William’s Case Study
Nameof examinee: Date of examination:
Dateof birth: Date of report:
ChronologicalAge: Name of examiner:
William Thompson is a 38-year-old male, an attorney by profession whoserved in the United States military for six years as an active dutyofficer. He is married to Lula Kim, a 27-year-old Korean-American.William loves his wife, and he has no history of abusing women eitherverbally or physically. Before his active duty in Iraq, William was acommitted husband who took care of his wife and paid his mortgage ontime. He attended West Point for his undergraduate and later to BronxSchool of Law and Finance where he received his J.D. His interestsincluded marathon, collecting modern art, soccer, and listening tojazz music. Before his drinking problem intensified, William was acommitted member of the Catholic Church.
His drinking problem started during his active duty in Iraq as a wayof coping with the stressful and demanding nature of the battlefield.He confessed not having a drinking problem before moving to Iraq. Itleads to an early conclusion that the conditions of his work in Iraqled him to consider alcohol as an option to his feelings.
When he returned home, his drinking escalated to ten or twelvebottles every day. He also developed insomnia, and the horrifyingmemories of the battlefield interfered with his sleep. He lost hisjob at a New York law firm, and he was unable to pay his mortgage.Henry, his brother, understood his situation and accommodated him. Although Henry has a big family under his roof, he seems tounderstand his brother`s condition, and he did not hesitate to allowhim into the house. William loves his wife, and he tries as much aspossible not to involve her in his problems. It has led to himkeeping his thoughts to himself. He believes that his wife cannotunderstand the nature if the things affecting his life. Upon inquiryabout the things worrying him, he can only highlight to his wife andavoid getting into details. According to his wife, the vibrant man hemarried is no longer there, and he has been substituted by asolace-loving and estranged man.
Reasons for Referral
William spent six years in Iraq where he developed a psychologicalproblem that surfaced when he returned home. While in Iraq, hedeveloped a drinking problem. His drinking behavior intensified whenhe returned home. He became a heavy drinker, and he could not performhis family and occupational duties properly. As an attorney, he hadsecured a job in a New York law firm, but the managers relieved himhis duties since he could not cope with the work environment due tohis drinking problem. Consequently, he could not afford a mortgage topay for his residence and he had to move in with his brother whoidentified his problem and arranged for his referral.
His health also deteriorated due to his drinking behavior. He couldnot get enough sleep due to disruptions in his mind. He alsoconfessed to having persistent feelings of fatigue. Also, hisrelationship with his wife was on the verge of breaking down due topoor communication. William opted to keep to himself to protect hiswife from his battlefield ordeals. He feared that that he could hurthis wife by letting him share his feelings. By keeping to himself, hethought that he would protect his wife. While in Iraq, he developedabusive language and developed an angry behavior upon returning home.His angry tendencies were threat to the members of his familyespecially at the time he was living in a house with his brother’schildren.
Another important reason for the William’s referral was his lack ofinterest in the things he enjoyed before going to serve in Iraq. Hewas an active church member, but he lost interest in church’sactivities. He was also a fan of the marathon and the collection ofmodern art. According to him, he lost a vital part of his life whenhe went to Iraq.
Upon his referral, the psychologist assessing William used theWAIS-IV scale to assess various aspects of his intelligence uponwhich after interpretation would help in recommending the besttreatment method for him. The assessment tool was designed byWechsler, and it breaks down intelligence into several aspects thatpsychologists can measure independently (2008). The operatingprinciple of this tool is that intelligence is composed of elementsthat psychologists can singly isolate and measure. However theseelements are dependent on each other since none of them cancomprehensively define intelligence.
The WAIS-IV scales component of intelligence include verbalcomprehension, perpetual reasoning, working memory, and processingspeed (Wechsler, 2008). Verbal comprehension capitalizes on the useof general language, knowledge, and the extent of one’s memory. Itmeasures abstract reasoning, comprehension and the expression ofvocabulary. It also assesses the general information from one`sculture and the ability to deal with the available socialconventions, rules and expressions (Benson et al., 2010).Perpetualreasoning tests abstract visual processing and the ability to solveproblems. It assesses an individual’s spatial reasoning and theability to perceive visual details. It also tests one’squantitative and analogical reasoning (Lichtenberger & Kaufman,2009).
In assessing an individual’s intelligence status, the workingmemory as proposed by the WAIS-IV scale assesses an individual’scapacity to pay attention, concentrate, and exercise mental control.It assesses one’s mathematical capability in standard arithmeticalcapabilities and putting letters in a sequence. Processing speedassesses one’s visual perception and scanning speed through codingand cancelation (Lichtenberger & Kaufman, 2009). According toWechsler, standard mathematical and sequencing reflects onescapability to pay attention and exercise mental control.
