Reference no: EM133567048

Case Study: Mr. Stein Mr. Stein, a 34-year-old married investment banker company owner, goes to a local outpatient clinic saying, "he is experiencing a nervous breakdown." He reports always being a worrier and lack of sleep oftentimes affects his life in a notable way. However, over the past year he experienced feelings of inner agitation, frustration, and is oftentime "keyed-up" most of the time. Mr. Stein has symptoms of stomach upsets and diarrhea over the past 6 months as well as a decreased ability to concentrate at work. His wife, an attractive and well-educated woman in her early-thirties, accompanies her husband to the clinic and expresses he tosses and turns in bed until the middle of the night, and frequently gets up to urinate. She goes on to complain that her husband has gotten very irritable in the past 6-8 months and frequently yells at people, even at their 7-year-old daughter. The oldest and only male in a family of four children, Mr. Stein is from an affluent and well-educated family steeped in tradition. His father, grand-father, and several other men in the family attended the same northeastern Ivy League university. Mr. Stein felt compelled to continue this tradition, but he was apprehensive that his academic skills were not refined enough, although he was in the 95 th percentile of his graduating class. Once he was accepted to this prestigious university, he began to feel the pressure to perform exceedingly well. Despite experiencing tremendous anxiety and tension around exam time, Mr. Stein graduated from the university with distinction. While in college, Mr. Stein began dating his wife and recalls that he would worry for days about whether he had picked the right restaurant for the date, whether he had selected the right flowers, or whether his car, which had recently undergone a minor repair, would break down on the date. He notes that although he worried a lot about something or other not working right, he never had difficulty asking women out on dates or having them accept. He describes himself as driven and generally on the extroverted side. Three years before the current evaluation, Mr. Stein's parents separated and his investment banker company came close to bankruptcy. At night, he lays awake staring at the ceiling and worrying about routine work issues, what the future holds for him, and how he would support himself and his family if his company went bankrupt. Mr. Stein went to see an internist and a Gastroenterologist, but his exams were normal and his symptoms. He calms himself down occasionally with a beer or two but denied any alcohol-related problems. He tried cocaine a couple of times in his late 20s but did not like the feeling and denies using any other street drugs. He feels sad but denies feelings of worthlessness or sucidial thoughts.

Questions:

• Discuss what symptoms, behaviors, and stressors you believe are present.
• What is your diagnosis of Mr. Stein?
• Based on the Diagnostic Features of your diagnosis, discuss how they apply to Mr. Stein.
• Discuss which modality you would consider using to help Mr. Stein and why?