Case Scenario
Joanne is a 45-year-old divorcee with a long history of depression. She has had three prior suicide attempts: she has overdosed twice and attempted to slice her wrists. She sees a psychiatrist monthly and is prescribed medication. She is not compliant with her medication. She works a high stress job (60–70-hour week), finds all her satisfaction in her work, and has no hobbies. She has not dated since her divorce, resulting from her husband admitting to being gay, 10 years ago. One child is from that marriage, a 13-year-old daughter. Seven years ago, Joanne had an affair with her sister’s husband. Her sister never found out and Joanne ended the relationship after a year because of guilt, but the husband continues to pursue her. Joanne comes by your outpatient clinical counseling office unexpectedly to tell you how much she appreciates you and just wants you to know how important you are to her. In further questioning, she admits to having a gun in her car. She refuses to stay and talk. She “just wants to go for a drive.”
