CASE STUDY ASSIGNMENT #3
Case Study Assignment #3
Najah Blassingame
Department of Counselor Education and Family Studies
CEFS 546: Psychopathology
Liberty University
Author Note
Department of Counselor Education and Family Studies, Liberty University
I have no known conflict of interest to disclose.
Correspondence concerning this article should be addressed to Najah Blassingame
Email: nblasingame@liberty.edu
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CASE STUDY ASSIGNMENT #32
Jeff Case Study Assignment
Key Issues
Biological
Jeff is a 33-year-old divorced Caucasian male. Jeff is fourth child of six children. His
parents have been married for 45 years and he talks to them of a regular basis. His father and two
of his brothers drink on a daily basis. His mother has always been a sad type of woman. Jeff
drinks daily but it depends on if he is working on or off site at his job. When Jeff is working, he
will consume 4 to 8 beers after work. When he is not working, he will consume 6 to 8 beers a
day with a few shots of whatever he can find. Over the last 18 months, Jeff has noticed that he
drinks 18 months ago. Over the last 18 months, Jeff takes a long time to recover from his
hangovers. He has been experiencing the feeling of sadness daily after about two months when
his wife left . Jeff has symptoms of losing interest in activities he enjoys, feeling hopeless,
struggling with sleeping, fatigue, irritability, and low appetite. Jeff has also thought about killing
himself multiple times. He had a plan, but he has never done anything to hurt himself. Jeff has a
long history of alcohol use and his first drink at seven years old.
Psychological
Jeff has been working for the state as a part of the construction crew that builds bridges
and other state-run infrastructure for five years. He works two hours from home and works on
site for 10 to 12 days. He is a great worker, but his alcohol consumption has affected his image at
work. In the last 18 months, Jeff has had four violations for his blood alcohol content being
above the maximum allowed on site. Two of his violations has occurred in the past month. His
fourth positive resulted his supervisor to suspend him for five days with pay. He is required to
Social
In high school, he began spending time with peers who drunk heavily on weekends. Jeff
and his ex-wife separated three years ago and finalized their divorce two year ago. When he was
married, he did not drink as much as he does now. Drinking caused him to abuse his wife while
he was intoxicated. His alcohol problem caused his ex-wife to pack up and take their kids to her
parents’ house. Jeff and his ex-wife have a very tense relationship and he does not see his
children often. He used to see them on holidays and their birthday. When he was keeping the
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receive a mental health assessment and follow through any treatment requirements. He has been
late to work once a week for the past year due to a long night of drinking. He has been threatened
to get suspended over six months for his late behavior. Jeff’s drinking has caused him to get
arrested three times. He has been arrested for assault and battery because he has struck his ex-
wife numerus times while being under the influence of alcohol. He spent 15 days in jail. The
other two arrest was cause due to him driving under the influence in his mid-20’s and early 30’s.
His charges were misdemeanors and he spend two overnights in jail. He smoked marijuana in
high school and when he worked as a painter.
After his wife let him, he joined Alcoholics Anonymous and participated in four months
of outpatient treatment to impress his wife. Eventually, he dropped out of AA after he realize she
was not coming back. He also stopped treatment after a while because his counselors determined
that Jeff was an alcoholic and showed depressive symptoms. He has no intentions of eliminating
his drinking habits. Jeff has never experienced psychotic or manic episodes. Jeff has no
significant medical history, no history of medication, and no other drug use currently.
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children one night, he drunk too much and was visibly hungover to his ex-wife. His ex-wife is
remarrying, but Jeff has no intentions of dating or marrying anyone at the moment.
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Spiritual
Jeff’s mother’s parents were Baptist, and he went to church with them on occasion when
he was young. His family did not attend church and he has not been inside of a church since his
grandmother died. He is not interested in integrating spirituality in his counseling process at this
time. He only wants to attend counseling to save his job.
Assessment
The assessment that I choose for Jeff is the CAGE Questionnaire that consists of four yes
or no questions. This assessment is mainly used for older adults. CAGE is very brief and easy to
administer in a counseling setting. The four questions used in this assessment is have you ever
felt a need to cut down on your drinking; have people annoyed you by criticizing your drinking;
have you ever felt bad or guilty about your drinking; and have you ever had a drink first thing in
the morning to steady your nerves or get rid of a hangover (eye-opener)? If the results consist of
two “yes” responses, then the test taker will have the results of a positive test (DiBartolo &
Jarosinski, 2016). This assessment is easier to detect Jeff’s alcohol issues because he has a long
history of drinking.
