Not really sure if this is the right thing in the right place but I give up now :)

Identifying experiences of distress – naming them – what are they?

 

 

 

 

 

Periods of mania, low mood, anger and anxiety, period of inpatient admission. His father alcoholic and violent to mother and children. Worsened when business was struggling. Sexual abuse on several occasions – trauma PTSD – may have thought he was a bad person or questioned sexuality etc. Started drinking when 15 and failed GCSE’s. Parents divorced and dad moved back to Italy and hasn’t kept in contact. Effect of divorce massive – had to move and financially unstable. Jack drunk a lot of alcohol, took drugs and became involved in petty theft. Mother kicked him out of house and slept rough for a few months – loss of basic self care increasing chance of abnormal ideation and experiences like seeing his fathers face. Diagnosed with depression, paranoia and persistent delusional disorder – Robbie Williams. Looking in mirror and seeing fathers face reflected – fear and self-loathing. Avoidance and vigilance
Can you identify possible causes (there might be more than one) of those experiences and/or circumstances that might be contributing to those

experiences?

 

 

 

Father failing – may have seen himself to blame for his fathers anger, lack of emotional and financial support from family, drugs/alcohol – seen as his model of how men cope with stress, feeling of isolation, lack of sleep, trauma. Feels like he is failing to provide for his family – therefore similar to his father.
What diagnosis might be offered and why?

Remember a formulation is not premised on a functional psychiatric diagnosis

 

 

Diagnosed with depression – instead of writing problem as depression can ask ‘in what ways does depression show itself in your life?’, paranoia and persistent delusional disorder – Robbie Williams. Given medication. Due to emotional neglect and drugs/alcohol. Turned to the drugs/alcohol as coping mechanism for his depression.
What kinds of interventions might you suggest in this situation?

 

 

 

 

 

 

 

CBT therapy for his issues surrounding his dad and sexual abuse – both jack and therapist identify area that caused greatest distress in his life – collaboration, drug/alcohol rehab, an intervention to get him back into education & off the street, maybe put in mental hospital to help recover from the persistent delusional disorder so he no longer feels threatened by Robbie Williams. Evaluate and modify the unhelpful thinking then can positively affect his emotional wellbeing – learn healthier and more adaptive beliefs about himself and world around him.
Service-user’s strengths & achievements?

 

 

 

 

 

Loves music/talent, did originally do well at school and popular/sociable, still loves his dad – shows how much love he has to offer, compliant with medication and obviously wants to be helped. Ask if there are areas of his life that he manages more effectively and even enjoys, and how he copes with his low moods. Ability to form and make good use of family relationships in the past.