Tom is a 38-year-old car salesman with a long history of depression and substance misuse. He is currently at risk of losing his licence after a drink driving offence. Tom has so far avoided the physical and mental problems experienced by his father and two of his brothers as a result of their alcohol use. Tom’s father, a Vietnam veteran with a history of violence in the home, left the family by the time Tom was seven years old, but his older brothers grew up under their father’s influence.
Tom’s second marriage is currently in jeopardy as his wife is not able to cope with his erratic behaviour and constant drinking. She is very concerned for the wellbeing of their six-year-old son, who has been tearful and anxious because of Tom’s constant criticism. Tom is still moderately depressed despite antidepressant medications, but no longer suicidal. He has seen a psychiatrist and agreed to undertake drug and alcohol counselling. He and his wife have been referred for relationship counselling.
Tom’s therapist chooses to refer him to an online support and treatment program for people suffering from alcohol misuse and depression. She uses her face-to-face sessions with him to reinforce what he has learned and discuss how his own experience and the things he is learning resonate with his past experience of his father and older brothers. Tom’s wife also looks at the program, which provides a starting point for discussion in their sessions together with the therapist.
At their therapist’s suggestion, Tom’s wife seeks some support from a moderated forum for carers and together they undertake an online parenting skills program. Issues arising from these online contacts are discussed within the therapy sessions. Meanwhile, with Tom managing to curtail his alcohol consumption, more conventional face-to-face relationship counselling is undertaken.