Assessment TraitsRequires LopeswriteAssessment Description Read the “Case Study Analysis” document and select one of the six case studies. Write a 1,000-1,500-word analysis of the case study using Fre
Remember to address the goals from your
chosen counseling theory, not the counseling
goals of symptom reduction. When counseling
theory goals are being met, the client’s mental
health symptoms will decrease.
CNL-500 Case Study Analysis (Option 1)
Client Name: Ana
Client age: 24
Gender: F
Presenting Problem
Client states, “I recently lost my job and feel hopeless. I can’t sleep and don’t feel like eating.” Client also reports she has lost 10 pounds during the last two months. Client states that she is a solo parent and is worried about becoming homeless. Client states, “I worry all the time. I can’t get my brain to shut off. My husband is in the military and currently serving in an overseas combat zone for the next eight months. I worry about him all the time.”
Behavioral Observations
Client arrived 30 minutes early for her appointment. Client stated that she had never been in counseling before. Client depressed and anxious, as evidenced by shaking hands and tearfulness as she filled out her intake paperwork. Ana made little eye contact as she described what brought her into treatment. Client speech was halting. Client affect flat. Client appeared willing to commit to eight sessions of treatment authorized by her insurance company.
General Background
Client is a 24-year-old first-generation immigrant from Guatemala. Ana was furloughed from her job as a loan officer at local bank three months ago. Client reported that she was from a wealthy family in Guatemala but does not want to ask for help. Client speaks fluent Spanish.
Education
Client has completed one year of college with a major in business. Client states that she left college after her son was born as she found it difficult to manage a baby, college, and a full-time job.
Family Background
Client is the middle of four siblings. Client has two older brothers and one younger sister. Client’s parents have been married for 27 years. Client states that she has had a “close” relationship with her family, although she states that her father is a “heavy drinker.” Client states that all her brothers and sisters have graduated from college and have professional careers. Client states that her father is a banker, and her mother is an educator. Client states that she has not seen her family for 1 year. Client has a 1-year-old son and states that she is sometimes “overwhelmed” by raising him alone.
Major Stressors
Lack of family and supportive friends
Financial problems due to job loss
Husband deployed overseas
Raising a baby by herself
CNL-500 Case Study Analysis (Option 2)
Client Name: Jae
Client age: 19
Gender: F
Presenting Problem
Client reports wanting to discuss family stressors, her tearful and anxious mood, and previous abuse. Client disclosed a family history of conflict and abuse at intake, including physical and emotional abuse from her aunt and uncle, who had raised her, and sexual abuse from a male cousin.
Behavioral Observations
Client presented in oversized clothes with leg “bouncing” and eyes darting around the counseling office. Client sat on the edge of the chair, placed her backpack in front of her, and held the strap with both hands. Client stated that she had never been in counseling before. Signs of depression and anxiety. Client appeared willing to commit to eight sessions of treatment authorized by her student insurance.
General Background
Client is a 19-year-old individual Chinese American college student who was assigned female at birth and had known she was “probably gay” for about a year. Client stated that she felt affirmed and supported in her sexual identity at school, and the idea of coming out to her family seemed “unimaginable,” such that it felt too distant to be a current source of stress and was not something she was worried about.
Education
Client is currently starting her second year of college at a local university. She lives on campus with a roommate and is studying sociology.
Family Background
Client’s mother had died when she was young, and she had been raised from an early age with her aunt, uncle, and an older male cousin in the United States, while her father and older sister lived in China. Her uncle, father, and cousin were withdrawn and emotionally distant, while her sister and aunt depended a great deal on her for emotional support. Client’s sister, who was primarily responsible for taking care of her father, exhibited strong affective and relational dysregulation, suicidal ideation, and substance use; her aunt frequently drank heavily, became sad, and texted the client. Client became tearful as she described her deep concern for her sister, whom she felt would be doing better, perhaps even living independently, if she was a “better support.”
Major Stressors
Previous abuse
Family relationships
Sexual orientation
CNL-500 Case Study Analysis (Option 3)
Client Name: Tommy
Client age: 8
Gender: M
Presenting Problem
Client has been increasingly disruptive the past few months. He has verbal outbursts and pushes classroom materials onto the floor after being given an academic task during quiet work time. His verbal outbursts include yelling that he is not doing the assignment, telling a student to shut up, using profanity, and calling student’s names. His teachers do feel that they spend about an hour per day dealing with the behavior, and they usually respond to client’s behavior by scolding him or by initiating an office referral.
General Background
Client is an 8-year-old bi-racial boy who enjoys baseball, swimming, and baking. He does not like art activities or large crowds. Tommy has a good sense of humor, but he can be irritable. He is fearful around new people and may become quiet and more reserved in those situations. His parents and teachers talk him through exposure to new people. Client is highly verbal and speaks in sentences. Client is above grade level in reading. He enjoys reading, and his favorite book is the Percy Jackson Lightning Thief. According to client, he dislikes writing. Most of his writing is simple sentences with a great deal of grammatical errors and little detail. He also struggles with math, in which he is approximately 2 grade levels below. He has recently learned how to pitch left-handed. Client has a new baby brother who is 5 months old.
School Classroom Environment
Client attends a regular K-5 public elementary school; however, client is new to the school. Client is in the 3rd grade. There are 19 students in his class. Client has two segments in a resource special education (SPED) class with five other students. Client also has one co-teaching segment for math. His teacher is very organized and structured; she is loving and understanding about the client’s needs.
Previous Interventions
Tommy has attended this school for two months now. Initially, he seemed to acclimate to the
the new school well. However, things have gotten more difficult for him lately. Client’s teacher
set up some rewards for him to earn if he does not engage in the disruptive behavior. His
behavior has not improved, and it has been difficult for his team to identify “why” he is engaging
in the behavior.
