Case Conceptualization

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Case Conceptualization


My patient in this case will be Tracy Freeland from Catherine Hardwicke’s Thirteen. Tracy is a thirteen-year-old female schoolgirl. A White girl, she lives with her mother in a state of socioeconomic turmoil as her alcoholic mother strives to support Mason, her older brother, and her through school. She can barely afford decent or ‘trendier clothes’ for Tracy. Tracy is not handicapped in any manner and currently has neither a boyfriend nor children.

Chief Complaint

“I have been feeling ignored by my mother since she is always pre-occupied with her boyfriend. The feeling has landed me in depression and worsened my stress. Consequently, I have been using drugs and sex as my source of coping up with the current situation. Gradually, I have become addicted to sex and drugs which have combined to deteriorate my health. I wish to stop but I have no clue how to do that. Please help.”

Presenting Concerns

The symptoms of Miss Freeland’s depression and stress include paranoia, suicidal tendencies demonstrated by frequently cutting herself to cope with stress, and violent acts like hitting her friend Evie after heavy drinking. She began on this trend of behavior since the beginning of her mother’s recovery from alcohol addiction and does it as frequent as anytime she pleases. Correspondingly, her life and behavioral pattern has changed drastically. Tracy is deep into sex and drugs, and even engages in petty theft. She has grown violent and in disregard of her studies. Her primary source of stressor is the neglect with which her mother treats them in the course of her recovery. Besides, Tracy feels that it is unjustified for her mother to be concerned with Brandon, her boyfriend, more than she is with them.

Treatment History

It is the first time Tracy has sought treatment owing to her worrying condition. She has no history of treatment. However, at present, she indulges herself in heavy drinking and inhaling substances, but has had no treatments yet. Similarly, she has never been hospitalized for any mental health or substance-related problems.

Personal History

Tracy Freeland is a product of a normal birth and had a normal early childhood development. There were no complications or psychosociological issues that may have influenced her current behavioral trend. However, given that she was raised by a single parent, the mother, there is sufficient grounds to presume that she has had social/family relationship issues in the course of her childhood development. The issues may have passively persisted with her through her adolescence and largely contributed to her gradual degeneration. She had no notable romantic relationships. Tracy is a middle school student who starts off as a ‘smart and sweet honor student.’  Like her romantic relationships, Tracy has no notable sexual history except her attempt to seduce Luke, who together with the duo, leaves to follow their delinquency in the streets. Apart from the seemingly unstable paternal relationships, Tracy’s best friend Evie, with whom she is socially close, is similarly a degenerate who facilitates Tracy’s deterioration of behavior. Her current living situation is pathetic. She spends most of her time in the streets drinking and away from the house avoiding her mother, Melanie. She carelessly abuses substances and engages in sexual escapades without any restrictions or supervision from her parents. Finally, her recreational activities and hobbies have recently become drug abuse.

Family History

Tracy is raised by a single mother who is living with her boyfriend, the only significant male figure that Tracy has encountered in her life apart from her brother.  Without a paternal fatherly figure in life, Melanie’s neglect has greatly affected Tracy’s development and wellbeing. Moreover, it is important to reiterate that the history of her substance abuse and sexual degeneracy begins when she feels that her mother neglected the family, save for her boyfriend.

Medical History

Tracy has no significant medical history that would help in this case.

Risk Assessment

Tracy’s condition is escalating quickly. Her relentlessly increasing levels of depression and stress has led her to inflict harm on herself. Her extensive scars and body marks reveal that she has been frequently cutting herself to cope with the stress. In some cases, in a drunken stupor, she turns violent and hits herself or her friend.

Diagnostic Impressions

Tracy is in her early stages of addiction, stress and depression. However, in her current condition, the situation is quickly escalating and may reach advanced stages if not managed in time as Hartman, Ho, Arbour, Hambley and Lawson (2012) asserts. Her suicidal tendencies are majorly as a result of stress and depression. There are no rule outs, and her condition is entirely manageable.

Treatment Recommendations

In this case, I would primarily recommend sexual compulsivity and drug abuse rehabilitation therapies. Rosenberg, Carnes, and O’Connor (2014) notes that the most common treatment recommendation for sexual compulsivity is often abstinence. However, I would be reluctant to recommend abstinence, and in its stead, recommend that Tracy forms new romantic relationship partnerships which will keep her off the dangers associated with her sexual addiction. A combined sexual compulsivity and drug addiction therapy replete with education, medication, and behavioral therapy (Schneider, Sealy, Montgomery & Irons, 2005; Hartman et al., 2012) will go a long way in correcting Tracy’s condition and reorienting her behavioral pattern. Tracy’s condition is in the early stages, and in addition to medication, extensive therapy is just enough to induce normalcy. On this document, click on ‘file’ up there, see ‘author’, get me there for future cheaper services. Remove this part before you hand in your paper.










Hartman, L. I., Ho, V., Arbour, S., Hambley, J. M., & Lawson, P. (2012). Sexual addiction and substance addiction: Comparing sexual addiction treatment outcomes among clients with and without comorbid substance use disorders. Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention, 19, 284-309.

Rosenberg, K. P., Carnes, P., & O'Connor, S. (2014). Evaluation and treatment of sex addiction. Journal of sex & marital therapy, 40(2), 77-91.

Schneider, J., Sealy, J., Montgomery, J. & Irons, R. (2005). Ritualization and reinforcement: Keys to understanding mixed addictions involving sex and drugs. Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention, 12, 121–148.






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