2. Client Information
• Client #9
• George Lawler
• Address: 2650 Virginia Avenue
• Phone: 867-5309
• Referral: Wife
• Insurance
• Account #31415
3. Client Information
• Medications
– Haloperidol
• 5mg – 2-3 times a day for 3 weeks
– Lithium
• 900mg on the first day
• 1800mg per day over the next 2 weeks
• 2100mg per day for maintenance after
third week
5. Client History
• 35 years old
• Married
• 2 children
• Works at a small junior college
• Teaches physical education
• Coaches men's and woman's track
teams with outstanding seasons
6. First Serious Episode
• During his junior year of college
• Defensive back on football team
• Good academic student
• Fairly popular
• Found that he was losing interest in
everything
7. First Serious Episode
• Did not look forward to classes or
studying
• Never been an outstanding student
• No longer enjoyed going out with
friends
• Friends said he seemed depressed
all the time
• George said he just didn’t care
anymore
8. First Serious Episode
• Starting finding faults with his
girlfriend
• Spent most of his time watching t.v.
• Had no concentration
• T.V. was mostly a distraction not
entertainment
9. First Serious Episode
• Football Coach recognized problem
• George told coach that
– He couldn’t make it through the
simplest of practices
– Did not care about the team or his
future
• Coach referred him to a Psychiatrist
10. First Serious Episode
• Began
– Anti-depressants
– Counseling sessions
• Back to normal in several weeks
• Treatment was discontinued
• From there George found himself
with periods of unusual ambition
and energy
11. First Serious Episode
• Friends to amphetamines to stay
awake
• George seemed able to summon
endless, internal reserves of energy
• Hypo manic episodes
• Had tendency to toward excess
verbosity
• Behavioral excesses went unnoticed in
competitive university environment
12. Subsequent Episodes
• 8 months prior to hospitalization
suffered a depressive episode
• Loss funds for travel
• Began to inadequate sleep
• Assistant coach took leave of
absence in which he took personal
• Began having suicidal tendancies
13. Subsequent Episodes
• After treatment form same doctor
in college he began a manic episode
• Became consumed on athletes and
their performance
• When home he talked endlessly
about team
• Began planning intricate strategies
for important events
14. Subsequent Episodes
• Wife thought it was just pressure from
job
• During pre conference meet George
began pacing back and forth
• Talking about specific events and
virtues of winning
• Pulled ceremonial sword out and gave
“the most inspirational pregame
performance he had ever seen in a
locker room” according to reporter
15. Subsequent Episodes
• Wife thought it was just pressure from
job
• During pre conference meet George
began pacing back and forth
• Talking about specific events and
virtues of winning
• Pulled ceremonial sword out and gave
“the most inspirational pregame
performance he had ever seen in a
locker room” according to reporter
16. Subsequent Episodes
• Next day during interview George
went into a grandiose tirade
– Began rambling for three hours
– Boasting
– Stated he planned chaperoning a star
jumper to a NCAA national meet that
wasn’t going to happen
– Told the reporter to quote him as it
wasn’t every year he got to take a free
trip with a pretty girl
– Stated it could end in a genuine romance
17. Subsequent Episodes
• In his picture for the paper he was
disheveled
• When director confronted George a
shouting match ensued in which
George stated that he was just named
coach of the Olympic track team
• Was making calls for potential
assistants and any interference would
be attributed to foreign countries
18. Subsequent Episodes
• George was then escorted to the
hospital by the police.
• Involuntary commitment was
necessary
• Psychiatrist testified in court that
George might be a danger to
himself or others
19. Current Episode
• George is seeking both
prescription and
psychotherapy treatment
• Wife did divorce however
he took it well
• Work friends are a
constant support
21. Treatment
• Haloperidol
– 5mg – two to three times a day for
three weeks
• Lithium
– 900 mg on the first day
– 1800 mg per day over the next two
weeks
– 2100 mg per day for maintenance after
the third week
• Continued Therapy
