Pearl is a 50 year old woman who takes care of her husband. His main problems are with executive functioning, anxiety, and organizing. Pearl believes he is on the spectrum, as he has issues with attention deficit and similar GI tract problems, but has never gotten this properly diagnosed. He has severe irritable bowel and is on a very strict food diet. Most of the strain Pearl experiences is not physical, but psychological in nature.

Needs Current Approaches used by Pearl Alternate Suggestions  What Could Be Created?
1. Pearl needs help dealing with the emotions accompanying her care for her husband. Providing care for her husband strains her relationships with her family and friends. Neither her nor her husband’s family provide support for them, which makes them socially isolated. She studies Buddhism, which helps her with compassion. She is also learning about communication, empathy, and respect.
2. Pearl needs help changing her husband’s behaviours; he is impatient, triggered by certain things, and has problems anticipating what he needs to do. This is due to his lack of executive functioning. Behavioral modification: reinforces behaviors you want to achieve and discourages behaviors that you do not want.

OT and psychodynamic counsellor once a month.

3. Pearl needs a way to help diagnose adults like her husband. Pearl believes he is on the spectrum, as he has issues with attention deficit, similar GI tract problems, and his youngest daughter was diagnosed with attention deficit. Her husband has never gotten this properly diagnosed. There are multiple reasons for this: Finances to do it privately, transportation, and there is nothing in their geographical region to do it as an adult.  
4. Pearl needs help sorting out her husband’s dietary needs. She has tried going to the medical doctor to rule out anything severe. She has also tried going to a traditional Chinese medicine doctor.