Clinical Vignette Mr. Wilson is a 37-year-old male veteran with posttraumatic stress disorder (PTSD) related to combat service in Iraq and a past history of alcohol use disorder. He had two deployments to Afghanistan and Iraq. His job was ordinance removal for which on several occasions he had to clean up after a bomb explosion. […]
Clinical Vignette Irving Gardner is a 48-year-old married Black heterosexual cisgender man working as a lawyer who was referred for treatment by his primary care provider. His presenting problems were nocturnal complaints of difficulty initiating and maintaining sleep and daytime complaints of fatigue and difficulties with concentration and attention. He also presented with daytime and […]
Clinical Vignettes Vignette 1 In January 2020, you started working with Maria, a 35-year-old client with obsessive-compulsive disorder (OCD) centered on contamination-related concerns. You and Maria collaboratively developed a hierarchy of items through which you were making uncertain but steady progress, starting with repeatedly saying words such as “germs,” and working towards classic exposures that […]
Clinical Vignette Lindsey is a 27-year-old transgender female client who contacted your practice looking for an assessment due to difficulties with social interactions and staying focused at work and home. She is hoping to better understand herself, receive a diagnosis (if applicable), and receive support and recommendations. During your initial contact with her through a […]
Clinical Vignettes Samira: Irritability, Emotion Regulation, and Bonding Samira is a 35-year-old, married, cisgender, first generation Indian American woman. She initiated treatment in the third trimester of pregnancy for mild depression and anxiety. In her first few days postpartum (i.e., following delivery), her symptoms of anhedonia, avolition, insomnia, and excessive guilt worsened, and she struggled […]
Clinical Vignette “James”[1] is a 20-year-old cisgender (he/him/his pronouns), bisexual, Black young man living and attending college in a northeastern metropolitan area of the United States (US). James’ family moved to the US from the Caribbean when he was a toddler. His family raised him in a working-class community not far from the college he […]
Clinical Vignette Dr. Smith identifies as a 36-year-old cisgender woman (she/her/hers) who works as a full-time, un-tenured, assistant professor and neurologist at a large academic center. She has a large clinical practice with limited grant funding for clinical research. She is a mom to a young son Max. Recently she started her current professional staff […]
Clinical Vignettes Jasper Jasper (they/them/theirs) is a 17-year-old, Mexican American, pansexual, transmasculine person. As a health service psychologist, Jasper was referred to you for depressive symptoms. You have been conducting weekly therapy sessions with them for the past six weeks. In their most recent session, Jasper tells you a story about a visit to the […]
Written by Terry Bardagjy on October 31, 2022
Some readers may prefer to read this article in PDF format, available on the Pragmatic Case Studies in Psychotherapy website. Editor’s Note: for the interested reader, an outline of the structure of the case study of Kelly is shown in Appendix 1, and a Glossary of technical terms is shown in Appendix 2. CASE CONTEXT […]
Clinical Vignette John is a 54-year-old man being seen by his primary care provider (PCP) for management of diabetes, chronic pain, and chronic obstructive pulmonary disease. When he screens positively on a brief depression screener at his regular primary care appointment, his PCP asks him whether he would be interested in meeting with the primary […]