Case Study
Patient Demographic: Client Age: 35 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Hispanic Relationship Status: Divorced Counseling Setting: Private Practice Clinic Type of Counseling: Individual Counseling Presenting Problem: Anxiety; Depressed Mood, Difficulty with Changing Relationship Roles Diagnosis: Adjustment Disorder with Mixed Anxiety and Depressed Mood (F43.23)
Mental Status Exam: Mental Status Exam: The client presents as oriented to person, place, time, and situation. The client appears anxious because he avoids eye contact often and expresses that he has never been in counseling and is ner
Presenting Problem: You are a licensed counselor in Texas in a private practice. A 35-year-old male client comes to counseling for support during a recent divorce. The client says that he and his wife separated a year ago and had to wait a year for divorce per state law; therefore, they finalized the divorce recently. The client says that his wife decided she married him because she was lonely and that, after 8 years of being married, she wanted to find someone she loved. The client states that he still loves his ex-wife and that he has a hard time with his new relationship with her because he shares custody of his children and still has to communicate with her regularly. He continues saying that his wife often calls him for emotional support and he does not know how to respond when this happens because he loves her and wants to support her, but this is confusing for him. The client says that he knows he “shouldn’t be with someone who doesn’t want to be with him and that things won’t go back to how they were.” The client identifies that anxious and depressive symptoms are present and that they affect his ability to engage socially, engage with his children, and perform at work. The client wants to work on navigating his new relationship with his ex-wife, his relationship with his children, and being single again.
Other Contexts: The client talks about when he went to see his daughter at a dance recital and how, afterward when he went to say hello to her, she ignored him. He called his ex-wife later that day, and she denied knowing what was wrong, but when he talked to his son, the boy said, “Mommy told us you didn’t want to live with us anymore and that is why you left.” The client expresses frustration and anger with his ex-wife because she chose to leave him, and he thinks that it is not fair that she is telling the children a lie and also that it is affecting his relationship with them. The client states that he wanted to talk to you before he confronted his wife about this. You and the client discuss conflict resolution skills.  You are supervising a counseling intern, who thinks that he is not a good match for this client

Question: You are supervising a counseling intern, who thinks that he is not a good match for this client. Which of the following would be an appropriate consideration for addressing this issue?
(A): The fact that the intern has some experience with divorce, but might benefit from some education to improve his competency and therefore comfort with this client.
(B): The impact of the client and the intern having different values on the counseling process.
(C): The intern does not think that he has the skills to support the client; therefore, he should be guided in attempting to provide services within the skills that he has.
(D): The intern is not a Christian or Catholic and would not be able to support the client; therefore, a Christian counselor may be more appropriate for this client.

Correct Answer: The fact that the intern has some experience with divorce, but might benefit from some education to improve his competency and therefore comfort with this client.
Explanation: The intern would benefit from some education to improve competency because he does have some experience, which would make added education an appropriate option. Having different values or religious beliefs would not matter because the intern would not refer based on these differences because he should be focusing on supporting the client’s worldview (ACA Governing Council, 2014, p 6). The intern should not try to provide services the best that he can with the skills that he has if his skills do not meet the needs of the client. Therefore, the correct answer is (B)
Competency: counseling skills and interventions