"Completing a Diagnostic Conceptualization: The Case of Devon" ,
Program Transcript ,
This is your very first session with Devon. Devon is a 24-year-old biracial, gay, male who self-referred for
counseling. When Devon called your office to schedule his session, he stated that he recently broke up
with his boyfriend of 3 years, Marcus, after he discovered that Marcus was being unfaithful to him. He
stated that he was feeling really anxious and sad and needed someone to talk to about his feelings.
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COUNSELOR: Hi, Devon! Thanks for coming in today. I’m sorry to hear that you and your boyfriend broke
up, that can be a really painful thing to go through. I’m happy you’re here so we can through what
you’re feeling. To get us started, I have your intake here and I just wanted to follow up on some of what
you shared.
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Walden Counseling Intake:
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Client Name: Devon
Today's Date: January 18
Legal Name: Devon
Address 16 Birch Dr
Cell Number: 555-555-1111
Is it okay to leave a voicemail: Yes
Age: 24
Preferred Pronoun (example: She, he ze, they): He
Self-identified Gender: Male
Primary Language: English
E-mail address: devon15@gomail.com
Secondary Language: None
Relationship Status: Single
Children: None
School / Employment: Software Engineer for Network Solutions.
Previous history of counseling: Yes, about two years ago
Other health conditions: heartburn and migraines
Medications: over the counter heartburn medications, Relpax for migraines
What brings you in to the counseling at this time? Breakup with boyfriend
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COUNSELOR: In reviewing your intake, I noticed that you’ve had some previous counseling. Can you tell
me a bit more about that experience? What brought you into counseling in the past?
DEVON: Yeah, I went to see a counselor about 2 years ago for some issues related to my eating. I was
basically out of control.
COUNSELOR: You were eating more than you wanted?
© 2020 Walden University, Inc.
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"Completing a Diagnostic Conceptualization: The Case of Devon" ,
Program Transcript ,
DEVON: Yeah, I was eating my feelings. I would binge constantly and then do whatever I could to try to
get rid of all of the calories.
COUNSELOR: During those binges, did you feel like you were out of control once you started eating?
DEVON: Yeah, for sure. Once I started, I couldn’t stop, even if I started to feel sick. I can easily eat like
three boxes of cookies, couple bags of chips, a box of doughnuts, and two cheeseburgers within like the
span of 40 minutes. It’s disgusting but once I get going I can’t stop. Like in my brain, I’m like “Devon,
stop this you’re not hungry don’t eat” but my body takes over and I just feel like it can’t stop it.
COUNSELOR: I noticed that you said “I can eat and I can’t stop” – is this something that’s still happening
now?
DEVON: Yeah, good catch, I didn’t even realize I said that. It’s definitely something that I’ve been doing
more since Marcus and I broke up. I mean, it’s definitely something that’s been off and on for like the
past eight years but when I get upset or stressed, I definitely turn to food.
COUNSELOR: Would you say it’s something that you do weekly? Or perhaps more or less often than
that?
DEVON: Yeah, a couple times a week would probably be more accurate, especially since the breakup.
I’ve really been hating on myself since I found out that Marcus had been cheating and that’s made me
eat more which then sort of leads to me hating myself even more and needing to get rid of the calories
because I don’t want to become fat and unlovable.
COUNSELOR: It sounds like this breakup with Marcus has really exacerbated some of those feelings of
self-hate?
DEVON: Yeah, definitely. Not even so much the breakup as the finding out that he was cheating on me
part.
COUNSELOR: Learning that your partner has been unfaithful can be pretty traumatic; I’m sorry you’re
going through this. You mentioned that you try to compensate for overeating by getting rid of the
calories. Can you tell me a bit more about what sorts of things you’ll do to get rid of the calories?
DEVON: Yeah, I throw up mostly. Usually, it’s pretty easy to do because I feel so sick after I eat all that
food. Sometimes I’ll also exercise a lot more than usual to try to get rid of all the crap I’ve eaten but
that’s more of a next day sort of thing. Most often, it’s me eating all that crap and then immediately
trying to get it out of my body.
© 2020 Walden University, Inc.
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"Completing a Diagnostic Conceptualization: The Case of Devon" ,
Program Transcript ,
COUNSELOR: Would you say that trying to get all that food out of your body is related to a desire to
maintain a certain appearance.
DEVON: For sure. If I gain weight I feel like a failure. Like if I’m fat my life is over. No one will love me. I
will die alone. I know that’s a pretty insane thing to think but that’s where I am.
COUNSELOR: These eating issues that you’ve shared with me here, is that something that you’ve shared
with others too?
DEVON: Not really. I suspect Marcus knew something was up when he would go into the kitchen and
find that I had plowed through like four boxes of Girl Scout cookies, but he never said anything about it.
COUNSELOR: So, it’s fair to say this is something you’ve struggled with on your own?
DEVON: It is, yes. I wanted to be more honest with Marcus about it but I’m glad that I wasn’t because he
obviously wasn’t honest with me.
COUNSELOR: You’ve said you’ve been feeling pretty overwhelmed since the breakup, can you describe
to me what you’ve been experiencing?
DEVON: I’m just sad all the time. I cry about what could have been. I’m mad that he would do this; that
he would lie right to my face. I really pictured us having this good relationship and it was all built on a lie.
COUNSELOR: Have you had any problems at work?
DEVON: I took a couple sick days at work right after we broke up. I know that sounds stupid, but my job
requires concentration and I had zero ability to do so. I’m back to work now. But honestly, I continue to
struggle to feel fully invested in anything. I sort of feel like a zombie going through the motions. We
weren’t even living together but I stayed at his house most nights and to now be back at my apartment,
by myself, I just feel so alone. I haven’t even been spending much time with friends because they are
friends of Marcus too and I just find it hard to believe that they didn’t know that he was cheating on me.
And if they did know, then I feel like a fool. Like everyone knew something I didn’t. Every time I think
about it that way, I feel so disgusted. Thinking about that stuff like that definitely starts the cycle of selfhate which then leads to the overeating and which then leads to even more self-hate.
© 2020 Walden University, Inc.
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