Running head: THE CASE OF MARK SNOOZE 1
THE CASE OF MARK SNOOZE 2
The Case of Mark Snooze
This is a sample of a case study. It is not perfect and if it in anyway disagrees with the instructions or the grading rubric, follow the instructions and the grading rubric. This will hopefully give you a general idea of how to write a Case Study. There are places in the case study where you will have to use the passive voice and it will be appropriate, this is when the there is no person who can be the doer of the action and still present the case in an objective manner. An example of this would be: A personality disorder is ruled out. The only other way you could say it would be I ruled out and you do not want to use first person in this report at all.
This case study is a bit shorter than what is assigned for your project, so be sure to add the needed details in order to meet the length requirement.
The Case of Mark Snooze
(The information should be obtained from the book, Rosa Lee: A Mother and Her Family in Urban America, but written in a clinical style. You should still be using proper APA style citing and quoting to indicate that this information is from the book.)
Name: Mark Snooze
Dates of Interviews: 2/2/22
Evaluator: Cindy Counselor
Reason for Assessment
Mark Snooze is a 43-year old Caucasian male of average height and mildly overweight build. Mark has been married for 20 years. He has a daughter, Heidi, who is a student at Michigan State, and a step-child who is in the military. Mark has worked with a union plumbing job for the past 18 years. Lately, he has been repeatedly late for work and has excessive absences. He recently participated in counseling through his company’s Employment Assistance Program (EAP); however, he has reached the allowable limit of 3 sessions and EAP referred him for consultation and further counseling. In addition to occupational difficulties, his presenting complaints consist of a lack of concern about anything and a strained relationship with his wife. He states, “The only thing I care about is that I don’t care. Everything sucks.”
Sources of Information
Self-report and family input, in addition to records from EAP program were the sources of information.
Mark is the middle child with an older brother (a professor at Virginia Tech), and a younger sister (now deceased). His mother is a retired secretary and his father is a retired teacher. Mark reports no experiences of early childhood trauma or abuse. Although he sees his family as lazy and boring, he does not report any strained relationships with his biological family. He has a daughter in college and a step-child in the military, and apparently has a positive but distant relationship with them both. As mentioned previously, his relationship with his wife is unpleasant. Mark works with the same union plumbing company for the past 18 years. Prior to the past two years, he enjoyed his work, but now sees it as just something he has to do. He has no military history.
Regarding Mark’s romantic and sexual relationship history, he has been faithfully married to his wife for 20 years. Though he acknowledges flirting with other women at parties years ago, his wife has been his only sexual partner since they married. Mark currently reports the sexual relationship as being “not a problem,” due to his lack of interest in a sexual relations between himself and his wife.
Mark has a slight history of aggression, as he reports getting drunk and getting in a fight some years ago. He had a problem with the law due to an incident of disorderly conduct and public intoxication, but the charges were dismissed. Other legal history involves three DUIs, the last of which he did serve 7 days in jail and had to attend driver safety classes.
As mentioned previously, Mark’s recreational history included working on and riding his motorcycle, going to parties, playing softball, hunting, and socializing with family and friends. Prior to the last two years of feeling depressed, Mark was actively involved in these activities and enjoyed them as well.
Spiritual history includes a brief period of going to a Christian Science church, but becoming unsatisfied with their practices. This occurred prior to the period where Mark began to feel depressed, and he states he has no desire to continue any spiritual involvement with this organization.
Mark’s support system historically included his wife, child and step-child, co-workers, and friends. However, his relationships are problematic because of Mark’s depression and alcohol use; his support system has waned in the past couple of years.
Mark’s typical daily activities include waking up, possibly being late for work because of oversleeping, or possibly not going into work at all that day. Mark describes a feeling unrested upon awakening. Mark works typical day shift hours at his plumbing job, and reports being unable to concentrate at his job and throughout his day. Mark admits, “I drink a lot.” He denies incidences of drinking on the job, though he admits that approximately 20 times in 10 years, he has taken a drink of alcohol at work during his lunch break. When Mark returns from work, he normally drinks six beers every night in order to “chill out.”
