Randal initially sought a psychological evaluation for his current problem of depression. He began by stating that he had struggled with simple tasks and felt easily overwhelmed. After further questioning, Randal began to process some of the thoughts that were occupying his time and causing him difficulty concentrating. He was constantly absorbed in anxiety about himself or his family, coming into contact with a microbial disease. This thought pattern led him to compulsively wash his hands, obsessively clean surfaces and doorknobs, and throw away perfectly fine clothing for fear of contamination. He went on to further state that he often avoided places due to anxiety about their cleanliness. Furthermore, Randal explained that often, just when he thought about dirt and germs, he would take a shower, because he felt contaminated. When asked, Randal implied that this behavior had been occurring for several years, but recently began to disrupt his daily functioning. As a first step, an examination of Randal's mental state was carried out. Dressed in business casual clothes, Randal looked physically appropriate. His thought processes were reasonable and he showed the right affection. He had stated that his mood was depressed and anxious. Intellectually Randal had a large vocabulary and seemed extremely bright. As for Randal's sensorium, it was oriented three times. Although he fell into the overweight category, Randal appeared in good health and had no adverse health history. Randal was asked to undergo lab work to evaluate the functioning of his thyroid, as this can often affect anxiety levels. It was decided that Randal was neither a candidate for psychological personhood nor for personality…middle of the paper…through their compulsions. In Randal's case a therapist can ensure that Randal simply thinks about getting dirty, but is not allowed to wash his hands or shower. The therapist would then work slowly until Randal was presented with something contaminated, but he would still be denied the ability to carry out his cleansing compulsions. Randal's OCD is unlikely to be severe enough to require neurosurgical intervention. Randal's prognosis if taking medicine alone is not very good, as is common with the average individual with OCD. If Randal were to take an SSRI, Anafranil, and/or a benzodiazepam, he would most likely see positive results. These improvements would most likely diminish if Randal stopped therapy. Fortunately, with the right form of therapy, the prognosis improves. When medicine is combined with therapy, the prognosis does not improve.