What are the clients most prominent lsquopresenting issues


Leon is a 52-year old man who describes his family of origin as "extremely dysfunctional," with both parents having "addictive personalities." His father was an alcoholic, and fathered many children by several woman. Leon's father was also verbally and physically abusive. Shouting and violence were common family experiences.

His parents divorced when Leon was six. As a divorcee with illegitimate children, his mother became an outcast in his small town, so she moved his family to Mexico City. There, his mother dealt with the stresses of life by becoming extremely angry and violent with her children. At age 17, Leon had reached the limit of his ability to endure this violence. He moved out of the house, along with his brothers and sisters. As the oldest child, Leon became the main source of support for his younger siblings.

Leon studied to be a plumber, and later a general contractor. He had deep anxiety about committing to marriage and family, and especially feared being abandoned. Eventually, Leon married a designer, and they had two daughters, and have been married for 27 years. He describes himself as "committed, but distant" from his wife, feeling himself disengaged from family activities and finding little joy in anything. Mostly apathetic, recently, his older daughter chose to work instead of attending college, Leon noted that he reacted with frustration and anger, reminding himself of his mother. Leon feels lack of energy, occasional heart palpitations, insomnia, and constipation (since age six, when his parents divorced).

References

Problems of Body, Mind,• & Mood Specific diagnoses & key features, Etiology, Diagnostic & Values and the Helping Relationship •Treatment issues

Read: Yarhouse, Butman,• & McCray: Ch. 6 & 8; Collins: Ch. 10 & 11; Corey: Ch. 3

Review Bb Learning Unit (In Course Materials and Assignments section) and complete Discussion Board•

Please respond (short answer is fine) to all of the following questions:

In your diagnosis, please use DSM IV-TR diagnoses when appropriate (found in your powerpoint presentations)

What are the client's most prominent ‘presenting issues' (that is, what seems to take priority as being wrong)?

What else do you feel you need to know (or, what might be some areas you may ask about in order to determine what is going on and how severe the problem may be)?

What do you think may be your ‘initial diagnosis' based on the information given in the case study? Why?

What, if any, psychospiritual factors might be present and maintaining the presenting issue?

What are possible methods of treatment or referral?

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