Running head: CASE STUDY 2
Case Study 2: Jacob
Lisa Robertson
Liberty University
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CASE STUDY 22
Case Study 2: Jacob
This case study of Jacob will explore key issues, diagnostic impressions, and treatment
options available to assist him with the current mental health issues he is experiencing. Jacob is a
21-year-old college student who is majoring in business. Jacob’s family and friends have begun
to worry about him. They reported that his behavior over the last three months has been bizarre.
Jacob has been talking to himself, praying excessively, and staying up late at night. Jacob has
stopped all communication that involves the use of cell phones. He believes that if he uses a cell
phone a chip in his brain, implanted by aliens, will be activated. Jacob believes that his college
professors are secretly plotting against him. Jacob seems to think that everyone around him,
including family and friends, is conspiring against him with aliens, to kill him and steal his brain.
Although Jacob is still currently enrolled in college, his grades have begun to suffer. If he does
not receive treatment soon, he will most likely fail out of school.
I. Key Issues
A.Jacob feels that he must protect himself from almost everyone around him.
B.Jacob believes that he is going to be attacked by aliens.
C.He thinks that all of his family and friends are plotting against him to help the aliens steal
his brain.
D.He thinks his professors are also plotting against him to help the aliens steal his brain.
E.His family and friends are worried about his mental health.
F.Jacob has stopped all communication that involves the use of cell phones.
G.Jacob is refusing treatment.
H.He has begun to do poorly in school.
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I.He is in danger of failing his classes.
Jacob’s bizarre behavior has become an issue. He is worrying his family because of his
paranoia. He feels he needs to protect himself against people who pose no threat to him. This
issue is at the top of the list because Jacob could potentially harm someone. The other issues are
also very important. Jacobs is in danger of destroying close relationships. Failing out of school is
serious, however, with the proper treatment he can get back on track with his education. If Jacob
physically harms or even kills someone due to his paranoia, he may not be able to come back
from that. It will be more damaging to his future.
II.Diagnostic Impressions
Over the last 3 months Jacob’s family and friends have noticed that his behavior has
changed drastically. Some of his behavior was reported as being bizarre. Jacob’s diagnosis can be
found and confirmed in the schizophrenia spectrum and other psychotic disorders located in the
DSM-5. Schizophrenia spectrum and other psychotic disorders “are defined by abnormalities in
one or more of the following five domains: delusions, hallucinations, disorganized thinking
(speech), grossly disorganized or abnormal motor behavior (including catatonia), and negative
symptoms” (American Psychiatric Association p.290).
After careful research of his symptoms, I found that Jacob is most likely suffering from
schizophreniform. He is having persecutory and bizarre delusions, as well as negative symptoms.
He believes that aliens want his brain. He also believes that the devil is trying to possess him.
These symptoms will classify as bizarre delusions. His accusations of his family friends and
professors plotting against him is a persecutory delusion (APA, 2015). These delusions indicate
that Jacob has lost control over his mind and/or body (APA, 2015). Some of the negative
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symptoms that Jacob is experiencing are avolition and asociality which is noted by his current
lack of motivation or interest in things that he would normally be interested. His family reports
that he is no longer motivated to attend church, family gatherings, hang out with friends, or
attend school classes. These negative symptoms are interfering with his daily functioning. He has
not been maintaining a good standing in college. His social life and relationship with family is
rapidly diminishing, and he has completely stopped doing other things he used to love such as
riding his motorcycle and working out at the gym.
Other than occasionally having a couple of beers and one usage of marijuana many years
ago, Jacob does not have any issues with substance abuse. There was no mention of any medical
or mental health issues such as, schizoaffective disorder or bipolar with psychotic features that
would contribute to his diagnosis. He does, however, have an estranged aunt who has been in and
out of mental institutions due to her mental health issues and bizarre behavior.
Jacob’s symptoms have been present for less than six months but more than one month.
Schizophrenia and brief psychotic disorders can be ruled out. His belief that aliens want his brain
and his family and friends are out to get him closely aligns with delusion disorder but this too
will be ruled out because Jacob’s functioning is noticeably impaired and his behavior is
obviously bizarre.” (APA, 2015).
III.Treatment Recommendations
A.Cognitive behavioral therapy- While participating in CBT, Jacob will begin to learn more
about his mental illness. He will set goals and learn how to identify and manage triggers.
CBT will also give him the tools he needs, such as identifying negative thoughts in a
structured manner, to manage his feelings and problems that are associated with his
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disorder, helping to prevent relapse (Murdock, 2013). CBT will also help Jacob to begin
to control his emotions and thoughts and think more positively
B.Family therapy- The love, support, and understanding of an individual suffering from
schizophreniform disorder is an important factor in the rehabilitation of the individual
(Murdock, 2103). Because Jacob’s recent bizarre behavior has caused concern and has
strained his relationship with his family, family therapy would be helpful. His family will
learn ways to cope with Jacob’s disorder. They will also learn more about the signs and
symptoms associated with schizophreniform disorder. The more they understand the
disorder the easier it will be to repair the relationship.
C.Psychopharmacological therapy- Jacob has agreed to explore medication therapy. He will
be referred to a qualified psychiatrist where he will learn about medications available to
help treat his symptoms.
D.Hospitalization- After assessing Jacob if it is found that his negative thoughts are too
severe and he indicates that he has the potential to physically harm others, he will be
referred to be hospitalized until the symptoms are under control.
E.Journal writing- Jacob will be required to keep a journal. Journal writing will allow him
to keep track of his thoughts (negative or positive), feelings (negative or positive),
activities, moods, behaviors, and his medication regimen (Kring, 2018). Keeping a
journal will give him an extra tool to help with identifying triggers. This will be helpful
for him and the therapist treating him.
F.Church and family support- Jacob and his family have mentioned that they are all active
in their church. Jacob is encouraged to return to church and utilize any support groups
they may offer. Jacobs’s family is very concerned about his wellbeing. His family will
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continue to support him by applying the education they receive in family therapy such as,
recognizing triggers and warning signs of relapse, practicing stress relieving techniques,
and remining Jacob to take medication.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). Arlington, VA: Author.
Kring, A. M., Johnson, S. L., Davison, G., & Neale, J. (2018). Abnormal psychology: The
science and treatment of psychological disorders (14th ed.). Hoboken, NJ: John Wiley &
Sons, Inc. ISBN: 9781119456230.
Murdock, N. L. (2013). Theories of counseling and psychotherapy: A case approach (3rd ed.).
Upper Saddle River, NJ: Pearson.
