Case Study
Patient Demographic: Client Age: 27 Sex: Female Gender: Female Sexual Orientation: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: Career Counseling Center Type of Counseling: Individual Presenting Problem: Employment-related Stress; Anxiety Diagnosis: Adjustment Disorder with Anxiety 309.24 (F43.22)
Mental Status Exam: Mental Status: The client was well-groomed and dressed appropriately. She appears nervous and jittery and quickly places her hands under the table when she notices them shaking. The client states that she is not sleeping well and says it is difficult making it to work each day knowing that “things rarely go as planned.” She explains that she has irritable bowel syndrome, which is exacerbated by stress. The client reports that there are no known medical conditions that would cause her chronic headaches. The client denies homicidal or suicidal ideations but remarks that she has felt like this in the past. Wor
Presenting Problem: You work in a career counseling center, and your intake is a 27-year-old white female employed as a fourth-grade elementary schoolteacher. The client has been a teacher for 3.5 years and has become increasingly dissatisfied with her job. The client explains that she is “at her breaking point” and relays that her stress level has increased sharply within the past 3 months. This is her first school year with a newly hired principal who has been “unreasonably demanding and unsupportive.” The client states that she was already second-guessing her career choice and explains that disruptive students and a lack of parental involvement have made teaching incredibly challenging. She reports “stress-induced physical symptoms,” which include acute stomach distress and chronic headaches. She worries that her skill set is nontransferable.
Other Contexts: The client reports that her husband’s patience continues to wear thin, so she has explored the possibility of alternate employment. She states that she applied for a position as a curriculum sales representative but did not get an interview. The client reports that the company used a personality inventory to prescreen job applicants. She says that someone in human resources told her she was not selected for an interview because the company was looking for someone who was more extraverted and a “thinker” rather than a “feeler.” The client explains that she was under the impression that they were looking for a male. She expresses an interest in using personality inventories to help identify employment that would be a good fit for her

Question: Which one of the following theories would best address the client’s anxiety related to her professional identity and the search for purpose and meaning in her life?
(A): Behavior modification
(B): Psychoanalytic theory
(C): CBT
(D): Existential therapy

Correct Answer: Existential therapy
Explanation: Existential therapy would best address the client’s anxiety related to her professional identity and the search for purpose and meaning in her life. Existential therapists help clients create purposeful lives, learn to exist with themselves and others peaceably, and remove the anxiety blocking them. Behavior modification uses learning techniques (eg, operant conditioning, aversive conditioning) to help clients make behavioral changes. CBT focuses on how a client’s thoughts influence how they think and feel. Psychoanalytic theory is based on the assumption that there are unconscious influences that affect how a person acts or feels. Therefore, the correct answer is (A)
Competency: counseling skills and interventions