Course of Treatment

The initial assessment indicated that Bob was experiencing a marked crisis across two of the three domains (behavior and cognition) with a total severity score of 25. This score suggested that the clinician should use a very direct approach in helping Bob. The imme- diate course of treatment involved using direct statements to place Bob on the shortest course to resolving the crisis. Although the behavioral and cognitive reactions were assessed at 9 on the severity scales, the clinician began by addressing Bob’s behavioral reaction. The clinician chose this approach to ensure Bob’s safety. The clinician worked to have Bob contact his family and use them as a support system. The discussion focused on helping Bob work out what he would say. After he talked with Bob for approximately 45 minutes, Bob was able to telephone his family to let them know where he was and that he was safe. During the call, Bob talked briefly with them about what had happened and asked them to pick him up, and they agreed to do so.

Before Bob’s family arrived, the clinician began helping Bob sort out his thoughts. This process involved helping Bob develop a strategy to determine his financial status. The clinician recommended that Bob contact someone who would be able to determine his financial status. The thought was that Bob was not able at this time to gather this information on his own and someone with experience in this area would be of great assistance. Although Bob did not know of anyone with this expertise, he agreed to talk with his extended family about his fears and to ask their advice about whom he might contact.