This 12 page paper has two distinct sections. The first part deals with a case study of Stan, who presents himself to a counselor with major depression, suicidal ideation, alcohol abuse and a number of other conditions. The writer identifies Stan's problems, then discusses different therapeutic models the therapist may use to help this patient. The second part of the paper discuses three specific theoretical orientations to counseling and explains why they are preferred. Also, the role and goals of the counselor are discussed. Bibliography lists 11 sources.
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is his suicidal ideation. In his autobiography he said: "I fantasize about committing suicide and wonder who would care." "I even made a weak attempt to do myself in a
couple of years ago." "Id be better off dead." A very small percentage of patients with suicidal ideation actually commit suicide but a past attempt is considered to be the
most accurate predictor of a completed suicide (Gliatto and Rai, 1999). Studies have found that more than 90 percent of completed suicides in all age groups are associated with
psychiatric disorders. It is not the disorder itself that increases the risk of a completed suicide, it is the combination of the disorder and a specific stressor that brings the
patient to successfully commit suicide. Alcohol abuse and severe depression are two of the most common disorders associated with suicide. Bipolar disorder is another illness that is often associated with
suicide. The risk of suicide is much greater for those patients with suicidal ideation who suffer from both depression and alcohol abuse (Gliatto and Rai, 1999). Stan suffers from
all three: suicidal ideation, major depression and alcohol abuse. He has said he wants to change his life, which is a point in his favor but the three conditions must
be treated at once. Depression is most often treated with a combination of psychotropic drugs and therapy but these medications cannot be mixed with alcohol. This creates a major problem
for the psychotherapist. The therapist needs to determine how often Stan abuses alcohol before prescribing drugs. If it is safe, an antidepressant should be prescribed. Stan needs to know that
these medications can take as long as four weeks before the patient feels much differently, in other words, before his depression is significantly reduced (Gliatto and Rai, 1999). Therapeutic treatment
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