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Psychosocial Assessment

SOWK 657

Melissa Degenhardt

February 16th, 2017

This psychosocial assessment is based on the first three sessions as seen within the In

Treatment TV series.

Who is the client?

The client is Alex (42), an African-American pilot for the US navy currently inactive

with the force. Alex is a father of two children, and husband to Mikayla for the past 15 years.

Recently this week, Alex has decided to separate from Mikayla. Alexs mother is deceased and

Alex reports a strained relationship with his father.

What is the context, who is he?

There are several important contextual factors to consider within Alexs life. Alex reports

that his last mission with the Navy was a bombing mission in Iraq. Alex explains that he

correctly hit his target as directed within his mission, but later learned that the target that he hit

led to several children dying. Alex has mentioned within session that he does not feel anything

for the victims of the bombing and has even returned to the bomb site and claimed not to

experience emotion. Alex relates his lack of feelings in this matter as a result of his military

training and demonstrates an ability to compartmentalize his duties as a navy pilot from the

impact that it has on other people.

Alex had a heart attack after this mission while running due to alleged overexertion. Alex

indicates that he has not returned to duty for this health reason, but in session # 3 indicates that

he was suspended from the force. This contradicting information has not yet been addressed.

Alex has been married to his wife Mikayla for fifteen years and reports a sudden and

recent realization that he no longer wants to be with her. Alex describes Mikayla as being

repressed and behaves in a very structured and scheduled manner. Alex has said within session
that he loves Mikayla and attributes positive qualities to her such as being a selfless person.

Alexs decision to leave Mikayla appeared impulsive. Alex commented that he told Mikayla that

he was leaving casually without emotion and that she responded in a similar sense.

What is the problem from his perspective?

Alex began therapy indicating a concern regarding his lack of emotion and feelings

surrounding his last bombing mission that killed many children.

Alex is also aware that there are problems surrounding his Dad but has protected this

issue from the exploration of the therapist up until the third session where he begins to talk about

his fathers infidelity, lack of guilt, and lack of emotion demonstrated in his ability to remarry

quickly following his wifes death and the fact that Alexs father, killed his own father, and

shows little remorse for this.

Based on what I know how do I pull it together?

It is this writers hypothesis that Alex is suppressing a lot of emotions in regards to

experiences within the navy, his recent separation from his wife and family, and past relational

issues with his father. Alex displays perfectionist tendencies, as displayed by his choice of wife,

career, and coffee. Alex displays an ability to compartmentalize and use logic to separate himself

any emotion that he experiences. When asked to empathize and imagine the perspective of others

in session, Alex displays a difficulty doing so. At times, Alex is avoidant of questions or

attempts to take the attention off himself in session, especially when asked questions about his


What is the plan? What would I do next time with him in the next session?
Alex is making progress and appears to be becoming a bit more vulnerable within

therapy. By session #3 Alex begins to open up more about his father where in the initial session,

Alex made a point to indicate that he was not ready to discuss his father. For session number four

it could be beneficial to acknowledge and commend Alex on his openness in the last session. In

the next session, the therapist could see if the client is ready to explore some of the issues that

exist within his relationship with his father and some of hurt and resentment this is likely present

within their relationship, and this is likely when Alex first began to repress his feeling. Exploring

this guarded area of Alexs life could be beneficial for Alex if he is able to explore his own

feelings, even the feelings he experienced as a child, regarding his fathers infidelity towards his

mother. The similarities between Alexs fathers reported emotional presentation and the way that

Alex presents emotionally in session appears similar. This connection is one that has been eluded

to in therapy, and one Alex has denied. It is suspected by this writer that Alex has focused his

whole life on being different from his father, and recognizing these similarities could be

alarming for him but simultaneously beneficial and possibly motivating to make changes to

expand his emotional capacity and strive to get in touch with his feelings. This approach is

related directly related to Alexs presenting problem that he does not feel anything towards the

victims of his bombing mission and his separation from his wife Mikayla.