Case Formulation

The crisis event in Ann’s case was the burglarizing of her apartment, allegedly by her former boyfriend; however, there was no proof for her belief. The crisis was complicated by the fact that Ann had lingering anger toward the boyfriend, who had apparently been abusive in the past. Sorting through the anger became the focus of treatment as the clinician worked to help Ann understand her feelings and not let them be the catalyst for taking action that would only result in more problems.

Affective Reaction. Ann’s primary affective reaction is anger/hostility. She repeat- edly made statements to this effect during the first few minutes of the session. However, she was not able to sort through this feeling in a constructive manner. In fact, over the past several days the anger had seemed to become increasingly pronounced. The severity scale rating was assessed at 8. Ann’s mood was not under her control and her emotional reaction, although expected, seemed high. The reason the clinician assessed the affective reaction as too high was that it had become stronger until Ann was considering behaving in a manner that would likely make the situation worse.

Behavioral Reaction. The clinician assessed Ann’s behavioral reaction as primarily approach. This assessment was predicated on the fact that although Ann had not acted on her wish to get revenge, she was close to acting on that desire. The severity of Ann’s reaction was assessed as 8. Ann appeared to be performing the tasks of daily living such as eating and maintaining contact with others, with the exception of having difficulty in sleeping. However, she was contemplating engaging in behavior that could potentially complicate her crisis even more.

Cognitive Reaction. Ann’s primary cognitive reaction was transgression in social relationship. She perceived that her boyfriend had wronged her by allegedly breaking into her apartment. Her severity scale rating was assessed as 7. Ann had frequent distur- bances of concentration and her problem-solving ability was impaired. In addition, Ann had decided that her former boyfriend had committed the break-in yet had no facts to support this belief, meaning that her interpretation of the event could not be considered accurate at this time.