Introduction: The case presented here is Mr. Juan Alvarez a 45-year-old, Mexican American married male, with three children(Boy-13, Boy-11 and Girl-9). He was recently employed as engineer working for a large tech company thatmanufactures microchips and his wife works as a middle school teacher. Due to his company facing economicconcerns they closed his work site down and was laid off with several others. Mr. Alvarez was prompted by his wife to see his primary care physician (PCP) after he had been "moping around the house," avoiding friends, andhad shown little interest in participating in family or social activities. He often complained of feeling fatigued andtired, experiencing a loss of interest in social and family interaction, isolating himself from friends, and havingdifficulty concentrating. These symptoms had persisted for about 9 months, having begun shortly after he was laid off from his job. Following the visit to his physician, the PCP concluded that Mr. Alvarez was suffering fromdepression and gave him a referral for mental health treatment. Although initially he was reluctant to seek mentalhealth services, Mr. Alvarez, again at the behest of his wife, set up an appointment to see a therapist.

Presenting Complaints: Mr. Alvarez initially indicated that he thought his problems (e.g., feeling tired and not eating or sleeping well) werephysical. He admitted that he worried about his future and his ability to support his family due to his recent jobloss. He stated that his wife had urged him to seek help because she thought he was depressed. When asked aboutthis, he admitted feeling "down" occasionally but denied feeling depressed and appeared somewhat defensiveabout it. He said he not "depressed but disappointed in himself" because he can no longer financially provide forhis family. In his personal history inventory, Mr. Alvarez denied any past history of depression or any other mentalhealth issue. He also denied any past or present use of alcohol or other drugs. The results from a physical exam and laboratory work done by his PCP revealed no physical health concerns. There is no history of suicide ideation.

Initial Interview: Mr. Alvarez reported being the third of four brothers born to parents who were Mexican migrant workers in Yuma,Arizona. Throughout his childhood and formative years, he witnessed his parents working long and hard hours tobe able to provide for the children and ensure their education. Mr. Alvarez had been an excellent studentthroughout his school years and attended a local university. He was the first member of his family to graduate college and receive a degree in engineering. Following his graduation, he accepted a job offer from one of the techcompanies, and shortly after, he got married. Eventually, Mr. Alvarez also earned a master's degree in engineering.He worked for 23 years before he was laid off. Mr. Alvarez stated he loved his job and discussed his work designing machines that manufactured microchips that ae used in our phones.In the case of Mr. Alvarez, although he had been born and raised in the United States, he had remained engagedwith the Mexican culture of his family. As an adult, he continued to value the various aspects and traditions of hisoriginal culture while successfully participating in all aspects (e.g., education, employment, friendships, etc.) of thedominant American culture. Growing up within his family of origin, Spanish had been the dominant language at home. Now, English and Spanish were used in the home although English was the language preferred by hischildren. Nonetheless, Mr. Alvarez strived to maintain the use of Spanish and used it at every opportunity withboth his wife and children. The food he enjoyed, the music he listened to, and other aspects of his current family life reflected his family's Mexican culture. At an early age, he learned the central importance of the concept offamily and the respect afforded to the father. Mr. Alverez has always prided himself in being self-sufficient andproviding for his family.Mr. Alvarez presented core beliefs that were both positive, "I am a hard worker," "I am competent," "Family is the most important thing in life" and negative "A good man is a providerI am not a provider," "I have let my familydownI am useless". Mr. Alvarez explained that he did not see himself as "useless" because he had lost his job butrather, he saw himself as "useless" because in his view he was no longer a provider for his family. Mr. Alvarezstated he grew up learning, "A man should provide for his family"; "If a man does not provide for his family, thenhe is not a man"; and "If I provide for my family I will be respected by others."Mr. Alverez explained that financially they "good" for the time being and had enough to "meet their needs". Hewent on to tell the clinician, his wife continued to work and he had significant financial benefits accrued from hispast job including a "decent" severance package.Mr. Alvarez had followed a couple of job leads without success, and each time this happened he felt "frustrated"and "just not motivated". The client stated that each time he went out for an interview "everyone asked how itwent" and it was "tough" to explain he did not get the job. It appears as a reaction to this situation he began toisolate from family spending more time in his room and not attending family events. Mr. Alvarez stated that he gotso frustrated he has "basically stopped" looking and applying for employment. Mr. Alvarez said he thinks that a lotof what he is feeling is just because he "is tired" and "feeling rundown". Mr. Alvarez did say he would be willing totry a couple of counseling sessions but was not "overly optimistic" about it working. "I owe it to my family to givethis a try..... maybe this is in my head...I don't know".

Treatment plan (template below). Remember you are demonstrating the ability to match appropriate interventions to the clients presenting problems and needs.You will be graded on the following:

• Do the overall goal, treatment goals and objectives align to complete a comprehensive plan?
• Are the treatment goals clear and measurable?
• Do the objectives create a stepped plan to meet the goal?
• Are the objectives intervention based and specific?

Diagnosis (if applicable):

Overall Treatment Goal:

Treatment Goal 1:

Objectives:

Interventions used in objectives:

Treatment Goal 2:

Objectives:

Interventions used in objectives:

Treatment Goal 3:

Objectives:

Interventions used in objectives:

Treatment Plan Estimated Date of Completion:

Treatment Plan Next Review Date:

Client Signature:	Date:
Therapist Signature:	Date