A Case Evaluation of Noah Pierce
Afaf Al-Ghamdi
PRESENTING PROBLEM
Noah reports he felt depression shame, regret, insomnia, guilt, and Post-Traumatic Stress Disorder PTSD over the fatal killings that he committed or witnessed in Iraq that led him for a suicide to get rid of his self-agony, growing sense of isolation, and feeling the lack of morality.
Clinical Formulation
Noah Pierce suffered guilt, shame, insomnia, psychological and moral injury due to feeling regret about involving in an unjustified war. Noah has experienced episodes of isolation, self-hatred, agony, despair, having consistent nightmares, sleeplessness, violence that has occurred unexpectedly, and frequently during and after his deployment to Iraq. In Iraq, boldly he …show more content…
Noah grew up in Sparta, Minnesota, on the Mesabi Iron Range. Noah got everything right, including his sensitive heart, from his stepfather, Tommy who was working as a deep-sea diver. Tommy loved Noah and was kind and supportive of him as if he were his biological father. Tommy used to take Noah to the "spot" for hunting and fishing, which Noah preferred to go to school. Noah has one sister called Sarah, who he said kept him alive. However, Noah began to be violent with her few months before his suicide. Once, Noah threw her across the room. Sarah jumped over him to let him realize what he did. However, she excused this because it was the first time. Noah's rage referred to horrible incidents he saw in Iraq. Noah said once he collected the body of his friend who was scattered due to a bomb explosion, "he watched his best friend in Iraq blown up by a roadside bomb, how he went around with a plastic bag picking up body parts to send home." Noah felt anger, anxiety, and self-responsibilities about the tragedies he saw in a war he thought was nonsense and unjustified. His mother, Cheryl is a little woman and a heavy smoker to get over her fears and anxieties for …show more content…
Reduce violence thoughts and think positively
3. Decrease thoughts of shame and guilt
4. Gain perspective on coping skills, and painful experiences and reduce PTSD
5. Reduce worry and moral injury by constructive living
Objectives
1. Client will learn traumatic, depressed and stressed symptoms and triggers.
2. Client will learn relaxation and coping techniques for controlling violence, anger and guilt.
3. Client will identify depression-producing thoughts.
4. Client will learn how to increase coping skills and change depression-producing thoughts.
5. Client will discuss and share his thoughts and experiences.
6. Client will increase participation in exercise and healthy leisure activities.
7. Client will build confidence of himself, forgiveness abilities and positive social interaction.
Interventions
1. Client will share his thoughts by participating in Cognitive Processing Therapy CBT weekly or bi-weekly sessions. Client needs to discuss any traumatic motivations and triggers for current violent behavior. In these CBT sessions, client will work on monitoring behaviors and emotions provoking concerning thoughts and behaviors, with coping strategies to control thoughts and feelings by increasing cognitive
Afaf Al-Ghamdi
PRESENTING PROBLEM
Noah reports he felt depression shame, regret, insomnia, guilt, and Post-Traumatic Stress Disorder PTSD over the fatal killings that he committed or witnessed in Iraq that led him for a suicide to get rid of his self-agony, growing sense of isolation, and feeling the lack of morality.
Clinical Formulation
Noah Pierce suffered guilt, shame, insomnia, psychological and moral injury due to feeling regret about involving in an unjustified war. Noah has experienced episodes of isolation, self-hatred, agony, despair, having consistent nightmares, sleeplessness, violence that has occurred unexpectedly, and frequently during and after his deployment to Iraq. In Iraq, boldly he …show more content…
Noah grew up in Sparta, Minnesota, on the Mesabi Iron Range. Noah got everything right, including his sensitive heart, from his stepfather, Tommy who was working as a deep-sea diver. Tommy loved Noah and was kind and supportive of him as if he were his biological father. Tommy used to take Noah to the "spot" for hunting and fishing, which Noah preferred to go to school. Noah has one sister called Sarah, who he said kept him alive. However, Noah began to be violent with her few months before his suicide. Once, Noah threw her across the room. Sarah jumped over him to let him realize what he did. However, she excused this because it was the first time. Noah's rage referred to horrible incidents he saw in Iraq. Noah said once he collected the body of his friend who was scattered due to a bomb explosion, "he watched his best friend in Iraq blown up by a roadside bomb, how he went around with a plastic bag picking up body parts to send home." Noah felt anger, anxiety, and self-responsibilities about the tragedies he saw in a war he thought was nonsense and unjustified. His mother, Cheryl is a little woman and a heavy smoker to get over her fears and anxieties for …show more content…
Reduce violence thoughts and think positively
3. Decrease thoughts of shame and guilt
4. Gain perspective on coping skills, and painful experiences and reduce PTSD
5. Reduce worry and moral injury by constructive living
Objectives
1. Client will learn traumatic, depressed and stressed symptoms and triggers.
2. Client will learn relaxation and coping techniques for controlling violence, anger and guilt.
3. Client will identify depression-producing thoughts.
4. Client will learn how to increase coping skills and change depression-producing thoughts.
5. Client will discuss and share his thoughts and experiences.
6. Client will increase participation in exercise and healthy leisure activities.
7. Client will build confidence of himself, forgiveness abilities and positive social interaction.
Interventions
1. Client will share his thoughts by participating in Cognitive Processing Therapy CBT weekly or bi-weekly sessions. Client needs to discuss any traumatic motivations and triggers for current violent behavior. In these CBT sessions, client will work on monitoring behaviors and emotions provoking concerning thoughts and behaviors, with coping strategies to control thoughts and feelings by increasing cognitive