Jeff Case Study
Client Concerns
Symptoms Behaviors Stressors
Drinking to the excess. Seems to be an alcohol
increase of consumption.
Divorced.
Feelings of fatigue. Has suicidal ideation. Not enough sleep.
Feelings of hopelessness. Not taking interest in
everyday activities.
Occurred after his wife left
two months prior.
Appetite loss During those times, weight
loss from about twenty-five
to thirty pounds.
Has anxiety and fear related
to job loss.
Doesn’t want to quit drinking
excessively.
Outside of work, drinks
excessively.
Sees no issue with the fact
that he has a family history of
drinking.
Job performance declining. Lateness to work due to
alcohol consumption.
Violations for work because
of being tardy.
The amount of alcohol
consumed has increased.
Drinks two more beers than
normally did.
Assessment
One assessment that could be used to diagnosis the client would be the Alcohol Use
Disorder and Associated Disabilities Interview Schedule (AUDADIS-5). This particular
assessment is a structured interview that was created in order to be able to assess the drug-
related, alcohol-related, and mental health related disorders in regard to the DSM-5 criteria. It
can be used directly for measuring drug and alcohol use, as well as several different other
disorders such as anxiety, mood, and others (Grant et al., 2016). The client may also be linked to
other disorders by his drinking, so it can be said that this particular assessment could be used to
help figure out the other disorders.
Diagnostic Impression
After reading the case study, the client can be diagnosed with Alcohol Use Disorder
303.90 (F10.20) as the primary diagnosis, whereas the second diagnosis would be major
depressive disorder 296.33 (F33.2) (American Psychosocial Association, 2013).
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Jeff Case Study
Signs and Symptoms
DSM-5 Diagnostic Criteria: Alcohol Use
Disorder 303.90 (F10.20)
Client’s Signs/Reported Symptoms:
Criterion A: tolerance of alcohol increase Consuming more alcohol to get the same
drunk effect.
Criterion B: strong impulse towards alcohol
or craves the taste of alcohol
An increase on impulsivity in regard to
drinking after a long workday.
Criterion C: continues drinking even though
relationships are diminishing around him
Divorced, not close enough to children,
doesn’t talk much to his favorite brother.
Criterion D: withdrawal When drinking stops, bad headaches and
hangovers occur.
Criterion E: no concern for personal or
public safety
Goes to work intoxicated from the night
before.
Criterion F: irritable or provoked easily Has a tendency to get violent and has hit his
wife multiple different times.
DSM-5 Diagnostic Criteria: Major
Depressive Disorder, 296.33 (F33.2)
Client’s Signs/Reported Symptoms
Criterion A: has a depressed mood that
occurs longer than two days.
Has feelings of sadness most of the time.
Criterion B: weight loss Lost 25-30 pounds more so on the more
depressive side.
Criterion C: Insomnia or hypersomnia Has trouble sleeping at night.
Criterion D: feelings of fatigue Usually wakes up tired and hungover.
Criterion E: suicidal ideation Has thought about and planned how to
commit suicide.
Other DSM-5-TR Conditions Considered
There was another diagnosis that could have been considered, which would be
Substance/Medication-Induced disorder 291.89 (F10.24). This can be disregarded due to the
client’s symptoms of depression and his state of sadness that occurred whether or not he was
drinking. Another diagnosis that could have been considered would have been Persistent
Depressive disorder 300.4 (F34.1). This particular diagnosis can be disregarded to those
depressive symptoms not occurring persistently for the two-year mark.
Developmental Theories and/or Systemic Factors
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Jeff Case Study
After viewing the case study of Jeff, there seems to be several aspects in Jeff’s familial
relations that could possibly be the influence of his behavior. For starters, heavy drinking seems
to be a recurring factor within the family system, which can lead to a normalcy surrounding
drinking. It can lead him to think that his alcohol consumption is not seen as an issue per say but
as something that men just do in his family. According to research, the age in which one starts
drinking and family history of alcoholism has the potential risk to the client in regard to
becoming dependent upon alcohol (Salvatore, 2020). Another factor would be his divorce with
his wife. He seemed to be affected in his daily functioning such as losing interest in certain areas,
not eating enough, fatigue, and suicidal ideation.
