Discuss Psychosocial History

Assignment: Discuss Psychosocial History

Ryan was born and raised in rural Mississippi. He comes from an intact family and is the youngest of four children. He referenced a narrative within the family that characterized him as the “unplanned pregnancy.” Ryan described a “good childhood” and he denied a history of emotional, physical, or sexual abuse. He graduated from college and has had a successful career as an insurance broker.

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When Ryan was age 9, his mother was diagnosed with breast cancer.She passed away four years later. This event caused tremendous emotional pain. After his mother’s death, his father began using alcohol heavily and eventually received voluntary inpatient treatment. Ryan reported a strained relationship with his father and a sense of rejection after he told his father he was homosexual. He experienced significant inner emotional conflict as an adolescent related to his sexuality. He began to seek sexual contact with others and by age 17 was having sex with men for money. He does not believe he has a sexual addiction and denied any compulsive sexual behavior. He did note that he feels somewhat conflicted about his sexual behavior but tended to minimize its impact on his life.

Ryan was in a relationship with his ex-husband for 19 years. He described the relationship as chronically strained, stating that “I’m not sure I ever loved him.” He also described his ex-husband as manipulative and unstable which instilled fear in the children. They have two adopted sons(ages 16 and 11). Both were characterized as having“special needs” and both sustained abuse when in the foster care system. Both children have received extensive inpatient and outpatient mental health treatment.

Ryan endorsed significant alcohol use throughout his life. After the loss of a previous partner, he began to drink more frequently and noticed a similar pattern to that of his father when he turned to alcohol after the death of his mother. After treatment, he stayed sober for 13 years. Currently, he considers himself a social drinker and consumes three to four drinks each evening. He does not believe that he has a drinking problem.

Ryan’s psychiatric history is also positive for depression. He believes his depression started after the loss of his mother and “I never could shake it.” He has been hospitalized three times for risk of harm to self. He reportedly made threats about ending his life and this was reported to the police by his ex-husband. He has been in therapy “on and off” and expressed a strong disdain for medication.

Behavioral Observations

Ryan was dressed casually and his grooming and hygiene were fair. He was mostly uncooperative but warmed up slowly over time. He appeared agitated and despondent. Eye contact was poor. He expressed a strong mistrust in the “system” and beliefs about being unfairly accused. He denies any wrong doing, stating simply, “I was in my own house!”

Ryan was fully oriented. His thought process was mostly linear with no apparent thought problems or abnormalities. His mood and affect were dysphoric. He demonstrated mild emotional lability and became tearful when discussing his family and stressors in his life. Emotional expression appeared to be within normal limits and congruent with the topic. His speech was normal for rate, tone, and intonation. Intellectual functioning was judged to be in the high average to superior range.

Based on the vignette provided above, please compose a well-written and organized response to each of the following questions. When writing your responses, please: