Robert was encouraged to to seek counseling by his fiance, and willingly scheduled and attended his first appointment on April 18, 2011. Robert is unaware he that exhibits symptoms of Alcohol Dependence, with Physiological Dependance, minimizing the severity of his alcohol use. This diagnosis is based on the apparent increasing tolerance withdrawal symptoms, continued and increased use of alcohol despite the damage to social relationships and work performance. Also, he has used more alcohol to alleviate withdrawal symptoms. He has a history of alcohol use, resulting in missing work and even an arrest. He minimizes his alcohol use and makes excuses for the frequency and amount consumed. He does not show any concern for the effects the alcohol is having on relationships and at work.
Robert also shows symptoms of a Phase of Life Problem. He states that there is concern with any changes the upcoming marriage will cause. I believe that the failure of his parent’s marriage had effected the way he sees relationships and has a negative or doubting attitude towards marriage. This could in fact, be adding stress and anxiety due to his plan to get married.
Alcohol Dependence is distinguished from “social drinking” due to multiple symptoms being exhibited over extended period of time. These symptoms include: tolerance, withdrawal, and compulsive use.
Robert reports a time of being “down in the dumps and hated most people, but getting through it.” This doesn’t meet the criteria for depression, but should be monitored due to up-coming marriage and change of life stressors.
Additional Information/Assessments Needed:
Suicide Risk Assessment
Physical examination and laboratory tests to check for possible liver and kidney damage
Although depression does not...