Introduction - Client Profile

James is a 30 year old male. Throughout his twenties he struggled to keep a job for longer than a couple months. James has also had one prior admission to an acute mental health unit for a failed suicide attempt.  He had tried to hang himself from the garage ceiling using a belt, but his partner at the time found him after getting home from work and cut him down.  It was noted that during this prior admission, James shared several different stories about why he tried to kill himself with the healthcare team.  He had also threatened to report the nursing staff to the unit manager if they did not meet his needs and frequently engaged in self-harm behaviors on the unit.  These behaviors included cutting his forearms with a razor and banging his head when he became emotionally dysregulated.

James has worked at his current job, a local construction company, for the past two and a half years. He recently got promoted to the position of foreman. He is quite excited about this promotion and his increased responsibility. This position creates many opportunities for him and provides stability.

James lives with his boyfriend, Alexander. Alexander is interested in adopting children someday and starting a family with James. However, James is hesitant to adopt and doubts his ability to be a good father.

Since starting his new job 2 months ago, James has been experiencing constant harassment for his sexual identity.  James has been coming home later and later and he is often drunk when he gets home. James often begins arguments with Alexander, especially around adopting children and expanding their family. Alexander said that “sometimes the arguments can escalate so quickly over nothing” and he feels that James is lying to him about why he does not want to have children.