WAIS-IV is a reliable scale, and it was verified in adults rangingbetween 19-90 years. A sample, of 2,200 adults in the United Statestook part in validating the Wechsler scale and another group of 688individuals in the same age brackets in Canada. It registeredconsistent results in the two groups, and it is therefore a universalmethod for psychologists (Weiss et al., 2010).
However, the results obtained from the assessments are usually raw,and the psychologists have to convert them into standard scores bydividing them by 10 and subjecting to a standard deviation of 3. Thebattery scores from the verbal assessment are converted intointelligent quotient scores.
Also, the performance scores pass through the same standardizationmethod. To obtain a full-scale score, psychologists combine theperformance and the verbal score. The two scores are normative, andthe WAIS-IV calibrates them to a mean of 100 using a standarddeviation of 15 (Canivez & Watkins, 2010). A score of above 130classifies an individual as superior or intellectually gifted. Ascore of 120-129 terms an individual having a high intellect. Thosewho score 110-119 have normal intelligence that is slightly aboveaverage. A score of 90-110 depicts an individual with an averageintelligence. A below average intelligence score is between 80 and89. The borderline for intelligence is between 70 and 79 wherebyindividuals might be struggling to understand the environment aroundthem. A score of 50-60 shows mild mental retardation while a range of35-49 shows moderate retardation. Severe mental retardation isexhibited by a score of 20-34 while a score below that indicates aprofound mental challenge.
During the test, the assessor found it difficult to establish rapportwith William. He fidgeted and expressed frustration with his poorperformance in the various tests. The assessor noted his behavior ofsurveying the room, and this distracted him from the main activity.However, his behavior during the assessment had very minimal effectson the outcomes of the test and his capacity to complete the tests.
His verbal comprehensions stood at 102 similar to his perpetualreasoning. He had a working memory of 80 and a processing speed of81. His full scale was 92, and his general ability score was 101. William has mood disturbances although he may not be having anoutward signs to depict it. He also has oppositional tendencies thatare major cause of his anger and resentment. It is also the primaryreason for his irritable behavior and inability to handle stress. Healso seems to be experiencing a chronic stressor that makes him feeloverwhelmed.
His inability to share his thoughts with his wife portrays a personwho focuses on self-gratification without minding the effects of hisbehavior on others. He draws a false conclusion that his wife isunable to help him am this is an indication of his misperception ofpeople’s behavior.
William’s verbal comprehension was 102. According to the WAIS-IV,he is of average verbal comprehension intelligence. His score of 102in perpetual reasoning depicts an average individual since it fallswithin the average range of 96 to 108 on the WAIS-IV score (Weiss etal., 2010). He has a working memory of 80 which is of low-average(Brooks et al., 2010). Also, he has a below average processing speedthat has a score of 81. William’s full-score score is 92, and heis, therefore, of average capacity (Brooks et al., 2010).
William’s verbal comprehension is above average. It means that heis well educated and informed about his environment. His ability toidentify similarities, understand vocabularies, and synthesisinformation is above that of an average person. His educationalbackground may have contributed immensely to this outcome. Hisperceptual reasoning is also above average and it means that hismathematical capability in solving standard equations is above thatof an average person. His working memory is below average (Sattler &Ryan, 2009). He might be having difficulties sustaining attention,exerting mental control and concentrating. William has a an averageprocessing speed of 92 (Weiss et al., 2013). He has an averageability to process simple and routine visual material without makinggross errors. However, he cannot match an individual with a superiorspeed. He might be a bit slow in processing novel information
William may not be in a position to solve his problems in anintellectual manner despite his strong educational background. He hasanger and resentment, and these are the primary causes of his abusivebehavior. It also affects his ability to handle stress and makingsound decisions. William may also try to solve stress but in anadaptive manner that leads to excessive drinking. As depicted in hisperceptual reasoning, although he scored above average he does nothave fine skills to examine his problem, draw visual-spatial skills,organize his thoughts, and create a solution. He has a slowprocessing speed, and that is why he has more information than he canprocess. It leads to being overwhelmed and inability to make thesound decision.
The preliminary efforts should be to help William speak out hisfeelings to a person that he trusts. The psychologist should informhim of the confidentiality observed in the treatment process andallow him to talk without making a perception that nobody can helphim. Also, his ability to make the right decision regarding hisbehavior is highly influenced by alcohol. The professional shouldhelp him correct his behavior by keeping track of the beer heconsumes every day. A significant reduction of his drinking shouldpositively influence his discharge of duties as a husband and a legalprofessional.
Also, there should be a reinstatement of William’s self-worth andinterest. By knowing his former hobbies, it is easy to have him trythem out again and possibly develop a new interest in them. Forexample, going to church may remind him of the good days he enjoyedthere. During the assessment, it was difficult to establish rapportwith William. If the problem persists, it can adversely affect theoutcomes of the treatment. The psychologist attending him shouldcapitalize on creating a strong relation with William to gain histrust and consequently help him improve his on his condition.
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