Case Study I
Tina is a 17-year-old high school junior who resides with her parents and 14-year-old brother. Tina’s mother is concerned about her daughter’s recent 22-pound weight loss. Tina counts calories and exercises each morning and evening. Despite her weight loss and low-average size, Tina says that she is “fat” and she weighs herself several times a day. Tina has always felt close to her family, especially to her mother. She is an excellent student, active in cheerleading and works a part-time job. Tina’s mom tells her that she looks too thin, but Tina still believes she needs to lose more weight. Tina quickly is offended and reacts defensively. When Tina’s father encourages her to eat more, she argues with him during dinner. Tina’s brother teams up with Dad, sometimes calling Tina names. On several occasions, Tina has left the table and locked herself in her bedroom. Tina’s parents are unsure if she is showing some ordinary teenage rebellion or if she is developing an eating disorder. Until now, Tina has never given them any problems.
Case Study II
Robert is a 45-year-old married man with two adult children. He has been employed as a metallurgical engineer in a local steel mill for 20 years. Robert married his high school sweetheart. He describes their relationship as “typical.” They eat meals and attend family gatherings together but do little else as a couple. Robert spends his spare time reading, playing golf and watching TV. For the last two months, Robert has felt blue and his appetite has decreased. Because he has not been sleeping well, Robert drinks more at night. Sometimes he feels like life is hardly worth living. Robert has tried to “snap himself” out of this sour mood but nothing seems to work.
Case Study III
Martha is a 52-year-old divorced woman with three grown children. Her oldest child, Heather, is married with a good career and is expecting her first baby. Martha’s middle child, Scott, is single. He has a teaching degree and a history of drug and alcohol abuse. Carter is Martha’s youngest child. He lives at home and commutes to a local university where he is a senior. Martha works as a legal secretary and lives on a tight budget. She is considering returning to college, and maybe even dating, now that her children are older. But Martha is afraid to make a decision that she may regret. In fact, when Martha makes plans to return to school or to join an online dating site, she feels so anxious that she sometimes experiences panic attacks. Martha can’t decide if she should let her life remain status quo or if she should work through her fears holding out hope for a more fulfilling life. Martha asked her family doctor for something for anxiety, but he suggested that she call a counselor.
Assessments and Recommendations
WWC therapists encounter scenarios similar to those above every day. In fact, they welcome individuals and families with these kinds of concerns and help them to discover positive solutions.
Regarding the counseling cases cited above, WWC therapists would assess the following areas:
- Family history of depression and anxiety – For example, in Case Study II, if lack of sleep and decreased appetite affected Robert’s functioning, his therapist would encourage him to exercise. If Robert’s symptoms persisted, his therapist may refer him to a doctor for a medication evaluation. On the other hand, in Case Study I, Tina’s therapist may refer her to our dietitian for nutritional counseling. At WWC, we evaluate nutritional and exercise regimens and help clients to make better health choices in order to improve brain and physiological functioning.
- Cognitions or how a person thinks – Tina’s thinking about her eating has become obsessive. Whereas, in Case Study III, Martha’s thinking may be too focused on the future and her fears. Clients can learn to modify unhealthy ways of thinking to reduce anxiety.
- Expression of feelings – This is one of the important initial benefits of counseling as therapists encourage clients to talk about their thoughts and express their feelings. Because Robert may not talk about his feelings, he may have a decreased awareness of probable causes of his depressive feelings. Tina’s attention has become so focused on food that she is possibly shutting out her feelings about maturation.
- Relationships and support systems – Positive relationships and social supports promote good mental health. Tina’s family relationships are becoming strained in Case Study I. Too much attention on her food consumption during meal time could be encouraging Tina’s anorexic behavior. Robert needs to take a more serious look at his relationship with his wife since it is probably not as “typical” as he believes. More importantly, improvement in his marital relationship would help to relieve his depressive symptoms. Martha is probably affected by her two older children “leaving the nest” and the prospect of her youngest son leaving home after graduation. Martha’s hesitancy to find a love relationship may have something to do with fear or uneasiness in a past relationship. All these possibilities would be explored in therapy sessions.
- Past and current stress levels – An accumulation of stressful life problems often builds up over time and can result in psychological problems that may affect an individual’s ability to function well at work, school or home.