The client, a 29-year old male, seek for clinical evaluation and counselling due to having persistent thoughts about having a bad body odor despite confirmation from family members that he does not smell bad. These thoughts have been present for more than 6 months. Due to his problem, the client takes a bath and applies cologne more frequently than the usual. The thoughts have also often made him worry and get anxious of other people’s reaction towards his smell. The client remained cooperative all throughout the interview. He smelled good, has no unusual behaviors and showed no signs of extreme depression or anxiety. More importantly, no hallucinations of any kind were detected. Initial diagnosis was made pertaining to delusional disorder, somatic type, multiple episode, currently in acute episode. Obsessive compulsive disorder, body dysmorphic disorder and illness anxiety disorder were ruled out. A cognitive approach was used to explain the client’s condition, emphasizing on cognitive biases and maladaptive cognitive distortions. The treatment plan includes the objective of correcting the irrational thought through Cognitive-Behavioral Therapy. The frequent anxiety and worrying were also aimed to be reduced through counselling and family support.
Identifying Information and Reason for Referral
Client name: Daniel Walters
Marital Status: Married
Referral source (and telephone number, when possible): Client’s wife
Reason for referral: Consultation and counselling
Interviewer: Pam Thibeaux
Date of report: July 7, 2014
Present complaint involves persistent thoughts about having a bad body odor. He said that he believes that he has foul body odor even if “my friends, family and wife tell me that I do not have a foul body odor.”
Current Situation and Functioning Daniel is able to fulfill his daily tasks and responsibilities. He reported that during weekdays, he wakes up at around eight in the morning, takes a shower, applies deodorant and cologne to be sure that he smells good, and then goes to work. He is currently employed as a web developer in an IT company. He stated that his condition has not interfered significantly with his job and with his relationships with other people at work. He considers himself as a good and responsible employee. However, he is often anxious that his coworkers may be smelling his body odor and worries that they may get offended by the smell and avoid him. He also frequently imagines that his coworkers are being repelled his body odor.
At home, Daniel is also able to fulfill his responsibilities as a father and a husband. His condition has not also significantly interfered his relationship with his wife and child.
Overall, the client is capable of performing daily activities at work and at home. He thinks of himself as a family man who likes to spend time with his family. He considers himself uncomplicated except for his problem regarding his body odor. Currently, he is coping with this problem by trying to ignore thoughts related to it.
Behavioral Observations (including Mental Status) At the time of the interview, Daniel appeared neat and healthy. He smelled good, like the scent of cologne which is not too strong or too dominant. He had a good posture. He maintained eye contact and his facial expressions were appropriate. He articulated himself clearly. He answered questions spontaneously with normal rate and speed. He was cooperative throughout the interview and reported information adequately. His memory is intact and he did not show signs of emotional disturbance or depression. He also has no suicide or homicide ideation. He described his current mood as “normal except for having these thoughts of smelling.” Minimal signs of anxiety can be detected while answering.
History of the Presenting