Robert Jones Case Study
Psychology
The Robert Jones case explores the case alcohol dependence by a middle aged man. The case is reviewed from the point where Robert Jones has had too much to drink and is arrested after being caught driving while drunk and failing a Blood alcohol test. He is consequmtly taken to court which requires him to attend psychological therapy as well as mandatory Alcoholics Anonymous classes. The case study reviews Jones’ attitude towards his alcohol dependence and his eventual acceptance of his condition. It explores the behavioural symptoms that led to the conclusion by the therapist that Robert was dependant on alcohol.
Part 1
Review of the Diagnosis
Under the five axes of DSM-Iv, Robert was diagnosed as follows;
Under the first axis which classifies clinical developmental, substance-abuse and learning disorders, Robert was diagnosed to have a psychological dependence on alcohol (Getzfeld & Schwartz, 2012). This is because he presented with denial, memory loss, carelessness and loss of control. He was also very defensive and did not seem to comprehend his problem or that he even had one.
The second and third axes, which largely classify mental disorders as well as physical and physiological disorders did not apply in Robert’s case. The fourth DSM axis classifies factors that cause, influence or affect the disorder of a patient or that may influence the treatment of the same (APA, 2000). In Robert’s case marital problems and legal problems resulted from his condition and in a large way influenced his treatment (APA, 2000). In the fifth axis, involves the Global Assessment of Functioning which is a scale used to measure the functioning of individuals in various dimensions (socially, psychologically, career wise).Robert did not score highly in the scale as he should have been functioning better at age 48.
Part 2
Justification of Diagnosis
The attending mental health expert’s diagnosis of Robert’s condition can be justifying by examination of the symptoms that the client presented with at the time of the diagnosis. For the Alcohol dependence diagnosis (Axis1) justification is provided by Robert’s high BAC test results as well as drunken driving, and evidence of loss of control both in driving and in financial spending. High tolerance, defensiveness and denial also helped to make the diagnosis. There was also evidence of significant memory loss. His inability to stop drinking by will was also put into consideration.
In axis 4, Robert’s wife’s testimony concerning marital problems as a result of Robert’s excessive drinking and her threats to leave the marriage was indicative of marital factors influenced by the condition. His drunken driving also led him to arrest and legal action against him. This was a direct result of his condition. His social life seems to have presented him with a desire to drink so as to fair on easier.
Part 3
Case Formulation
Although DSM_IV classification is usually preoccupied with overt characteristics in its classification of conditions and disorders, the case formulation in Robert’s case may be explored from a psychoanalytic point of view. The psychoanalytic theory mainly bases overt behaviour characteristics as a sign of a larger problem within (Paul, 2005). Using this perspective, it is possible to conclude that Robert’s overt drinking behaviours and his subsequent dependence on alcohol was a result of much deeper seated issues in his life. His need for alcohol for social purposes such as cook –outs and barbeques mentioned may be indicative of much more serious shyness and self esteem problems. His overly aggressive defensive behaviour when questioned about his condition by the therapist may be a form of compensation of certain insecurities within himself. He views therapy as a thing for mad people, a thing which he constantly repeats he isn’t. This may be compensation for a belief that he is not really ok and may need help. His treatment is aided by teaching him how to handle stressful; conditions, which results in speedy recovery. This may indicate an initial lack of ability to manage stress well. A lot of his reasons for drinking seem to boil down to an inability to handle stressful situations well which points to an internal problem. Personality disorders under axis 2 might have been considered in Roberts’s case if his physiological dependence on alcohol and his extended period of abuse had not been considered.
References
Getzfeld, A.R. & Schwartz, S. (2012).Abnormal Psychology. San Diego, CA: Bridge point
Education, Inc.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders,
4th ed., text revision . Washington, DC: Author.
Paul, R.M. (2005). Striving for Coherence: Psychiatry’s Efforts Over Classification. Journal of the
American Medical Association .Vol.20.2526-2528.
