Client name: Ana

Client age: 24

Gender: Female

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

Describe the role of choice and decision making within cognitive behavioral therapy regarding the efficacy of treatment. How can a counselor assist their client in using these concepts more effectively? Cite sources