Background

Leah Michaels is an 18-year-old young lady who was just about to graduate high school and was planning on enrolling at her near by community college. She lived in a middle class area where both of her parents worked hard to provide the best for her and her siblings. Both of her parents emigrated from Mexico but had lived in the U.S for most of their lives. Leah and her family were members at the near by Catholic Church but were not too involved and mainly attended mass on special occasions like Christmas and Easter. She is the oldest of three children and enjoyed spending time with her mother and sister although she occasionally argued with her younger sister like most sisters do. She was healthy and never had any problems with her family. Through out high school she had always been very successful and was part of many after school clubs. Leah found it very easy to find friends and was popular amongst her classmates. She loved going out and meeting new people. Every weekend Leah would be the person planning outings and weekend projects with her close friends. As her graduation day started getting closer Leah began to feel very sad and unsure if she wanted to graduate along with her classmates. Despite her uneasy feeling about her graduation ceremony Leah’s mom convinced her to go.
Present Complaints
Almost immediately after she graduated high school Leah began to loose interest in her friends. She no longer had the desire to go out with her friends like they always did in high school. For the past two weeks she spent most of her days lying in bed under her blankets. After taking several long naps during the days and not getting any sleep at night, Leah’s mom became worried. She no longer felt happy. She hated the feeling of always being tired and not having the energy to get up or even take a shower. Her room became increasingly dirty and she stopped caring about her appearance. Leah started her classes at her community college within a week after her high school graduation. She felt she was not worthy of attending a community college. After it took her hours to fight the heavy feeling of getting out of bed, Leah would drive to school feeling extremely tired. She hated sitting in a classroom because she could not concentrate on the class lessons and she felt like she was just wasting her time. When she would be doing her homework at home she would start to cry for no apparent reason. Leah also began to notice that she was pushing away from any relationships she had. She no longer cared to spend time with her mother and sister. She would avoid going to dinner with them because she wanted stay home alone and lay in the dark. She would turn off her phone so that her friends would not call her to invite her out. When her friends would stop by her house she would shut her blinds so that they would think she wasn’t home. On some nights she would have horrible nightmares and would keep her from getting sleep. She didn’t like going outside because the sound of ambulances made her panic and think about her dad.

Contributing Factors
Leah shared with her friend that a years ago she had lost her father and had witnessed the entire event. She began to tell her that when she was seventeen her father had suffered from heart attack in their home. One day Leah had came home from schools and jumped in the shower. Her younger sister was playing in her room and her mother was just getting home from work. When Leah was changing she heard a loud scream coming from her mothers room. Leah ran out of the restroom to see what the commotion was all about. She was shocked to see her father unconscious and her mother crying. Leah grabbed the phone to call the ambulance but she was too late. Her father had already stopped breathing. After the paramedics had taken her father to the hospital where he was later pronounced dead, Leah stay home with her younger sister and waited for her mother