Case Study of Mr. Angeli:
Mr. Angeli is an 82-year-old Italian man who was referred to your office by his primary care provider for
treatment of depression. His primary care provider discussed antidepressants with Mr. Angeli, but he was
resistant to this approach.
During your intake assessment, you learn that Mr. Angeli emigrated to America when he was 7 years old. He
worked at a variety of jobs throughout his life and had been divorced twice. He had two children, a son and
daughter. His daughter died in her teens, but Mr. Angeli would not expand on this, and instead focused on his
son with whom he lives. He moved in with his son and his son’s wife about 6 months ago because he was
having difficulty caring for his house. Mr. Angeli informs you that his son said that he could come and live with
him. He has since sold his house and when speaking of its sale, tells you “I’ve been able to help my son out
with some money- he lost his job last year and has been having trouble finding work.”
Mr. Angeli begins to open a bit more and informs you that his two divorces resulted from his “trouble with
drinking” over the years. He explains having lived a very stressful life and talks about some of the challenges
with being marginally educated and his years of struggle to make ends meet. He acknowledges that over the
years he “lost his patience” with his children a few times, to which he adds “I never meant to hurt them, I love
them.”
Mr. Angeli has problems with high blood pressure and what he describes as “liver problems.” He says that he
goes to see his primary care provider once a month for follow up treatment.
Several times during the clinical interview, Mr. Angeli becomes tearful, but fights the tears from coming. He
states that he feels both “helpless” and that “things will only get worse for me.” When you ask him what he
means by this, he pauses and says “well, sometimes when my son has been drinking, he gets a little nasty.”
He further divulges that he “understands” how his son feels as he used to get like that himself. He then admits
that during one of his son’s drinking episodes, he got into an argument with his son & that his glasses got
broken- to which he added with a small smile “thankfully I had this other pair!” as he points to his face. He said
that when his son has been drinking, he often says “some really nasty” things to him. Mr. Angeli explains that
he has been giving his son money from his social security check, and has also been giving him additional
monies from the sale of his house. He also reports that from time to time, he hears his son and his wife
fighting, which frightens him as he says that “it reminds me of the fights I used to get into with my two wives.”
You ask Mr. Angeli if he is afraid of his son and he remains silent…
PART 1:
After reading the above case study, please respond to the following questions: