Case Study
Patient Demographic: Client Age: 26 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: African American Relationship Status: Single Counseling Setting: Community Mental Health Center Type of Counseling: Individual Presenting Problem: Depressive Symptoms Diagnosis: Persistent Depressive Disorder (PDD) (Dysthymia) Diagnostic Criteria 300.4 (F34.1)
Mental Status Exam: Mental Status Exam: The client is dressed in age-appropriate clothing and is well groomed. His affect is blunted and anxious at times. The client denies anxiety but discloses that he is nervous about the counseling process and doesn’t know what to expect. He is cooperative but hesitant to offer more information than is asked. The client is tearful when discussing his breakup and states that there are days when it is a struggle to get out of bed and go to work. He denies suicidal ideation, and he says that he has had no previous attempts. The client is oriented to person, place, time, and situation, and his thought content is organized. Fam
Presenting Problem: You are a counselor working in a community mental health center. Your initial intake appointment is with a 26-year-old African American male who presents with symptoms of depression. The client states that he has felt depressed since his teens, with symptoms increasing within the last couple of months. He reports feelings of worthlessness, fatigue, and occasional bouts of insomnia. In addition, the client indicates that his symptoms worsened after his girlfriend of 2 years broke things off with him. He explained that she grew tired of his low energy and pessimistic outlook on life. As a result, he has been hesitant to seek help, believing that he just needed to “man up” and handle his problems privately. The client is unsure of his insurance benefits but thinks his policy allows for a limited number of counseling sessions.
Other Contexts: The client has responded well to identifying automatic thoughts and distorted thinking. Although some depressive symptoms have decreased, he reports continued distress stemming from the breakup with his girlfriend. He believes that he is “unworthy of love” and is destined to fail in his intimate relationships. Despite his progress in identifying cognitive distortions, the client reports feeling stuck. You and the client discuss your theoretical orientation, the therapeutic relationship, and the treatment plan goals and objectives. The client says that he values your collaborative approach, believes that the two of you have a strong working relationship, and agrees with the overall therapy goals. Despite slight improvement with his depressive symptoms, he is committed to therapy and trusts the process.  The client believes he is unworthy of love and destined to fail in intimate relationships

Question: The client believes he is unworthy of love and destined to fail in intimate relationships. This is an example of which one of the following?
(A): Confirmation bias
(B): Overgeneralization
(C): Black-and-white thinking
(D): Personalization

Correct Answer: Overgeneralization
Explanation: The client concludes that because he and his girlfriend broke up, he is unworthy of love and is destined to fail romantically; this is an example of overgeneralization, which occurs when broad conclusions are drawn without supporting evidence. Personalization involves a person believing that they are being targeted by someone else’s behavior when it has nothing to do with them. Black-and-white, or polarized, thinking consists of “either/or” statements or beliefs. Confirmation bias is the tendency to seek out and retain information in line with one’s preconceived notions. Therefore, the correct answer is (B)
Competency: counseling skills and interventions