Diagnostic Impressions
I came up with the two following disorders because of matching criteria to Jeff’s
symptoms. Jeff has been consuming large amounts of alcohol and has experienced many
Secondary Diagnosis – Severe Alcohol Use Disorder with Alcohol – Induced Depressive
Disorder, with onset during intoxication
This disorder can be applied to Jeff because the substance of alcohol has caused Jeff to
experience depressive symptoms. There is evidence from Criterion A because Jeff experienced
depressive moods after his wife had left him. This event caused him to feel sad daily. The alcohol
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symptoms. The symptoms that were identified was his obsessive use of alcohol in large amounts,
an unsuccessful effort to control alcohol use, spending most of his time using alcohol, failing to
fulfill major roles at his job, using alcohol while being employed as a constructer, and he has
developed a tolerance for alcohol by trying to achieve his desired effect. He also does want to
solve his drinking habit. With the given information I choose the Alcohol Use Disorder and the
severity of his disorder is Severe. The other disorder was chosen because Jeff met the criteria for
Substance-Induced Depressive Disorder by having a depressed mood toward his enjoyable
activities.
Primary Diagnosis – Alcohol Use Disorder, Severe
Jeff showed many symptoms of the Alcohol Use Disorder because of how severe his
symptoms were. Jeff presented at least 6 or more symptoms from Criteria A. Jeff has consumed
alcohol is large amounts, he has an unsuccessful effort to control alcohol use, spends most of his
time using alcohol, he fails to fulfill major roles at work, he uses alcohol while being employed
as a constructer, and he has a tolerance for alcohol by trying to achieve his desired effect. Severe
alcohol uses also affected Jeff with feelings of sadness and suicidal attempts. This disorder could
have affected Jeff by genetic influences from his father.
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is a depressant that is affecting Jeff’s life. Criteria E is also a part of Jeff’s diagnosis because
Jeff’s sadness has affected his social and occupational life. The depressive disorder also
influenced Jeff to have suicidal thoughts because of his alcoholism.
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Treatment Recommendations
Suicidal Ideation
Jeff has experienced suicidal thoughts due to his consumption of alcohol. He has never
harmed himself in any way, but he had a plan for it. I believe that he may have another incident
like that last one that he had. Dealing with suicide can be very serious when a person has already
figured out a way. Jeff sadness from losing his wife caused him to think of suicide. Jeff needs to
understand that his wife has moved on and needs to try get better to keep his job.
Alcoholism
Jeff has allowed alcohol to affect him in many ways such as losing his family, risk his
job, and life. Alcohol has also caused Jeff to develop a tolerance because he takes larger doses to
produce his desired effect he received in the past. He has tried Alcohol Anonymous and
outpatient treatment, but both did not work him. Jeff may can try treatment for his psychological
problems until he gets comfortable to actually quit drinking. The Cognitive Behavioral Theory
can also help with Jeff’s treatment by lessening the negativity of alcohol in his life. Using this
theory can help him to replace negative behaviors and thoughts with positive ones (Siang-Yang
Tan, 2011, p. 258).
Specific Considerations
Multiple diagnosis effects the decision-making process for diagnostic impressions and
treatment planning because this client does not want to fix his alcohol abuse. Jeff is at risk of a
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lot of things such as his job, family, and health. He feels that no one has a problem with his use
of alcohol. I would address his sadness and alcohol abuse because many people are noticing that
his is not his normal self. Jeff depression can get worse, and the alcohol can affect him
negatively. Substance use disorder can affect the process for diagnostic impressions and
treatment planning by Jeff being intoxicated during a session or not showing up due to a
hangover. I would address these barriers by letting Jeff know that his session is important, and he
should take his process serious.
DiBartolo, M. C., & Jarosinski, J. M. (2016). Alcohol Use Disorder in Older Adults: Challenges
in Assessment and Treatment. Issues in Mental Health Nursing, 38(1), 25–32.
https://doi.org/10.1080/01612840.2016.1257076
Siang-Yang Tan. (2011). Counseling and psychotherapy: A Christian perspective.
Baker Academic.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). American Psychiatric Association.
