1. A 43-year-old overweight female talking with an intake social worker about her failures and loneliness.

Social Worker: Jeanne, let's talk for a minute about some of the things that are bothering you.

Client: My weight. I guess it's all cyclical, I mean being overweight. Not a lot of people want to be your friend. I've felt rejected since I was little.

Social Worker: It's hard for you to remember a time when you felt as though you belonged?

Client: Yeah. I feel crappy about myself. Lonely. I don't make friends. I hurt the people who actually do love me. I let down my family all the time.

Social Worker: Tell me about that. How do you let your family down?

Client: Well, they always try to build me up. They support me. When I quit school, it hurt them. I work at a laundromat, I'm sure they want more for me than that. I was never motivated enough to learn trade. So I work in a laundromat, and I guess I do okay there. I don't know.

a. Most important aspects of the client's statement:

i.

ii.

b. Your summarization response:

2. A 61-year-old female talking with the hospital social worker.

She is considering suicide after recently learning that she has terminal cancer.

Client: The news is terminal cancer, so I am not going to live like this! I don't want to feel myself dying every day. I think I'm just going to take care of it on my own.

Social Worker: What do you mean "take care of it"?

Client: I think I'm just going to go off on my own, and whatever happens, happens. I don't want to live. I don't want to end up incapable of taking care of myself. I'm going to die anyway. I'll say my good-byes while I'm okay.

Social Worker: You feel hopeless about what the future holds, and you don't want to be a burden.

Client: I've always had a full life. Lots of friends. My family is the best. How can I put them through my slow and painful death? I don't want to inflict myself on the people I love. It would be so unfair.

a. Most important aspects of the client's statement:

i.

ii.

b. Your summarization response:

3. A 37-year-old male talking to a hotline worker about his marriage. "I think my wife is having an affair. She hasn't said it in so many words, but I can just tell. She's not home much, and when she is, she seems miles away. She is beautiful, and any guy would love to have her. I don't know how to ask her or even if I want to know. We've been married for seven years-some times have been better than others. This time I am sure that she is cheating on me."

a. Most important pieces of information:

i.

ii.

b. Your information-giving response:

4. A 45-year-old female talking about her alcohol usage to an intake caseworker. "I drink a lot. I don't deny that, but an alcoholic, that's a joke. Alcoholics are bums on the street, drinking a bottle of whisky out of a brown paper bag. My father, now he was an alcoholic. He'd leave for days at a time, and he never held down a job. He was a loser who never amounted to anything. I have a good job. I make decent money. There has never been a time that I haven't been able to control my drinking. Do I fit the alcohol profile?"

a. Most important pieces of information:

i.

ii.

b. Your information-giving response:

5. A 38-year-old male is fighting for greater visitation rights with his two children. He has shared with the social worker that he is having a sexual relationship with a coworker. The divorce decree states that he is not to have any overnight guests while the children are with him. He also reports that his ex-wife plans to take him back to court. She wants the judge to order only "supervised day time only visits" until the children are older (they are 6 and 10).

a. What issue(s) would you address?

i.

ii

iii.

b. Statement of concern followed by your confrontational response:

6. A 17-year-old female who is four months' pregnant comes to your agency, stating that she wants to keep the baby. She is excited about becoming a parent. During her session, she casually mentions that she is drinking alcohol and smoking marijuana. She reports that she feels good most of the time but has recently been experiencing low energy and a loss of appetite.

a. What issue(s) would you address?

i.

ii.

iii.

b. Statement of concern followed by your confrontational response:

7. A 45-year-old man who is currently unemployed reports that he is looking for work, but no one is hiring a "middle-aged has-been." He also reports that there have been other times in his life when he has been unemployed for over six months. He was a mid-level manager at a welding company prior to his layoff. He is the sole financial support for his family.

a. What underlying issues could you address?

i.

ii.

iii.

b. What underlying issues could you address?

8. A 56-year-old woman is currently the caretaker of her elderly parents.

Her mother, age 80, is able to manage fairly well. Her father, age 85, has been diagnosed with Alzheimer's disease and is no longer able to recognize his family or do any self-care tasks. Your client refuses to place him in a nursing home, stating, "He'd never forgive me. Finally, after all these years, I'm able to repay him for all the trouble I caused. I never was the daughter he was proud of. My sister, the perfect one, is now nowhere to be found. I guess she's too busy." (Stated softly)

a. What underlying issues could you address?

i.

ii.

iii.

b. Statement of concern beginning or followed by your interpretive response.

