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Question
The client is a 22 year old Hispanic male who self-referred to the intake office today. He reports that he bought a gun 2 months ago with the plan to end his life and has the gun in his car. Police are called and find the gun as stated, but no bullets. The man reports having made suicide plans with specific timetables to end his life several times over the 8 weeks, but held back at the last minute. "I cannot live any more with the pain of my wife and children leaving (3 years previous). He admits to beating his when they were together; she is in another relationship now and he recently learned of her plans to remarry. He has no contact with his daughters from the marriage and is isolated from his own family. He describes his distress having increased over the past week, though the client can give no specific reasons for this. The client reports an extensive history of substance dependence including alcohol, meth and opioid medication that led to his divorce, but that he has been clean and sober for 14 months with the help of a detox and ongoing attendance in AA/NA. When he was attending AA/NA, he reports having many people in his support group and enjoyed volunteering with homeless outreach. He stopped using following an arrest for theft, and a subsequent hospital admission for suicide attempt by overdose on opioids and alcohol. He stopped attending AA/NA because he found a job at a local car dealership but was let go after his criminal record was brought up. He has no job and has not returned to AA/NA. During the interview the client appears depressed and irritable; he is angry and hostile, especially with female staff. There reports difficulty sleeping and poor appetite.
1. How would you develop rapport with the client specifically? What information of his would you use to try to develop a relationship?
2. What is the core problem? How well is the client functioning? How does the client perceive his situation?
3. What coping skills could you employ with the client? How would you follow up? Who would you refer the client to?
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