CASE STUDY: REBECCA HASBROUCK Demographic information: 18-year-old Caucasian female Presenting problem: Rebecca self-referred to the university counseling center

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CASE STUDY: REBECCA HASBROUCK Demographic information: 18-year-old Caucasian female Presenting problem: Rebecca self-referred to the university counseling center. She is a college freshman, living away from home for the first time. After the first week of school, Rebecca reports that she is having trouble sleeping, is having difficulty concentrating in her classes, and often feels irritable. She is frustrated by the difficulties of her coursework and states she is worried that her grades are beginning to suffer. She also reports that she is having trouble making friends at school and that she has been feeling lonely because she has no close friends here with whom she can talk openly. Rebecca is very close to of 3 years though they have both stanted atnding college in different cities. She was tearful throughout our first session, stating that, for the first time in her life, she feels overwhelmed by feelings of hopelessness. She reports that although the first week at school felt like "Torture." she accustomed to her new lifestyle, but she still struggles with missing her family and is slowly growing boyfriend, as well as her friends from high school. Relevant past history: Rebecca has no family history of psychological disorders, She reported that sometimes tends to get "really stressed out" though she has never received professional mental health treatment her mother Symptoms: Depressed mood, difficulty falling asleep (insomnia), difficulty concentrating on school denied suicidal ideation Case formulation: Although it appeared at first as though Rebecca was suffering from a major depressive episode, she did not meet the diagnostic criteria. While the age of onset for depression tends to be around Rebecca's age, given her lack of a family history of depression and that her symptoms were occurring in response to a major stressor, the clinician determined that Rebecca was suffering from adjustment disorder with depressed mood. Treatment plan: The counselor will refer Rebecca for psychotherapy. Therapy should focus on improving her mood, and also should allow her a space to discuss her feelings surrounding the major changes that have been occurring in her life.

Questions I. In Rebecca's case study, what single factor do you think may have led to her breakdown?

2. How might the lack of support from Rebecca's family and her boyfriend have contributed to Rebecca's mental state?