Mr. B is a 58 y/o DBM. presenting in a VA heaith clinic for assistance with ongoing depression and health issues, including
chronic cough and shortness of breath. He was treated with 14 days of oral antibiotics following a previous clinic visit last
month, but did not finish the medication and reports he cannot find the medication bottle. He reports that he is sad or blue
most of the day, has difficulty falling asleep, but then sleeps until noon most days, has a lack of motivation to do things
outside of home and family. and has a low appetite. He is HIV+ and has a history of substance dependence and criminal
activity leading to arrest and incarceration. He is currently on probation for one more year, he is compliant regarding
meeting with his probation officer. He reported no previous history of psychiatric treatment. outside of substance
dependence treatment. He has a history of two previous inpatient substance abuse treatment stays (one year ago and five
years ago). but returned to the substances shortly after discharge. He is a current daily smoker and user of alcohol; THC
use is 3-4 times per week. He states that “treatment doesn’t work” and acknowledges that he does not want to stop
smoking. drinking, or drugging.

Mr. B is the youngest of 5 children (3 males, 2 females: oldest sister deceased in 2002). He was raised in an intact family
and denied abuse or neglect (However, his father had many affairs. and his mother was aware of them.). Otherwise. he
describes his childhood as “beautiful” and his current family relations as “very, very close.” He describes himself as “the
baby of the family” and the “fixer.” He reported that he continues to function in these roles. Mr. B performed well in school
in spite of some “bouts of non-criminal delinquency.” He was involved in the school’s competitive chess team and other
activities. He also has training as a Legal Aide. He began smoking cigarettes at age 14yo, drinking at 14/15yo, and
smoking THC at 14/15yo. He stated that “it didn’t get to be a problem until the military’ (Post Vietnam-era (1975-1977),
Army).

Mr. B reported that he married his first wife after he was discharged from the military. The marriage lasted ~3 years and
produced one daughter. Mr. B stated that the marriage ended because of his “drinking, fighting, and infidelity.” According
to Mr. B. he “divorced (his) first wife and quickly married (his) second wife” when she became pregnant. He reported that
this marriage also lasted ~3 years and produced a daughter. He stated that he continued all of the behaviors that led to

to Mr. B, he “divorced (his) first wife and quickly married (his) second wife” when she became pregnant. He reported that
this marriage also lasted ~3 years and produced a daughter. He stated that he continued all of the behaviors that led to
the collapse of his first marriage. This marriage ended when he relocated to New York without her. He reported that he is
“very close” to his daughters and second ex-wife, and they have a “good” relationship. However, his daughters are
unaware of his HIV+ status. Mr. B has had a long-term friendship with a Houston-area woman who is also HIV+. While
she would like to become romantically involved with him, he stated that he has been unable to break free from his self-
imposed isolation to pursue this relationship. He reported no other active friendships, acquaintances, or peer groups
outside of regular Narcotics Anonymous meetings (a condition of his probation) and family members. Mr. B also
expressed that being Black and HIV+ was difficult because he “initially thought that only gays get HIV” and “condom
usage” is not a widespread practice.

Mr. B has been “unemployed” (except odd jobs. exposure to TWE/TRE) since ~1998. His family has provided funds for all
of his expenses including housing. utilities, clothing, and “pocket change.” Mr. B states that he is “more spiritual than
religious,” but identifies as Southern Baptist. His recreation/social life includes television and spending time with family
members.

discuss the following:

  1. Pick TWO of the following areas where clients’ needs are always assessed.

a. Medical

b. Psychiatric/Psychological

c. Social/Relationship

d. FinanciavVEmployment

e. Functional Living/Housing/ADL

  1. Then answer the following for both of the areas you have chosen:

a. Discuss the primary needs Mr. B has in this area. What are the most important aspects for the case manager to
address in the short-termand in the long-term?

b. Identify the main resources that could help to address Mr. B’s needs in that area.

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