Case Study 1

Teresa is a 32-year-old woman in your practice who frequently misses her appointments, and at other times shows up without an appointment, often in crisis. She currently uses alcohol and tobacco, and has started to use street drugs.

As you have developed a therapeutic relationship with Teresa, you learn that she grew up in a household with a violent father who frequently assaulted her mother, her siblings and herself. Although now estranged from her father, the impact of his violence presents itself on a daily basis as Teresa struggles to cope with the trauma she experienced.

Teresa left school early, has few marketable skills and has never been able to hold a job for more than three months. Teresa receives $606 per month from Ontario Works and has no money left for food or other essentials at the end of the month. She is currently in a relationship with a man whom you suspect may be violent

Case Study 2

Thomas, a 16-year-old high school student, visits you during class in distress. He tells you that he’s being bullied at school because the kids think he is gay. Thomas tells you he thinks he might be transexual, but that he is scared to tell anyone, and voices suicide ideation. He is not supported at home: his mother and father, both professionals, work long hours and his older sister picks on him. Thomas’s best friend since the age of 10 recently told him he didn’t want to hang out with him anymore because he was “weird.” A few months ago another friend who was picked on more than Thomas went missing. Rumor in the school indicates that he ended his life.

Case Study 3

Anthony, 29, is under the jurisdiction of your local provincial Mental Health Review Board on your acute care ward. He’s in breach of a disposition because of repeated alcohol and marijuana use; Anthony is also diagnosed with bipolar disorder and is currently prescribed olanzapine 10 mg and lithium 800 mg daily. He experiences mania when he uses substances, and the incident that led to his review occurred when he was under the influence (he racked up over $100,000 in property damages). He uses substances and alcohol due to the negative side effects (weight gain) from his prescribed medications. Anthony is divorced and recently obtained regular visits with his kids. He holds down a steady job in construction, but he’s worried about losing his employment because he sometimes misses shifts.

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