hout the treatment process he remained responsive and clearly concerned with fully understanding and appropriately applying the cognitive procedures. Speech and tone of voice were always within normal limits with no indication of pressure, retardation or aphasia. Stream of thought was rational, relevant and coherent with no indication of disturbed thought process. Mood was initially dysphoric with features of anxiety, depression, and underlying anger; as treatment progressed, mood changed to less dysphoric. Affect was well modulated and appropriate. The client became visible distressed while presenting facts that were disturbing to him such as the lack of support he felt from his parents and family members. Angel was a good historian and appeared to be oriented in all spheres with no indications of perceptual distortions, delusions, or hallucinations.
Angel is the oldest of four children and reports no close relationships with any family members. He is single and has a one-year-old son. He reported no friends, role models, or support system. He reported being angry at family members for not being available to him and being angry at life in general. He was aware of his needs for emotional support, affection, and reassurance and the fact that he is unable to fill these needs. He reported a history of physical and emotional abuse and a history of temperament problems and suicide attempts.
Angel is a former gang member with current limited involvement in gang activities. He dropped out of school in the 12th grade due to problems such as school fights and lack of classroom participation. He reported a history of school problems with bullies in junior high and elementary school; he stated that he was constantly picked on by older and stronger kids. He stated that he has a history of leaving problem situations which is a behavior that he learned from his parents. He reported that he hated his life and was "always cry...