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Bob is a 47-year-old Native American man who comes to you with his wife of 15 years. He appears agitated and complains that he feels anxious. His wife reports that Bob has had a lot of trouble sitting still, frequently jumping up and pacing. While he has been this way throughout their marriage, it is getting increasingly worse. Bob tells you that he is a lot like his abusive father, who died of alcoholism. Bob feels that if he drank, he’d be able to relax, but swore he would never be like his father. The wife tells you that the children are frightened when Bob gets agitated as he has punched holes in walls. You notice the wife looks frightened when you ask her if she feels the children are safe in the home.
Discuss case-specific cultural factors as well as legal and ethical issues present in each case.
- Indicate the possible etiologies in a general way and the steps you would take to diagnose, treat, and manage these cases, with consideration of pharmacological intervention
- You don’t need to discuss every detail of your treatment – just write from the standpoint of a clinical psychotherapist who does not prescribe medication, but coordinates care with physicians who do.
