Case Study
Patient Demographic: Client Age: 60 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: Private Practice Clinic Type of Counseling: Individual Counseling Presenting Problem: Unemployment; Anxiety; Depressed Mood Diagnosis: Adjustment Disorder with Mixed Anxiety and Depressed Mood (F43.23)
Mental Status Exam: Mental Status Exam: The client appears to have a depressed mood as evidenced by his affect, slow speech pattern, and body posture. The client is dressed appropriately for the season and is in clean clothing. The client is oriented to person, place, time, and situa
Presenting Problem: You are a private practice therapist working in an outpatient clinic. Your 60-year-old male client comes into the intake session, sits down, and sighs deeply. You verbally acknowledge that the client looks as though he is carrying a big mental weight, and he nods. The client begins to talk about how he was let go from his job at an assembly plant a month prior due to budget cuts. The client says that he worked there for about 30 years and that he was most recently a plant manager for the past 10 years. The client states that the plant shut down because the automotive company moved their manufacturing to another country. The client expresses anxiety surrounding what he is going to do for work next. The client states that he worries that he does not have much to offer other employers due to the extent of time he spent at his last job and also that his age will make him unemployable. The client says that he has been isolating himself, feels down more often than not, and often worries about making ends meet. The client states that his wife is currently receiving cancer treatment and, because of this, they have significant, regular medical bills.
Other Contexts: The client comes into the session and reports that he and his wife have been getting along better since the last session following some conversations about what they can do to get through this situation together. The client says that he wants to work on figuring out what he is going to do for work next. You and the client discuss possible options, and he says a friend offered him a job at his restaurant. The client says that he is considering it just for the money but that he has never been a server before and has some reservations. You conduct a career interest assessment and discuss the results.  The client expresses worry about being a server in a restaurant because he has never done it before

Question: The client expresses worry about being a server in a restaurant because he has never done it before. Which one of the following responses would be most helpful?
(A): Encourage the client to take the position due to his financial needs.
(B): Encourage the client to continue looking for a position that more closely relates to his experience.
(C): Process the client’s experience in the automobile plant and compare it to being a server to demonstrate the overlap of skills between the two positions.
(D): Use your assessments to determine other positions that he might be a good match for.

Correct Answer: Process the client’s experience in the automobile plant and compare it to being a server to demonstrate the overlap of skills between the two positions.
Explanation: Many job experiences have some level of overlap, with the skills required being applicable in other positions. Because the client has an immediate financial need to be employed, he should be supported in considering this position. His experience as a supervisor lends itself to helpful social skills, and his work in the automobile plant was hard labor. You should emphasize that these skills are relatable to being a server. Meanwhile, the client can continue to look for positions that might meet his financial needs better and/or interest him more; however, the client’s financial needs are more urgent, and both of these things can be done while accepting the job that provides immediate work. It is not typically a therapeutic approach to recommend that someone make a life decision such as taking a job, leaving a job, staying with or leaving someone, etc. If these decisions do not end up in the client’s favor, it could leave the counselor liable. Using assessments to find appropriate employment matches for your client is helpful, but the client has more pressing needs financially and has a more immediate employment need. Therefore, the correct answer is (A)
Competency: counseling skills and interventions