Case A

A 22-year-old white man who is in counseling at the insistence of his girlfriend and parents.

CL: It's my fourth year in college and my grades are not where they aresupposedto be. My parents said they were going to cut me off financially if I didn't get my grades up. My girlfriend has been really getting on me, too, to do well inclasses.

Another thing, they think I have a drinking problem. I don't know if they are right ornot.

SW:You know it is really important for you to do well in your classes if you wantto get a job someday.

CL: (Looking towardthe floor) Yeah Iknow.

SW:And you know it is wrong to drink because it causes problems with your girlfriendand with school, not to mention,multiple health problems down the road.

CL: Well, Iguess that'strue.

SW: How much do youdrink each day?

CL: Maybe five or six beers a night, no more than my friends drink.

SW: .Wow! Sounds like your' on your way to becoming analcoholic.

CL: (Looking at the SW, face reddening) I am not an alcoholic. I cancontrol myself. Everybody drinks a few beers and relaxes. I don't see how that makes me analcoholic.

SW:Well, I understand you think you are not an alcoholic. But the statistics show that people who drink on a steady basis and whose jobs or studies are affected, are alcoholics. You need to get enrolled in a substance abuse treatment program. Now, I am going to give you the number for one close by. They only take insurance cases, so I hope your insurance is good.

1. What part of the communication, if any, could benefit from a stronger therapeutic stance on the part of the social worker?

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

1. How might you respond differently?