Major Stressors
New school
Academics
New sibling
CNL-500 Case Study Analysis (Option 4)
Client Name: Brett
Client age: 15
Gender: AMAB (assigned male at birth)
Presenting Problem
Client has been missing school often due to recurring medical issues (i.e., urinary tract infection (UTI). Client often tries to get out of attending the physical education (P.E.) course; when attending P.E., the client refuses to change clothes in the locker room. Client has had several outbursts and fights with other students. Client also appears withdrawn and isolated while in school. Client reported issues of bullying and being picked on by upperclassmen. Client’s grades have continued to drop over the last two school years; however, client is barely passing several classes this semester. School counselor met with client due to presenting problems. Client disclosed that they have been experiencing gender dysphoria and are questioning their gender identity.
General Background
Client is 15-year-old sophomore in high school. Client stated that they have always been interested in more “girly” things and was always happy to play dolls and dress up with his younger sister. Client stated their dad is a “masculine man” and always harps on the client to “man up.” Client stated that his dad hates that they like theater and choir instead of playing sports like football or basketball. Client wanted to grow their hair out, but their dad made them “buzz it all off”. Client reported feeling safer and closer with their mother and sister than their dad or older brother. Client stated they have “always felt different” than other people but never understood why. The last two years, client has been questioning their gender identity, and stated that since the client has started puberty their symptoms have gotten significantly worse. Client stated they hated their body before, but even more so with the ways their body is changing now. Client shared they hate their body so much they won’t “dress out” in the locker room during P.E. They refuse to use the bathroom at school, even if they really need to, because they don’t feel comfortable or safe using the boy’s bathroom and there is no gender-neutral bathroom at the school. This has led to numerous UTIs and significant discomfort.
School Environment
Client attends a regular public high school, grades 9-12. The school has a diverse student population for race, culture, and ethnicity; however, few students have explored sexual orientation openly at the school and no students have openly explored gender identity prior to this client. School district, school staff, administration, and teachers are open to creating a school where all students feel safe and accepted.
Major Stressors
Gender exploration/gender identity
Gender dysphoria
Family dynamics
Bullying
Academics
CNL-500 Case Study Analysis (Option 5)
Client Name: Imani
Client age: 35
Gender: M
Presenting Problem
Client is a refugee from East Africa and presents for problems related to feelings of fear and anxiety. The client reports having “panic attacks” since he arrived in the United States 10 years ago. He fled the family home with his sister and grandmother to a refugee camp prior to coming to the United States. He has difficulty remembering specific details. He vividly recalls the torture and death of his parents. Over the last six months, he has been having nightmares and flashbacks about childhood and is not sleeping well. His grades are slipping because of his inability to concentrate and not getting enough rest. He has withdrawn from his friendships and describes himself as depressed and anxious. He requests help with his concentration and ability to sleep so that he can complete his degree and go on to graduate school in finance.
Behavioral Observations
Client is well dressed. He is fluent in English. Client makes minimal eye contact and at times appears to have a fixed gaze. He speaks in a very soft voice and takes a long time to respond. Client presents with a blunted affect with occasional outbursts of agitation when asked for additional information. He exhibits little to no emotion when discussing his childhood trauma. He seems detached from the experiences.
General Background
The client was granted an immigration waiver as a victim of violence but is not officially a U.S. citizen. Client lives in an apartment with three other roommates; jokingly, the client says that his roommates describe his as moody. He works part-time at a local retail store. Client has a strained relationship with his grandmother, who is highly critical of him. His younger sister, who is 19 years old, lives with their grandmother. He does not have any other family members.
Education
Client is a nontraditional undergraduate student. He is currently a senior in college at a local university. Client is worried as his grades are “slipping” and he worries it could impact his ability to get into graduate school.
Major Stressors
Previous trauma
Academics
“Anxiety and Depression”
CNL-500 Case Study Analysis (Option 6)
Client Name: Samantha
Client age: 11
Gender: F
Presenting Problem
Client was once social, outgoing, and engaged in her classroom; however, she has become increasingly withdrawn and isolated. She no longer talks or “hangs out” with her friends at lunch or recess. Client often is teary-eyed during school but states that nothing is wrong. Client was a straight A student but has recently been struggling with turning her work in on time, organization, and concentration during classes. Her grades have slipped to Bs and Cs.
General Background
Client is an 11-year-old white female. She is an only child and her parents recently filed for divorce. She is a cheerleader on her junior high squad. She was the team captain; however, she has been “demoted” for tardiness and lack of energy at practice and games. Coach stated she is “just going through the motions.” Parents, coach, friends, and teachers reach out to her, but she pushes everyone away and becomes more withdrawn the more people try to help. The school counselor invited Samantha to have lunch once a week and after several lunch meetings, Samantha disclosed that her parents were getting divorced and “it was all her fault.” Client believes if she were a better child her parents would be happy together. Client shared that she has thought about cutting herself (i.e., nonsuicidal self-injury) but has been too scared to try. Client denies suicidal ideation but cried when sharing that she “just wants her pain to stop.”
School Classroom Environment
Client is in the 6th grade at a regular middle school (grades 6-8). Client appeared “popular” among her peers and involved in extracurricular activities. Client has begun after school tutoring to help her raise her grades and help her organize her schoolwork. Client stated that she feels embarrassed to go to tutoring but “like I don’t care at all at the same time.” Client shared that her favorite parts of the school day are during class changes because she can “disappear into the sea of students” in between class periods.
Major Stressors
Parents’ divorce
Academics
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