Case Conceptualization

Theory/Theorist: Name your theory (Adlerian, Person-Centered, Gestalt, Family systems, etc.—-pick one according to the directions in class)

Presenting Problem: Describe the client (name, age, gender, ethnicity, family, etc.) and the client’s issues in terms of how you perceive problems/issues (e.g., client exhibited symptoms of anxiety – pressured speech, tense features, agitated or restless). Be sure to include contributing factors.

Hypothesis: Explain why the client is experiencing these problems. If you see client as socially disconnected (indicating low social interest) from an Adlerian view, explain the evidence for this from the details in the case study. If you are posting for person-centered, provide evidence from the case that suggests the client is living incongruently. Be sure to always relate how you see the client to the features of the theory.

Goal: Explain your goal for your client in terms of the theory you are using. In other words, what would an Adlerian counselor want to see happen for the client and why? Be sure to cite your reference(s). For example, an Adlerian counselor might want to encourage the client to engage in a lifestyle that meets their social needs; whereas a person-centered counselor might want to see clients live congruently.

Interventions: List a minimum of two intervention from the approach you have chosen (outlined in readings), explain each intervention and why it might be useful in meeting goals.

· Intervention 1: Explain your method (and cite your source) and why it would be useful for your client in meeting goals

· Intervention 2: Explain your method (and cite your source) and why it would be useful for your client in meeting goals

Expected Outcome: The goal of xxxxx therapy is . . .. . Explain what outcome(s) you hope to achieve for your client using the interventions above. Support your thoughts with citations from our textbook and/or other resources.

References: List your references here. See Doc Sharing on proper citing and referencing. Remember you must cite and reference the chapter author(s) NOT the editors of our textbook.

Copy and paste your conceptualization into the Discussion Board. Do not use a title page and do not attach the document. Your post must be able to be easily seen in the Discussion Board. Delete these instructions. Thank you.

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This is an example of what you are being asked to do in Weeks 2, 3, 4, 6, 7, 8 and 9.

DO NOT apply psychoanalytic to any of the case studies.

Case Conceptualization

Case of Deidre – Psychoanalytic Theory

Presenting Problem: Deidre, a 22-year-old college senior of mixed African American and Latina heritage, was referred by her MD for symptoms of anxiety. She practices meditation but does not identify as religious. Her parents divorced when she was 9 and she reported a stormy relationship with her “moody” mom. Her dad was a calming presence but died suddenly 5 years ago of a heart attack. Deidre reported using drugs (marijuana preferably) and alcohol to cope. When she was 18, she became pregnant at a party and chose to have an abortion. This complicates her present relationship with Tom, her boyfriend of 4 years as he is prolife and they are considering marriage.

Hypothesis: Deidre’s anxiety is rooted in her early childhood experiences, her lack of secure attachment to her mother, the sudden death of her father, and her abortion. Much of her distress comes from unconscious struggles as her ego tries to balance her instinctual drives (her id) and her superego (Johnson, 2016). Deidre’s defense mechanisms of repression, avoidance, and rationalization help cope with her fear that if she tells Tom of her abortion he will abandon her. This is an unconscious attempt to bolster her fragile ego, likely linked to her early childhood experiences, her father’s death, and her fear of losing Tom.

Goals: The primary goal for Deidre is to increase awareness of unconscious drives and past experiences (Johnson, 2016) as related to her anxiety, drug and alcohol use, and feelings of guilt. Bringing deeply buried feelings and thoughts into consciousness will allow them to be examined and worked through building insight.

Interventions:

Free Association: Deidre will be encouraged to state any thoughts or feelings that come to mind in response to a word prompt, without censoring them. The goal is not to uncover specific memories but uncover patterns of thought. Then, she will be assisted to analyze the underlying unconscious feelings associated with these disclosures (Johnson, 2016).

Analysis of Resistance: When Deidre unconsciously reacts to keep unpleasant or perceived negative experiences hidden by changing the topic, refusing to respond, or giving up on counseling, her resistance will be analyzed (Johnson, 2016). These behaviors indicate that she is unconsciously trying to avoid threatening thoughts or feelings. These acts interfere with the ability to accept changes that could lead to a more satisfying life. Deidre will be encouraged to consider what these thoughts and feelings might be as well as how they are an important influence on the client’s mental health (Psychoanalytic theory and approaches, n.d.).

One example of Deidre’s resistance is keeping secrets from her boyfriend, Tom, and using drugs as a way of coping with her anxiety.

Expected Outcomes: Deidre’s anxiety will diminish because of her increased insight into her unconscious drives. She will be empowered to make decisions based on the insight she has gained. Her id, ego and superego will be more balanced and healthier.

References:

Johnson, A. L. (2016). Psychodynamic theory. In D. Capuzzi & M. D. Stauffer (Eds.),  Counseling and psychotherapy: Theories and interventions (6th ed., pp. 73-96). Alexandria, VA: American Counseling Association.

Psychoanalytic theory and approaches. (n.d.). Retrieved November 18, 2018 from http://www.apsa.org/content/psychoanalytic-theory-approaches.

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COUN 6722/6301S: Theories of Counseling Case Studies

Mike

Mike is a 14-year-old Asian American male who lives in Virginia with his parents and two sisters (Abby, 18, and Leesa, 20), who are now attending a nearby university. Mike’s family immigrated to the US when Mike was 9 years old so that his dad could better support their family as a working engineer. Mike’s mother works from home as a part-time booking agent and takes great pride in caring for their household. Mike’s math teacher referred him to counseling services because Mike is withdrawn and his grades are falling.  

Mike presents as meek and quiet-spoken. He rarely speaks unless spoken to and his responses are concise yet thorough. Mike reports that he is close with his mother and sisters, as they are gentle and supportive. Mike states that his dad pressures him to earn As and is angry with Mike for adopting a “lazy American teenager attitude” and not appreciating the efforts his family has made to ensure Mike’s success. Mike reports that his father is often verbally abusive toward him, so Mike spends most of his time alone in his bedroom to avoid his dad’s angry lectures. Mike’s dad accuses his wife of promoting Mike’s “lazy American attitude” and threatens to kick Mike out of the house if he does not bring home stronger grades. Mike feels responsible for the tension in their house, and he is glad to come to counseling if it will help his family.

Mike is an average student, with a 3.0 GPA. Mike’s classmates often tease him, call him derogatory names, and push him when teachers are not looking. Mike reports that he is often fearful and anxious in school and does not really have friends there, but he does have a 17-year-old male friend who works on cars with Mike, and the two of them talk about opening an automotive shop together. Mike’s car buddy dropped out of high school, and Mike’s dad disapproves of this relationship, thinking it is leading Mike away from his family and cultural values. Mike states that he wants to honor his family, but has no interest in the professions his dad wants him to pursue, and he struggles with the classes that lead in those directions. Thus, Mike feels inadequate much of the time.

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