CASE CONCEPTUALIZATION

James is 33 years old and identifies as a Caucasian, heterosexual, cis-gendered male. He prefers to be called “Jim” when being addressed. Jim reports he has been married to his “high school sweetheart” for 10 years. He and his wife share two biological children, one male and one female ages 4 and 6, respectively. He states, “I am a practicing Catholic, and my faith is very important to my family” on his intake forms. Jim is employed full time in an upper management position at a multinational biotechnology research and development firm.

Jim reports he has never seen a mental health provider, and expresses discomfort with the idea of counseling, as he is concerned others will view him as “a crazy alcoholic” if they were to find out. He notes that recently his wife told him she would “take the kids and leave” if he did not seek help for his drinking patterns. Jim states he believes his wife is “overreacting” to “a few bad nights” and is “hyper-sensitive because both her parents are alcoholics.”

Jim reports his first exposure to alcohol was at the age of 9, when he drank about half of his father’s beer at a neighborhood party. Jim states that when he was 14, he began consuming beer on the weekends with his friends. He estimates that he drank about two or three beers once a month or less throughout high school. His drinking patterns increased during his first year at college, stating, “I drank Thursday through Sunday, and it never bothered me. I couldn’t even tell you how much I drank.” He was unable to manage school and these drinking behaviors for long and reduced his drinking to one or two nights per week.

Jim states he began drinking whiskey after work with his co-workers approximately 5 years ago. He was able to describe a significant amount of stress as he rose through the ranks at his organization. Drinking became a way to “unwind and socialize” and was also an “expectation” when on business trips. Over the past 6 months, Jim notes he has had three episodes where he was intoxicated to the point of a “blackout.” During each occurrence, he was at home drinking alone on a weekend night. He also reports that in the past month, he has missed three days of work due to not feeling well after a drinking episode, and this is beginning to impact his relationship with the leadership at the firm.

Addiction Case Conceptualization Template