Rachel Miller

Client Intake Report

Name: Conrad Jarrett
Approx. Age: 18
Identifying Information and Referral Statement
Conrad Jarrett is a young (approximately 18 year old), unmarried male, who does not
currently work at this point in time. The client mentioned that he had just recently been in a
relationship with a woman named Janine, who he feels plays a significant role in his life. The
client has previously been seen at a hospital for a suicide attempt, where he stayed for
approximately a month and was given electroshock therapy. The client was also put on
medication however, the type of medication is undetermined at this point. From there he went on
to see Dr. Berger at a Psychiatric Clinic where he received weekly counseling.
The client was referred to this facility by his psychoanalytic therapist, Dr. Berger. The
client reports wishing to stay a client of Dr. Bergers however, he and his father had moved from
Illinois where Dr. Berger was located which was why the client was referred to this specific
facility.
Presenting Complaint
The client is presenting distressing behaviors at this point in time. The client reports
having no appetite, and having troubles sleeping. The client also reports that when he laughs or
smiles it actually catches his family off-guard. The client is very jumpy. Client in fact says, I
feel so jumpy, maybe I need a tranquilizer (Abnormal Psychology, 2014). The client reports
missing his time at the hospital after he has attempted suicide. The client also reports having a
distressing relationship with his mother. When asked about his mother the client said, We just
dont connect (Ordinary People, 1980). The client reports that he withdraws himself, he reports

not really spending much time with friends any more. The client also recalls his father saying
that he missed when the client had his friends over. The client reports being short with his
friends. The client said, When I let myself feel, all I feel is lousy (Ordinary People, 1980). The
client also reports having heightened emotions he recalls lashing out, specifically the client
mentions an incident where his father was trying to take a picture of the client and his mother
and his mother kept saying give me the camera and after hearing it so many times the client
yelled Just give her the Goddamn camera! (Ordinary People, 1980). The client does not
believe that his mother likes him, he said she cant love me (Ordinary People, 1980). The
client also reports punching one of his former teammates in a rage and then cries afterwards. The
most distressing complaint of the client at this time is that the client has excessive guilt over his
brothers death and places all the blame all on himself. The client reports being scared and that
he cant make it stop (Ordinary People, 1980).
The client hopes to receive aid in dealing with his emotions throughout his time at this
facility. When the client was asked what he was hoping to achieve he said, Im supposed to feel
better right? (Ordinary People, 1980). The client reports wanting to feel happy again, he doesnt
want to have to withdraw himself from his friends because it hurts too much to be around them
reminds the client of his times he shared with his friends and his deceased brother (Ordinary
People, 1980).
History of Presenting Complaint
The onset of the clients behavior is the time of his brothers sudden death. The clients
behaviors manifested from this point. A boating accident occurred where both the client and his
brother her involved, the clients brother, Buck, died, while the client himself survived. After the
traumatic incident occurred, the client placed all the blame of his brothers death onto himself

which lead to the development of the presenting complaint. Also, the clients difficult
relationship with his mother just got worse after the boating accident. The client reports his
father saying that his mothers love died with Buck.
Stressors of increased complaint occurred whenever he and his mother got in an argument
or whenever the client felt disconnected from his family because of what happened to his brother.
The client reported that his mother never went to visit him while he was in the hospital after
attempting suicide this could be a stressor for worsening behavior. The client felt as though his
mother needed to forgive him and by not going to see him in the hospital it helped manifest the
idea in his head that he is to blame. The client also reports a time when he was with Janine and
some school mates came into the diner where they were eating laughing and fooling around with
Janine. Janine began laughing and this upset the client. A contributing factor to the presenting
complaint could be that the client withdraws himself from his former friends because they
remind him too much of his brother and when he is around him they cause him to feel lousy
(Ordinary People, 1980). Perhaps one of the biggest stressors that caused a spiral of the clients
behaviors is when his friend Karen, from the hospital, who had recently told the client that she
was doing really good committed suicide. This caused the client to react and almost attempted to
harm himself the client reports running to the bathroom and looking at his wrists after he had
been made aware of the fact that Karen had killed herself.
The highest level of adaptive functioning that the client has participated in in the last year
is school. The client was a part of the swim team however, he quit shortly after he began therapy
with Dr. Berger. The client reports not being able to focus easily in school, and he is often
distracted.

