Case diagnosis

MHC 610 Client Case File Charles “CJ” Jones You are a counselor in an on-campus counseling center. Charles “CJ” Jones is a 21-year-old, single, straight, African American and Lakota man who sought treatment because he “feels lost,” withdrawn from friends, and “worried about money.” He said he had been feeling increasingly depressed for two months, and he attributes this to two essentially concurrent events: the end of a three-year romantic relationship (four months ago) and being unable to find his ideal employment situation. Mr. Jones has been on a job search for around five months. Mr. Jones has supported himself financially since high school and is accustomed to feeling nervous about making ends meet. He has become more worried after breaking up with his longtime live-in girlfriend, so he approached a family friend for financial help. He was turned down, leading him to feel alone in his financial struggles. This disappointment revived long-standing anger and sadness about not feeling close to and supported by either of his parents. His friends taunted him for “falling apart” over wanting to be financially stable saying, “We’re young. You have time to figure this out!” Mr. Jones is a full-time undergraduate student in his final year of college studying computer science; he also works full-time as a midnight-shift warehouse worker. When he finishes his early-morning shift, he finds it hard to “slow down,” and he has trouble sleeping. He has been looking for work daily and applies for jobs that are less physically demanding, with more flexible hours, but never gets past the phone call or interview. His appetite is unchanged, and his physical health is good. His grades have recently declined, and he has become increasingly discouraged about money and about being single. He has not previously sought mental health services, but a supportive cousin suggested seeing a counselor. Mr. Jones was raised as an only child by his mother and her extended family who all identify as African American. Mr. Jones reports that his extended family identifies as Baptist and, in his youth, he spent some time with family members at church; however, he now identifies as spiritual rather than religious. Mr. Jones describes that he has been drawn to exploring the spiritual beliefs and practices of the Lakota Nation. Mr. Jones regularly keeps in touch with his maternal extended family. Growing up, Mr. Jones mentioned he was a “good student and popular kid.” High school was complicated by his mother’s two-year period of unemployment and his experimentation with alcohol and marijuana. He recalled several heavy drinking episodes at age 14 and first use of marijuana at age 15. He smoked marijuana daily for much of his junior year and stopped heavy use under pressure from a girlfriend. At the time of the evaluation, he had “an occasional beer” and limited marijuana use to “being social” several times a month. Mr. Jones described his childhood as “normal,” and that while he had a very close relationship with his mother, it deteriorated in his adolescence. Mr. Jones’s mother decided that he should move out when he finished high school. She was dating a man she subsequently married and wanted time alone with this man. She was clear about her feelings that he needed to be more independent from her and that it was “finally her turn.” Mr. Jones’s father left shortly before his birth, telling his mother, “I didn’t sign on for this.” She relayed this story to him often in his childhood. On examination, Mr. Jones is punctual, cooperative, pleasant, attentive, appropriately dressed, and well groomed. He speaks coherently. He appears generally worried and constricted, but he did smile

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appropriately several times during the interview. He has a quiet, dry sense of humor. He denied suicidality, homicidality, and psychosis. He’s cognitively intact, and his insight and judgment were considered good. In your first session, Mr. Jones communicated to you that as a young biracial man, he is generally expected to be strong and independent, and norms of masculinity have made him hesitant to attend counseling. He further expressed that his family views counseling as something that is only for “crazy people.” He informs you that there may be individuals in his family struggling with addiction and other mental health concerns who are not receiving treatment.