Although Mark has excessive tardiness and absences at work, he is able to complete other typical activities of daily living (ADLs) on most days. However, he emphasizes feeling depressed and tired throughout the day, most days of the week. His sleep patterns are reportedly “chaotic,” as he reports that he wakes up earlier than he used to. Additionally, he reports increased need for sleep, sometimes sleeping 16 hours/day, mainly on weekends when he is not working. He currently no longer participates, or has a desire to participate in activities and hobbies he used to, including riding his motorcycle and going to parties with friends. He currently has a lack of desire to do so. Mark reports a definite change in overall functioning within the past two years, as well as weight gain of approximately 20 pounds in the last 18 months. He reports appetite changes, as he describes himself as overeating and being hungry all the time. Additionally, Mark reports a decrease in his sexual drive, but cannot pinpoint whether it is because of him or because of the tension between him and his wife. He says this is “not an issue.”
Mark has self-perceived strengths; he sees himself as a faithful worker and good at his plumbing job. Additionally, he describes himself as a good hunter. Additionally, Mark mentioned his previous enjoyment of social activities with friends and family and perceives himself as a “fun guy to hang out with” prior to the past two years. Self-reported weaknesses are his lack of desire to participate in any activities with anyone. He sees an additional weakness in his drinking problem, but lacks knowledge about how to approach this issue.
Mark reports various coping skills prior to the past two months when he has struggled with depression. He reports being involved in church, socializing with friends and family, as well as working on and riding his motorcycle. However, for the past two months, Mark reports lack of using these coping skills. Instead, Mark drinks approximately six beers per night to calm down each day as a way to cope
Indicators of Substance Use Disorder
Attitude and behavior. He focuses on activities related to his drinking and he often is negative and short tempered when dealing with a hangover or craving alcohol.
Social Functioning of Mark: He seems to focus more on his drinking friends. He lacks a positive support system.
Occupational functioning. He is on the verge of losing his job due to not functioning well after his nightly drinking binges. He seems to be in denial about this situation.
Financial aspects. Marks makes poor choices when under the influence and does not have any extra money at this time.
Familial relationships. Marks familial relationships continue to weaken. His wife, child, and step-child struggle to maintain a relationship with him.
Legal history. Mark had several incidents with the law including three DUIs, and dropped charges involving disorderly conduct and public intoxication.
Health history. Mark receives treatment for Hepatitis C.
Spiritual history. Mark is currently not involved in any church and has a negative attitude about God, religion, and church. He says, “I do not need such crutches.”
For the past two months, Mark has exhibited symptoms of a Major Depressive Disorder, including a major depressive episode. Qualifying symptoms include depressed mood most of the day, nearly every day; loss of interest or pleasure in previously enjoyed activities; psychomotor retardation which have been clinically observed; fatigue or loss of energy nearly every day; difficulty concentrating. Additionally, Mark exhibits an increased appetite nearly every day and hypersomnia many days of the week.
Absence of hypomanic, manic, or mixed symptoms eliminates bipolar disorders, and absence of delusions and hallucinations eliminate psychotic disorders. A Major Depressive Disorder, single episode seem most appropriate given the presenting symptoms. Other differential diagnoses considered are a Substance-Induced Mood Disorder, with depressive features and Dysthymia. However, Mark has been drinking for much longer than the symptoms occurred, he has not increased the amount of alcohol, and his symptoms are much better accounted for through a mood disorder. Due to this latter reason, sleep disorders and eating disorders can be ruled out as well.
An additional diagnosis of Alcohol Use Disorder can be noted. Mark’s additional diagnosis of Alcohol Use Disorder exists because of the following symptoms: a maladaptive pattern of using alcohol within a 12-month period in which Mark’s life has been significantly impaired; inability to consistently fulfill work obligations and home obligations; continuing to drive while drinking, even though Mark knows it is hazardous; recurrent legal issues related to his alcohol use; as well as continued use of alcohol even though its use has negatively impacted his lifestyle.
It is important to note the difficulty in making a psychological diagnosis, due to the unknown factor of the extent in which Mark’s Hepatitis C affects his mood. The co-morbidity of a chronic disease and depression is often substantial. Each component must be thoroughly examined to understand if Mark’s depressive symptoms are related to HCV symptoms, or if they are a separate issue. Until further follow-up from Mark’s physician, the diagnostic impression is as follows:
296.22 Major Depressive Disorder, Single Episode, Chronic, Without Psychotic Features
303.90 Alcohol Use Disorder
This part you need to research. Find treatments that are empirically validated. You MUST use Clinton and Scalise (2013) and other resources in this section, including multiple presentations from the course. Explain what research says about the treatments; why you choose these modalities of treatment; and what the expected outcome is. Be sure to cite your sources and use only scholarly sources (your textbooks and in addition peer reviewed journals and/or edited books). Do not use websites! This part of your paper should be at least two pages.