The client previously had been admitted into a hospital for approximately a month after
he had attempted suicide. The client also received prescription medication type of medication
is undetermined at this point. The client also saw a psychoanalytic therapist, Dr. Berger, for
approximately a year before he and his father left the state and the client was referred to this
facility.
Medical
There are not any ideations of any other present medical problems or substance abuse. The client
spent a month at a hospital after his suicide attempt with other people who attempted to harm
themselves. The client has previously taken medication prescribed to him after he had attempted
to commit suicide however, the type of medication prescribed and whether or not the client is
still currently taking the medication is undetermined at this point.
Personal History
Birth and Infancy The client has not given any information about possible difficulties
during his birth and infancy at this time. It is possible however, that the clients mother gave
more attention to the clients older brother while the client was still an infant it is possible that
he was not getting all the attention that an infant needs from their mother.
Childhood The client seemed to have been friends mostly with his brother and his
brothers friends growing up. It is clear that the client looked up to his brother and cared deeply
for him. There is no information about the clients academic performance during childhood at
this time.
Adolescence The seemed to be best friends and extremely close with his brother. His
brother was ripped away from him during the traumatic boating accident which caused the
abnormal behavior in the client to develop. The client reports that he had previously been smart

in school, it seems that after the accident the client has a hard time focusing in school. The client
reports withdrawing himself after the accident which did not leave much room for the him to
have any personal relationships with the opposite sex, aside from Karen from the hospital who
was more like a family member to the client.
The client reports recently having begun a relationship with Janine, he has not discussed
the extent of his sexual relationships at this point. The client is currently living with his father.
Up until recent months the client was living with both his mother and father until they split and
his mother moved to Houston to live with her brother. The client and his father stayed in Illinois
until they decided it was time for a change and they moved.
Family Constellation
The client has a mother, Beth Jarrett who currently lives with her brother in Houston after
her recent split from the clients father. The extent of Beths employment is undetermined at this
point. The client reports having a difficult relationship with his mother. The client reports her as
cold to his situation and claims that she doesnt love him. The client lives with his father in
Massachusetts. The clients reports that his father, Calvin Jarrett, was the one most concerned
with the clients abnormal behavior and suicidal ideations. The client reports that his father used
to take the train into work every day. Calvins company as able to find him a job in a company
building in Massachusetts after he and the client had decided to move. The clients deceased
brother still plays a significant role in the clients everyday life it seems as though he is the
route of the clients abnormal behavior. The clients brother, Buck, was an award winning
swimmer and seemed to be loved by many. The client seems to have deep respect towards Buck
and even now still looks up to him. Although Karen (the clients friend from the hospital) is not
part of the clients immediate family, she still has a familial role in the clients life. The client

reports Karen as being the one who helped him get through the time at the hospital. The client
reports meeting with Karen and her telling him that she was really happy and that she was doing
really great only to find out shortly after that she had committed suicide. This loss triggered a
flashback to Bucks death.
Clinical Descriptions, Impression, and Observations
Pertinent dynamic factors that have contributed to the presenting complaint of the client
are; the traumatic death of the clients brother and the fact that he was with him while he died,
the fact that the clients mother seemed to have more affection for his brother and seemed to love
him more than the client, the toll that losing a child takes on parents was bound to affect the
attention given to the client as well. The client is not excessively eager for treatment however, he
does want to see improvement on the way he feels on a day to day basis. The client is moderately
functioning. While the client can still live his life, his daily routines are disrupted by his
overwhelming emotions and outbursts as well as his flashbacks to his brothers accident. The
client reports not allowing people to get close to him which affects his personal relationships
which will take a toll on his daily functioning as well.
By being moderately functioning the client experiences symptoms on a daily basis, and
they are not something he can repress, he is forced to deal with the symptoms as they come. The
client is able to go to school however, the client reports not being able to focus very well, and he
also reports that he easily gets agitated with his peers. The client does not leave much room for
pleasurable activities he in fact quit the swim team. Although the client does report trying to
make an effort by going out with Janine, meeting with Karen, and watching the swim meets. The
client reports that he reads regularly. As far as interpersonal relationships, the two closest people
to the client are now deceased his brother Buck who died in a traumatic accident, and his friend

