Description

PATIENT SCENARIO

David S. is a bright and articulate 20-year-old student who is currently in his third year of college. He was referred to the clinic by his parents due to him recently experiencing anger outbursts. He is challenged by low motivation and is struggling with academic underachievement. David is creative and intelligent, but has been disappointed by his academic performance last year. David also reports that he struggles with feelings of internal restlessness, an inconsistent ability to concentrate, and difficulty with time management. He indicates that he has always had a difficult time concentrating in class, and that his mind has a tendency to wander. He states that at times his immediate reaction to anger and frustration is to become verbally defensive and irritable. He sometimes breaks things if he is really angry. David admits to having a daily dependence on marijuana. He states that this smoking helps to “calm” his mind and to decrease the perceived “non-stop” restlessness of his thoughts. While he has been trying to cut back on his marijuana usage, he smokes half a pack of cigarettes per day, and reports some concern that he has begun replacing marijuana with alcohol use. “Binge” drinking with friends is increasing. His parents are concerned, especially when he had previously been successful academically and socially in secondary school when he was living at home.