So tell me what's bringing you into counseling today.

I've I've just been feeling really really overwhelmed lately something happened on campus last week and I haven't felt like myself ever since. Okay. So tell me what you mean by overwhelmed.

Well, just I've been having a hard time focusing and I've been having a really hard time sleeping. Um, my emotions are all over the place. Sometimes I'll cry for no reason.

And really jumpy, you know, like I catch myself looking over my shoulder a lot in every little sound kind of sets me off. Mmm.

I noticed that you're shifting into chair a lot and you're kind of ringing your hands and I'm wondering how you're feeling right now.

Um, not great.

I've just I mean I kind of feel I don't know.

frightened or sad or kind of like I'm watching everything from really far away.

Kind of like things aren't really real around me.

and you know Okay, um, do you feel comfortable with me as a counselor and things like that? I'm not really comfortable with I'm not really comfortable talking to strangers let alone counselors and then especially after last week. I'm not typically comfortable talking to men.

Yeah with me being a male. Do you feel comfortable talking to me or would you rather me get someone else? I'm just not so sure how.

You'll be able to understand where I'm coming from. Okay. Well, I have some training in working with diverse clients. And so um, hopefully I can be able to relate to you and one of the things with counseling is that there is confidentiality with a few exceptions. I'm one of those deceptions is if you are thinking about harming yourself for our actively suicidal and so, um, hopefully that makes you feel a little bit more comfortable in our relationship together. So I'm gonna take a quick assessment and so I'm gonna ask you a couple of questions and just I just want you to be as truthful as possible and things like that. So tell me do you have any previous psychological diagnosis or anything like that? No, I saw counselor for a while when I was back in high school, but I haven't been diagnosed with anything. Okay, what about any family history of psychiatric diagnosis or anything like that?There's some depression in the family, especially. Yeah, I mean with my brother.

Okay, tell me about that.

Well, I mean he was always a weird little kid but um He was diagnosed in a pretty straightforward way. I mean we were able to get him into counseling and therapy early but his was different than mine. You know. I was just a teenager going through some stuff and his was different. Okay, um, Has there been any? Suicidal behavior in the family has anyone completed suicide or had any suicide attempts? Attempts, yes, but no suicides. Okay.

and so tell me.

Do you have any thoughts about harming yourself or anything like that? sometimes okay since last week tell me what happened last week.

I was I was finishing class and it was my late night class. I've been taking classes at night after work, and I didn't.

I don't really know.

the details of what happened campus security doesn't usually have the cameras on in that dark part of the quad but I was attacked from behind and I was assaulted and I still don't know who it was.

You sound really scared and really.

Kind of afraid right now. It seems like that is affecting you and multiple areas of your life right now.

Yeah, yeah. It's getting in the way of everything.

And so I'm wondering you mentioned that you kind of have some thoughts about harming yourself to have you thought about attempting suicide.

thinking about it and thinking about doing it or different things, you know like Like it seems like it would be a good idea. It seems like it would be really really easy.

When I can't sleep.

I have sleeping pills. They're right there.

I know how easy it would be and sometimes it just seems like the best option would just be go to sleep and not wake up again. So you have a plan and that would be to I mean if If I were to go through with such a thing hmm, okay, so like on a scale of um one to ten one being not at all and 10 being definitely gonna do it. Where would you say that you're intent is right now? I would say that.

but depending on whether or not I'm distracted and whether or not I'm I have had a nightmare.

Maybe seven, okay.

um So I'm really worried about your safety right now. So one of the things that I'm worried about is use the chair kind of intense kind of high right now. So I'm wondering what are some reasons to live. Tell me about some reasons.

That you have to wake up tomorrow.

I don't want to hurt.

Anyone who might care for me? I mean, you never know how that's gonna hurt people. I remember how I felt when that kid in my class killed themself when he was in high school, and I just I don't want to do that to people, you know.

um My mom loves me. My roommate would be really scared.

I'm certain that my friends from work would be worried about me. But um I don't really.

I don't really know why me being in the world would make it more important for me to be there.

So I hear that you're worried about the impact that completing suicide would have on like your family your friends your co-workers and things like that. Yeah.

But you still.

You still may be a little bit hesitant or you still kind of have those Suicidal Thoughts? Surrounding you.

It just seems like it would be the easiest fix. Okay, I'm wondering if you have any other maybe factors to live maybe some children or anything like that beloved pet. Just something to wake up to in the morning.

I do have a cat.

Who would be? very upset if anything happened to me and I know I know that my mom even though that we're not close like we used to be I know that my mom would She wouldn't be the same. Okay. Um, so I'm wondering if we can call someone to maybe secure those pills. Maybe your mom or someone who can just be able to kill those pills.

So that way we don't you don't attempt suicide or complete suicide because I'm really worried about your safety right now.

Do you think it's necessary that I go without the pills? Yeah, I I'm really worried about your health and your safety. And so I think that the best thing that we do is to secure those pills because one of the things about counseling is we want to make sure that you're safe and we want to make sure that things are secure. And so I think that the best option right now is to really call someone while we're here in session to secure those pills.

Call my mom. Okay, so let's go ahead and do that now.

Diagnose the individual in the video based on the symptoms and the DSM-5 diagnostic criteria. Support your diagnosis with a differential diagnosis.

Include a case conceptualization that explains the issues, symptoms, and diagnosis framed in a theoretical lens.