Multicultural and/or Social Justice Considerations
According to the DSM-5, the criteria for Alcohol Use Disorder is equal within most of
races or ethnicities. In relation to Jeff’s case, alcohol consumption is apparent in everyday life for
him due to normalcy surrounding it. Within his immediate family, his father and brothers are all
heavy drinkers, which can help to influence the alcohol consumption within Jeff’s life. He
believes that heavy drinking is normal and stated that drinking is just something that a man does.
Treatment Recommendations
Key Issues for Treatment
Suicidal Ideation
Substance Abuse
Episodes of Depression
Recommendations for Individual Counseling
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Jeff Case Study
In this particular case, the first step to treatment would be for his suicidal ideations. A
little after two months of his wife leaving him, he started to have thoughts about suicide.
Cognitive Behavioral Therapy would be a good treatment to use for his case. Research has
shown that CBT is effective in the case of Alcohol Use Disorder, as well as strategies that are
preventive to suicidal ideation (Coates et al., 2018). During the CBT process, the counselor helps
the client to gain a better understanding of how their emotions are running and work to change
the thoughts that could trigger suicide.
Another treatment recommendation would be motivational interviewing. This particular
treatment focusses on helping the client realize their strong points and ability to be able to
change. It can be used to help an individual to be able to change even if they are not given
specific advice to help them. It uses specific aspects from CBT and other techniques that can be
used to help these individuals come up with solutions that is the best fit for them. This particular
treatment has been shown to be effective for the treatment of Alcohol Use Disorder (Frost et al.,
2018).
Specific Considerations
Counseling an individual who has multiple diagnoses is an important factor when
considering how to proceed with treatment planning. When there is a client that has different
diagnoses, the diagnosis with the greatest impact on the client should be what is addressed first,
as well as how can both diagnoses be treated with the same treatment. When considering dual
diagnoses, it can become complicated to be able to properly diagnose and treat both of these
disorders, so it is imperative that both of the diagnoses be screened and treated in order to have a
better outcome (Subodh et al., 2018).
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Jeff Case Study
References
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders:
DSM-5 (5th ed.). American Psychiatric Press, Inc.
Coates, J. M., Gullo, M. J., Feeney, G. F., Young, R. M., & Connor, J. P. (2018) A randomized
trial of personalized cognitive-behavior therapy for alcohol use disorder in a public health
clinic. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00297
Frost, H., Campbell, P., O’Carroll, R. E., Dombrowski, S. U., Williams, B., Cheyne, H., Coles,
E., & Pollock, A. (2018). Effectiveness of motivational interviewing on adult behavior
change in health and social care settings: a systematic review of reviews. PLOS ONE,
13(10). https://doi.org/10.1371/journal.pone.0204890
Grant, B. F., Saha, T. D., Ruan, W. J., Goldstein, R. B., Chou, S. P., Jung, J., Zhang, H., Smith, S.
M., Pickering, R. P., Huang, B., & Hasin, D. S. (2016). Epidemiology of DSM-5 Drug
Use Disorder. JAMA Psychiatry, 73(1), 39.
https://doi.org/10.1001/jamapsychiatry.2015.2132
Salvatore, J. E. (2020). Disentangling Social-Genetic from Rearing-Environment Effects for
Alcohol Use Disorder Using Swedish National Data. Psychological Science.
doi.org/10.1177/0956797620931542
Subodh, B. N., Sharma, N., & Shah, R. (2018). Psychosocial interventions in patients with dual
diagnosis. Indian Journal of Psychiatry, 60(4), 494-500.
https://doi.org/10.4103/psychiatry.IndianJPsychiatry_18_18
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