9. An 11-year-old female who is sharing for the first time that she has been sexually abused by her stepfather.

Client: My stepfather. He touched me in places I know he is not supposed to touch. He told me that it was okay, but it doesn't feel okay.

Social Worker: I have to contact child protective services right away.

Client: No, please don't! He told me that he loves me. And we have done a couple of things that were a lot of fun together. He took me to a baseball game and bought me ice cream and took me to movies. He told me not to tell mommy about it.

Social Worker: Sharon, I'm really glad that you told me this secret.

Lots of children are sexually abused. Sexual abuse is something that makes kids feel bad, like they've done something to deserve this. Now that I know, I have to contact the agency responsible for investigating sexual abuse.

Client: You know, maybe I do things to make him touch me in that way.

Social Worker: You are not responsible for an adult's behavior. It's his problem. He needs help. No matter what, you are not to blame. Abusers.

try to put the responsibility on the child. It's wrong for him to do that. Wait here while I make the call.

a. What mistakes were made?

i.

ii.

iii.

b. How might that response lead to barriers in furthering the relationship?

c. Your corrected response:

10. A 54-year-old male whose job performance is slipping; he has some concerns about his future with the company.

Client: I've been this company's CEO for the past 25 years. I've been on top of the ladder for a long time, but I've seen a lot of things in the past year slipping. Dividends haven't been where they should be and, I don't know. People are starting to question me; I've started to question myself.

Social Worker: Are you saying that you are slacking off on the job?

Client: Well, I wouldn't call it slacking off. I just don't have the drive for success that I use to have.

Social Worker: It seems to me that maybe you don't care about your job. Maybe it's time for a change.

Client: I wouldn't say I don't care, but

Social Worker: You just said you are not doing the same quality on the job. What do you plan to do to change your situation?

a. What mistakes were made?

i.

ii.

iii.

b. How might that response lead to barriers in furthering the relationship?

c. Your corrected response:

11. A 18-year-old male is seeking help regarding a suspected health problem. He believes the illness may be serious.

Client: I've been fainting at different times. I don't know what's wrong. I don't know if it's something physical or if it's psychological or worse.

Social Worker: Right now you are extremely unsure about what might be going on with you both physically and emotionally.

Client: Yes, plus I'm afraid of what to tell my family. It might be something serious. I don't know if it is something, like, genetic. This could be a very bad thing and I don't know how my family would react.

Social Worker: Part of your concern is not just for your own health, but you are scared to tell you parents; you are afraid of their reaction.

Client: And I guess I'm also afraid of my reaction. I suppose I should go to the doctor. It sounds serious, these fainting spells. I've looked in medical books and online, but I can't figure out what it is. And I'm afraid that if I go to my doctor, she'll tell me it's serious. I don't know if I can take it.

Social Worker: As you're trying to figure this out, you become more and more uncertain.

Client: I feel scared. And I just feel in my gut that this is terribly serious.

Your response: using a summarization:

12. A 40-year-old female who has just had a third miscarriage. She is seeking help in coping with her loss.

Client: This is just awful. Three miscarriages, and my husband and I really want a baby. And I just feel, I don't know, as if I'm paying for something that I've done before.

Social Worker: These miscarriages have left you feeling as though you have no control over your body.

Client: And I thought that after the first one that ... the doctor told me that it would be all right for the next time. And then it happened again. And now it happened again . .. I'm really depressed about it.

Social Worker: It's a tremendous loss.

Client: I know. And after the second one, I thought that it was just not worth going through this again. I feel like this cloud is over me. I don't know what to do now. I feel hurt and alone and scared.

Social Worker: Kelly, your feelings are very understandable. You suffered repeated loss. You wanted a baby, and now it feels as though it may never happen.

Client: Why? I mean, I ask why? Nobody deserves to suffer. I'm a healthy person. I just don't understand why God is punishing me like this.

Social Worker: You wonder, "I take good care of myself. I'm aware of my own body and the things I need to do. Now the bottom has fallen out, for the third time."

Client: I want a baby so badly; I just want to be a mom. I want to raise a child. And when I found out I was pregnant, it's like a roller coaster.

Things were going so well, and we, we were going to build a nursery, and then this happened.

Your response: using a reflection of feeling and clarification: