Case Study
Patient Demographic: Client Age: 22 Sex: Male Gender: Male Sexuality: Homosexual Ethnicity: Latino American Relationship Status: Single Counseling Setting: Community Mental Health Center Type of Counseling: Individual Presenting Problem: Depression Diagnosis: Major Depressive Disorder, Moderate
Mental Status Exam: Mental Status Exam: The client is pleasant and dressed in age-appropriate attire. He is tearful when discussing his family and states this has been difficult for him. The client has had no previous suicide attempts. He is observed biting his nails. He describes feeling sad daily and states he sleeps during the day because he cannot sleep at night. He is slightly underweight but denied any difficulties with appetite. The client’s speech is coherent and clear. He denies suicidal ideation but often questions his worth and purpose. Fam
Presenting Problem: You are providing counseling services at a Community Mental Health Center. A 22-year-old Latino male, accompanied by his aunt, presents with symptoms of depression. The aunt is concerned about the client’s social isolation, feelings of hopelessness, and excessive daytime sleeping. Four months ago, the client’s parents kicked him out of their home after discovering a suggestive social media post of him with another male. He is close with his aunt and uncle, who have allowed him to stay in their basement. The client’s father refuses to speak to him and has told him he is “less than a man” and an embarrassment to the family. The client’s symptoms worsened last month when he was laid off from his job as a server.
Other Contexts: The client displays a blunted affect and remains pleasant and cooperative. He reports that he did apply for a few jobs, but it has been difficult due to his past experiences of workplace harassment and discrimination. He is socializing more frequently, primarily at LGBTQ-friendly bars and clubs. The client states he used to go to the gym daily and has recently started going some on the weekends. He explains that he has felt less depressed but remains poorly motivated. He denies suicidal ideation. The client is unsure how to prioritize goals for treatment.  To help the client identify treatment plan goals, you ask him to envision what it would be like if he woke up one day and a miracle had occurred—a miracle that caused his problem to cease to exist

Question: To help the client identify treatment plan goals, you ask him to envision what it would be like if he woke up one day and a miracle had occurred—a miracle that caused his problem to cease to exist. Which therapy approach does this reflect?
(A): Gestalt therapy
(B): Motivational enhancement therapy
(C): Client-centered therapy
(D): Solution-focused brief therapy

Correct Answer: Solution-focused brief therapy
Explanation: Solution-Focused Brief Therapy (SFBT) is a short-term, solution-oriented best practice used to help clients establish and reach goals by improving motivation and creating measurable behavioral change. The Miracle Question is an SFBT technique that encourages the client to envision a future without the problem. The client is then asked to provide details of what is pictured, enabling you to partner with the client to form manageable and attainable treatment planning goals. Gestalt therapy is based on developing a here-and-now awareness. Client-centered therapy emphasizes attaining congruence between one’s ideal self and actual self. Motivational Enhancement Therapy emphasizes increasing change talk to reduce ambivalence. Therefore, the correct answer is (C)
Competency: counseling skills and interventions