Bob is a 50-year old male on disability support. In your intake, he tells you that he was “just fine” until he got injured on the job, which led to a series of acute medical procedures, physical therapy, and major stress from filing disability paperwork. Disability was recently awarded. He tells you that he sits at home most days, despite his wife’s attempts to get him out of the house with her. He dislikes leaving the house because he never knows when his pain will flare up and therefore feel the immediate need to lay down and take his pain medication. He feels very guilty for not being a better partner to his wife and tries to make up for this by taking care of long-standing home repairs. Bob recognizes that he often overdoes it when he takes on one of these projects, which exacerbates his pain and leads him to feel hopeless. He starts to focus on all that he has lost and imagines a future in which he is weak and house-bound. He also acknowledges that, when he is in this physical and emotional state, he is likely to snap at his wife and say things he later regrets.