CASE STUDY JEFF 1
Case Study Jeff Assignment
School of Behavioral Sciences, Liberty University
Case Study Assignment Jeff
Jeff has been having issues with alcohol, but he does not seem to think it is a big deal, even
though he drinks 6–8 beers every day. He is only attending counseling to keep his job, as his
supervisor threatened to fire him if he doesn’t get his things together. Jeff’s drinking habits have
worsened since his divorce was finalized, and he now sees his children only occasionally.
CASE STUDY JEFF 2
Client Concerns
Biological factors
Psychological
Social/cultural
Spiritual
Physical symptoms, for
example: neurological,
past present impact
Past and present
Ideas, thoughts
feelings, beliefs,
values about self,
others the world
Past and present
Family systems,
Relationships with
others,
Cultural elements
Past, present
Religious and spiritual
aspects of self/family
Past present
Emptiness Feels not a big deal
drink this much
Divorced Not spiritual at all
Drik until 2am, wake up
2pm.
Fear losing his job
what he really likes
Friends drink as he
does
Not open to talk about
faith
Sadness Only doing this to
keep his job
Difficult relationship
with ex
Aggression Kids not his life right
now
Assessment
In Jeff’s case, I would use the Alcohol Use Disorders Identification Test (AUDIT), a 10item
screening tool developed by the World Health Organization (WHO) to evaluate alcohol
consumption, drinking behaviors, and alcohol-related problems (National Institute on Drug
Abuse, n.d.). The AUDIT is available for an interview format used by the counselor and a
selfreport version used by the client, each using a scoring system from 0 (never) to 4 (daily or
almost daily). I appreciate that this tool provides insight from both the counselor’s perspective
and the client’s self-perception, making it useful for identifying the severity of Jeff’s drinking
patterns.
Diagnostic Impression
Reviewing Jeff’s case and completing his AUDIT test what is showing his total score is higher
than 35, which indicates that he has a severe substance use disorder. The ICD-10 code is F10.20
Severe Alcohol Use disorder. (American Psychiatric Association, 2022).
Signs and Symptoms
DSM-5-TR Diagnostic Criteria: disorder name
and code number
Client’s Signs/Reported Symptoms from case
study:
CASE STUDY JEFF 3
Criterion A: (F10.220) for Diagnostic moderate
or severe alcohol use disorder is comorbid.
Jeff drinks daily, consuming 6–8 beers along
with a few shots.
B. Clinically significant problematic behavioral
or psychological changes (e.g., inappropriate
sexual or aggressive behavior, mood lability,
impaired judgment) that developed during, or
shortly after, alcohol ingestion
Criterion B: (F10.230) Alcohol Withdrawal If Jeff has not had a drink by 2 p.m., he finds
himself thinking about alcohol constantly. After
nights of heavy drinking, he often wakes up
around 2 p.m. and begins drinking again by 5
p.m.
C. The signs or symptoms in Criterion B cause
clinically significant distress or impairment in
social, occupational, or other important areas
of functioning
Criterion C: (F34.81) Diagnostic Criteria E Jeff has met few of the diagnostic criteria for
Disruptive Mood Dysregulation Disorder
over the past 18 months:
Criteria A–D have been present for 12 or more
months. Throughout that time, the individual
has not had a period lasting 3 or more
consecutive months without all of the
symptoms in Criteria A–D.
Jeff has been aggressive toward his ex-wife,
impatient with his children, and has recently
had outbursts with his friends while drinking.
Other DSM-5-TR Conditions Considered
Reading Jeff’s case study, Major Depressive Disorder also stands out as a possible
diagnosis, as Jeff has been experiencing sadness since he was 15 years old. During a previous
depressive period, he lost 25–30 pounds due to a significant loss of appetite. Based on the
diagnostic criteria, Jeff appears to meet approximately 4–5 symptoms. He continues to
experience sadness several times per week, making this diagnosis potentially fitting for his case.
Developmental Theories and/or Systemic Factors
Jeff’s father struggled with alcohol his entire life and was the one who introduced Jeff to
drinking at age seven, saying, “that’s what men do.” His other brothers were also introduced to
alcohol in the same way, except for one who eventually stopped speaking to the family for that
reason. Jeff has maintained a relationship with his family and siblings, and whenever they get
CASE STUDY JEFF 4
together, drinking is always involved. Because alcohol has been a consistent part of his family
life and social circle, Jeff feels it is a normal part of living. He does not believe his drinking is a
problem, as he feels he is able to manage it just fine.
Multicultural Competencies and Considerations
Jeff’s mother’s family were Baptist, and he attended church with them occasionally when he
was young, but he is no longer involved in any religious practices. He is not interested in
bringing faith or spirituality into counseling. Jeff is attending counseling solely to keep his job.
Treatment Recommendations
Key Issues for Treatment
•Excessive alcohol usage
•Deep Sadness
Recommendations for Counseling
Since AA meetings have not been effective for Jeff in the past, I would not recommend
starting with that approach. Instead, I would recommend integrated behavioral intervention
therapy combined with foundational cognitive-behavioral therapy (CBT). Integrated behavioral
interventions have been shown to reduce alcohol consumption, decrease heavy drinking, and
promote abstinence. However, current evidence is limited regarding whether these
interventions are more effective than standard care for individuals with Alcohol Use Disorder
(Hallihan et al.,
2024).
Specific Considerations
I would consider Jeff’s drinking as closely linked to his long-standing sadness, which he
reports experiencing deeply since his teenage years. His alcohol use appears to have escalated
during that time as a way of coping with these feelings. I would recommend implementing
mindfulness-based cognitive therapy (MBCT), as Jeff needs to learn strategies for managing his
CASE STUDY JEFF 5
depression without relying on alcohol and to develop skills to function effectively in his daily life
without using substances. (Tickell et al., 2019).
CASE STUDY JEFF 6
References
American Counseling Association (ACA). (2014). ACA Code of Ethics.
https://www.counseling.org/resources/aca-code-of-ethics.pdf
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders
(5th ed., text rev.; DSM-5-TR). American Psychiatric Publishing.
Hallihan, H., Srimoragot, M., Ma, J., Hanneke, R., Lee, S., Rospenda, K., & Fink, A. M. (2024).
Integrated behavioral interventions for adults with alcohol use disorder: A systematic
review. Drug and Alcohol Dependence, 263, 111406.
https://www.sciencedirect.com/science/article/pii/S0376871624003296
National Institute on Drug Abuse. (n.d.). Alcohol Use Disorders Identification Test (AUDIT). U.S.
Department of Health and Human Services.
https://nida.nih.gov/sites/default/files/files/AUDIT.pdf
Tickell, A., Ball, S., Bernard, P., Kuyken, W., Marx, R., Pack, S., Strauss, C., Sweeney, T., & Cran
e, C. (2020). The effectiveness of mindfulness-based cognitive therapy (MBCT) in real-
world healthcare services. Mindfulness, 11(2), 279-290
https://pmc.ncbi.nlm.nih.gov/articles/PMC6995449/
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