Kristofer Goldsmith was 19-year-old, fresh out of high school, when he joined the Army. He was soon deployed to Sadr City, one of the most violent places in Iraq. Goldsmith's duty was to photograph and document the incidents his platoon encountered, including mutilated men, women, and children.

When his unit was back home for a while, family and friends noticed that Goldsmith was a different man. His drinking escalated to binges every day. He also seemed to get into fights or be violent in some way every day. He was constantly hypervigilant for any threats. Simply walking through a crowded shopping mall was enough to spark paranoia as he scanned every person and scene for enemies who might spring out and hurt him. Innocent remarks by clerks or being touched by someone as he was waling by could spark violent outbursts. There were times when he seemed not to know what he was doing and was totally out of control. At one party, he sudently grabbed another guy and choked him until he stopped breathing.

Soon Goldsmith's unit was ordered to redeploy to Iraq. Believing he couldn't face the scenes of devastation and death that now haunted him, he attempted suicide, swallowing massive numbers of painkiller and gupling a liter and a half of vodka. Goldsmith survived and was eventually diagnosed with PTSD.

(Kristofer has been released from inpatient treatment following his suicide attempt and he is following up with you for outpatient treatment)

Identify in the order of importance, the problems that need to be addressed in treatment.

• Are there problems that may be present but do not need to be addressed immediately but rather followed up on after Kristofer has received treatment for a certain amount of time to determine if the problem still exist?
• Why does each of the problems you identified need to be addressed?
• What theoretical orientation would you use with Kristofer and why? (Be sure you support your answer with evidence-based interventions/best practices for PTSD)