Mr. and Mrs. J seek counseling for “communication issues.” During the first session, Mrs. J complains that Mr. J has “no interest” in her sexually, stating they have in fact not had any sexual interaction in over a year. They live together and have very little conflict, neither recalling the last time they argued. They mostly live separate lives, each highly valuing individuality, but do attend school events and church together regularly.
He is 46 and she, 38 years old, they have been married for 5 years, and have three school-aged children between them (each having children from prior marriages, but not having children together) living at home. Mr. J is an attorney, and works 50-60 hour work weeks. Mrs. J is a dietician, and works 35-40 hour work weeks at a local hospital. Childcare is shared between them, but often time activities are divided up based on interest, often leaving them active with their biological children (Mrs. J recants, “he and his sons enjoy sports, me and my son enjoy theater”). He has had problems with blood pressure, and takes medication to keep it under control. She had a hysterectomy last year. Neither have any history of mental health struggles.
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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