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:    tion. Family History: The client has been married for 25 years. He has three children, a 23-year-old son, a 21-year-old son, and an 18-year-old daughter. The client reports a strong relationship with his wife and children and states that they regularly spend quality time together.  The client states, “I’m unemployable because I’m old and have nothing to offer. They were right to let me go and not move me to another plant

Question: The client states, “I’m unemployable because I’m old and have nothing to offer. They were right to let me go and not move me to another plant.” What kind of cognitive distortion does this represent?
(A): Mental filtering
(B): Catastrophizing
(C): Fortune-telling
(D): Labeling

Correct Answer: Labeling
Explanation: This is an example of labeling because the client is making a generalized judgment about himself based on one event. The client is taking one bad experience and labeling himself as unemployable, which may not be an accurate assessment. The client is not catastrophizing because he is not exaggerating the impacts of the situation; rather, he is making a judgment about himself based on the situation. The client is not fortune-telling, and although identifying himself as unemployable may be a projective statement, it falls more under labeling because he is identifying himself based on one experience. Mental filtering occurs when an individual filters out the good and only focuses on the bad, and although this may also be happening, the statement does not present explicitly as mental filtering. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis