Ellen and Edward

Ellen and Edward represent the dynamic challenge of working with two people who enter therapy together , but present different levels of clinical symptomatology . In this case , Ellen appears to be experiencing the most difficulty functioning in her life . She reports a lack of energy , persistent sadness , and even occasional suicidal ideation . These problems are not new for Ellen as she has likely suffered from clinical depression for several years . Her termination of individual therapy may have triggered or intensified her recent increase in symptoms

Ellen 's diagnosis is Major Depressive Dis . Her

severity ranges from moderate to severe . At this time , Edward does not meet criteria for any Axis I diss , but further information would be necessary to understand his personality and other areas of functioning more thoroughly . Neither member of this partnership meets criteria for an Axis II diagnosis . There are no medical conditions reported and therefore , no Axis III diagnosis . Axis IV psychosocial problems for Ellen include her previous abuse . As a couple , psychosocial difficulties include communication problems and marital discord . Ellen 's GAF is estimated to be 35 while Edward is functioning more effectively at a GAF of 65 . The couple 's level of functioning is more reflective of Ellen 's more severe difficulties (Weeks Hof , 1995 . They are failing to communicate , meet basic needs of the household , and sustain meaningful aspects of the relationships

Because Ellen has experienced a mood disturbance for longer than the duration of her marriage , it is possible that even her mate...