Case Overview

Patient Names:
Adolescent: Alisha
Mother: Kathy

General information: Alisha is a 16-year old white female from Philadelphia, PA. She lives with her biological mother. She has a 19-year-old sister (Debbie) who does not live in the home. Alisha is currently in the 10th grade at a local high school. She typically receives C’s & D’s at school. Alisha has a few close friends. She hangs out with peers that abuse drugs and alcohol. Alisha has had a boyfriend for the past 6 months. Kathy is concerned about Alisha’s boyfriend, Rick, believing that he is controlling and fearing he will be violent towards Alisha. Alisha presents as street smart and tough. Kathy, 38 years old, has a high school education and is currently employed in a factory. Alisha’s father has not been in her life since she was 5 years old. Alisha’s mother has a history of domestically violent relationships. Kathy’s latest relationship which also involved domestic violence ended a few months ago. About 1 month ago, she learned that her ex-boyfriend, Charlie, had been cheating on her for the majority of the relationship.

Family Mental Health History: Kathy reported that there is a family history of depression, substance abuse/dependence, suicide (maternal grandmother), and PTSD. Kathy reported that she had mental health treatment for PTSD (due to abuse and prior domestically violent relationships) approximately 6 years ago and is currently in treatment. She started individual therapy 1 month prior to Alisha beginning therapy. Kathy entered therapy after learning that her ex-boyfriend had cheated on her. She presents as depressed and traumatized.

Presenting Problem: Alisha presented with severe symptoms of depression, abuse of alcohol (binge drinking on weekends with friends, occasional drinking during the week), abuse of marijuana (use with friends on weekends and smoking a joint at night to fall asleep), and smoking cigarettes. She has never made a suicide attempt and does not endorse suicidal ideation. She reported the following reasons for depression: feeling like her mother doesn’t understand her and doesn’t care about her, witnessing domestic violence, poor grades, feeling like she doesn’t fit in). Alisha endorsed feeling unsafe in her house until her mother’s ex-boyfriend left a few months ago. Alisha stated whenever there is a man in their home, she feels unsafe. Alisha noted that her father’s absence in her life also contributes to her depression and low self-worth. Alisha has been depressed throughout middle school. She began abusing alcohol and marijuana when she started high school.

Kathy reported the following problems with Alisha beginning approximately 2 years prior to treatment (around the time she started high school): stubborn or irritable, argues a lot, disobedient at home, impulsive, moody, unhappy/sad/depressed. Kathy became aware of the alcohol and drug use in the past 2 months when Alisha got arrested for underage drinking and possession of marijuana. The court has mandated that Alisha attend therapy.