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Question: Joseph is a 23-year-old student nurse in his first year of a nursing degree. Joseph was a high achiever prior to starting his nursing degree and he was captain of his local rugby team. However, Joseph has lost interest in rugby and is struggling to keep on top of his assignments. He is often late or absent from his lectures (reporting that he struggles with sleeping and waking up). He appears withdrawn, his levels of hygiene has deteriorated, and he has lost weight. Joseph lives with his mother and father. His father has an alcohol dependency and has a tendency to be abusive to Joseph's mother when he is under the influence of alcohol. Joseph reports that he does not want to be at home, but he does not want to be anywhere else either. Joseph has been prescribed anti-depressants and was referred for Cognitive Behavioural Therapy (CBT). Joseph has been taking the antidepressants for 4 months, and he has not noticed any change in himself. Joseph has attended 11 sessions of CBT but explains "it is not doing anything". Joseph reports that he wishes his life had ended, and feelings of "what's the point anymore". Although he does talk
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