jacob notes that he no longer has any interest in the majority of activities that he used to be interested in, such as spending time with friends, riding his motorbike, and working out at the gym.

There is no report of any mental issues in his immediate family members (parents, brother, sister). He does, however, have an estranged aunt who has been in and out of psychiatric hospitals over the years due to erratic and bizarre behavior. Jacob visited his family doctor a couple of years ago, and there were no physical issues noted from that visit.

As for spiritual issues, Jacob and his family have attended church regularly all of his life. They are Baptist. Jacob attended Bible school and vacation Bible school as a child and adolescent. Until recently he continued to be involved at his church, but now refuses to attend services or be involved in any way at church. Previously he was in the choir, but now he even refuses to sing hymns, stating that he is concerned that the devil is possessing him and his singing would displease the Lord.