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The Case of Adam – Psychology

Intake Session
David, 50-years old, and Simon, 32-years old, self-identify as cisgender, Latino-American gay
men. The couple is seeking treatment for concerns about their 6-year-old son Adam. David and
Simon have been together for 10-years. Adam is Simon’s biological son conceived through a
David was raised by his mother along with his 4 younger siblings. He describes his father as
an abusive, volatile alcoholic who he has not seen since he was 8-years-old. David admits to
being the target of severe physical abuse by his father as he would try to protect his younger
brothers and sisters from his father’s wrath.
Simon describes his upbringing as ‘traditional’, where he was the only child. He describes his
father as a hard worker who took care of his family’s needs, but had difficulty showing or
expressing emotions. He describes his mother as loving, yet overly reliant on Simon to meet her
own emotional needs.
Little is known about Adam’s surrogate mom, though there is suspicion that the mother was
a drug user. David believes she agreed to be their surrogate “for the money” so that she could
continue her mal-adaptive lifestyle.
David and Simon are present for the first session where they focus their concern on Adam.
They describe their son as being a happy, loving and affectionate child the first 4 years of his
life. Once he started pre-school, his mood and behavior began to change. He became sullen,
withdrawn, would have temper tantrums, would break his toys or throw them across the room.
He refuses to eat what he doesn’t like and throws his food on the floor in a rage. Adam has also
been acting out in his first-grade class, and has had to be removed several times for hitting his
classmates. Simon reports that he often hears Adam sobbing in his room at night, goes in to
comfort him, but that Adam refuses to talk to him.
When asked if anything has changed over the last few years in the household, both David
and Simon look at each other with trepidation. Simon is the first to speak. He reports that 2
years ago, David lost his job and is now a ‘stay at home’ dad. Simon does express concern that
since David is no longer working, he had become moody, short-tempered and irritated with
Adam often. Simon has also found empty liquor bottles around the house. While he has never
seen David physically hit Adam, Simon is concerned that David is becoming like his own father.
David denies that he drinks excessively, and that he is nothing like his father. He points to
Simon as the problem due to his inability to set limits with Adam and that he is overly indulgent
and ‘rescues him’ whenever there is tension in the home. David feels that Simon is
overcompensating for his own childhood and that he needs to toughen up and partner with
him in parenting.
Second Session
In the second session, David, Simon and Adam are present. Initially, Adam appears rigid and
sullen, but after a few minutes, he begins to explore your office, running about, picking up
random items and asking you questions rapidly. He does not appear to acknowledge your
responses and continues a barrage of questions. David tells him to sit down and be quiet at
which point Simon picks Adam up and sits him on his lap. At that point, the couple begins to
reiterate what they told you in the first session. David’s voice escalates and Simon holds Adam
closer to him. Adam closes his eyes and appears to be asleep.
You notice a few bruises on Adams arm. When you ask about them, David tells you that
Adam is clumsy and doesn’t watch where he is going, similar to how Adam just acted in your
office. Simon says nothing. Adam continues to appear asleep. You also smell alcohol on David’s
Directions: Complete each section in the page allotment indicated. You may include an
introduction, but it should be no more than a ¼ of a page.
Legal and Ethical Concerns [1 ½ pages]
There are several legal and ethical issues specific to the case as written.
Identify at least 3 pertinent legal and ethical concerns you have for this case. Support these
concerns by discussing what you see in the case as written, citing the APA Ethics code.
https://www.apa.org/ethics/code (also located under Resources in your syllabus). What are
your professional obligations and how would you manage the legal and ethical issues you
Provisional Diagnosis (Adam Only) [2 ½ -pages]
When looking at possible diagnoses, look at all of the factors presented in the case with regard
to Adam’s presentation.
Choose two (2) provisional diagnoses for Adam that are evident in the case as written. Use the
DSM-5 criteria to support your provisional diagnosis. Illustrate what you see in the case that
aligns with the diagnostic criteria.
Treatment Plan [2 ½ -pages]
When formulating a treatment plan, treat the person(s) and not the diagnosis.
Create an integrative treatment plan for Adam that considers both individual and family
intervention. Consider culture and diversity issues, and possible consequences of reporting
child abuse. Justify if your treatment plan should consider management of David’s alcohol use
as well as factors relevant to Adam’s birth that you might need to consider.

Demonstrate proficiency in the major theories of psychotherapy
Demonstrate proficiency in the etiology and treatment of psychopathology
Demonstrate proficiency in legal and ethical issues related to psychopathology
Demonstrate proficiency in culture and diversity in psychology

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