Karen who committed suicide. The client does report recently becoming involved with a women
from his high school, Janine, whom he reports makes him feel great (Ordinary People, 1980).
When it comes to handling ordinary conflicts and stresses the client has very low capability to
resolve them rationally. The client reports punching one of his old swim team mates after he
made a remark to him about quitting the team. The client also previously reported lashing out
when his mother did not want to take a picture with him. The client recalls a huge fight in the
living room about his mother as well that resulted from his parents wondering why he had quit
the swim team.
The client is still at risk with his suicidal ideations, however, after seeing Dr. Berger the
client seems to want to receive help and wants to be able to control his emotions and actions
more effectively. The client is still at risk for suicide because he is still experiencing depressive
behaviors. The client reports immediately thinking about harming himself when he found out
that Karen had committed suicide. Any type of emotional stressor could trigger the clients
suicidal tendencies.
Tentative Diagnosis
My tentative diagnosis for the client is that he is suffering from Post-Traumatic Stress
Disorder (PTSD), as well as Survivor Guilt which has caused him to develop a Mood-Stress
disorder making him depressed. I also believe that the client suffers from Major Depressive
Episodes. This has put him at a constant risk for suicide.
Symptoms for PTSD according to the DSM-5 include; intrusion, avoidance, negative
cognitions and mood, and arousal and reactivity (Abnormal Psychology, 2014). The client
reports having all of these symptoms at one time or another. The client reports having trouble
sleeping, and having night terrors. The client also reports getting agitated very quickly, especially

when talking about emotional subjects such as his suicide attempt, his relationship with his
mother, or his brothers death. The client also shows symptoms of PTSD by placing blame on
himself where it is not due. The client reports that he blames himself for his brothers death. The
client also believes that he needs to be forgiven for attempting to commit suicide. After his
brother died, the client reports withdrawing himself. Certain triggers set the client of. The client
reports running to the bathroom in a frenzy, thinking about harming himself after he found out
that his friend Karen killed herself. The client also reports getting severely upset after he finds
out that Karen had killed herself, where he experienced a flashback to the night that his brother
died. The client recalls going to Dr. Bergers office and admitting that he thinks it was his fault
for his brothers death. The client also recalls getting physical with someone from the swim team
whom he and his brother used to be close to, where he punched him repeatedly in the face the
client also recalls re-experiencing the night of his brothers death at this point in time as well.
The client continuously says its my fault (Ordinary People, 1980). The client meets each
aspect of criteria for being diagnosed with PTSD.
Specifiers for Major Depressive Episodes that the client displays are melancholic features
(Abnormal Psychology, 2014). the client has no appetite, he reports frequently not being
hungry or not eating, excessive guilt, and qualitative depressed mood. Psychotic features
(Abnormal Psychology, 2014). the client reports having an instance with Dr. Berger where he
recalls acting as if Dr. Berger was his brother without even meaning to, and he also reports
having feelings of worthlessness and guilt commonly. Atypical features (Abnormal Psychology,
2015) or mood reactivity, the client reports having being excessively happy after positive
events. The client recalls a time with Janine when she told him that he was a good singer, he
made her feel happy and he sang happily throughout his whole walk home that day.

Initial Treatment Recommendations

My initial recommendations for treatment for the client is primarily psychotherapy with either
myself or another therapist at least one to two times a week. I also recommend that the client
undergo exposure therapy which involves the exposure of the patient to the feared object or
context without any danger, in order to overcome their mood disorder behaviors (Wikipedia.org).
Exposure therapy would include the client being exposed to certain events and ideas that the
client finds distressing which causes a re-experience of the clients traumatic event which led to
the PTSD. I recommend the client receive exposure therapy two times a month. Lastly, I
recommend that the client take an anti-depressant most commonly used for comorbidity with
PTSD and depression are serotonin reuptake inhibitors (Theravive.com).
Initial Prognosis
My initial prognosis for the client is overall good. The client seemed to benefit from his time
with Dr. Berger. The Client is however constantly at a potential risk for suicide. Although he may
seem to be doing better the client portrays suicidal ideations. If the client is persistent with the
psychotherapy each week he is likely to gain more control of his emotions, as well as be able to
open up and discuss what he feels he is to blame for. Once the client realizes that the things he
blames himself for were inevitable and out of his reach I believe that the client will be able to
overcome and suppress his PTSD behaviors. If the client is able to work through exposure
therapy and be persistent in this as well, he will be able to manage more easily and be able to live
his life without having to worry about certain stressors setting him off into a range of emotions.
Lastly, if the client takes the medication as prescribed I believe he will see improvement in his
presenting complaint. It helps that the client is no longer living with his mother whom he has a
bad relationship with, just his father who actively wants to see him get better.

Works Cited
Butcher, James N., Hooley, Jill M. & Mineka, Susan. (2014). Abnormal Psychology. Upper
Saddle River, New Jersey: Pearson Education.
DSM-5 Category: Trauma and Stressor-Related Disorders. (2015). Posttraumatic Stress
Disorder (PTSD) DSM-5 309.81 (F43.10). Retrieved October 19, 2015 from
http://www.theravive.com/therapedia/Posttraumatic-Stress-Disorder-(PTSD)-DSM--5309.81-(F43.10)
Redford, Robert. (Director). (1980). Ordinary People. [Motion Picture]. United States. Schwary,
Robert L.