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.  You encourage the client to use natural supports during this time because it can be helpful to have other people provide support

Question: You encourage the client to use natural supports during this time because it can be helpful to have other people provide support. All of the following would be considered a natural support EXCEPT:
(A): An acquaintance from the client’s Bible study group
(B): A childhood friend
(C): A sibling who the client is close to
(D): The therapist because you meet with the client regularly

Correct Answer: The therapist because you meet with the client regularly
Explanation: A natural support is a relationship that occurs naturally. Although the therapist is a regular support, they are not a naturally occurring support. A childhood friend and a sibling would be strong natural supports because these relationships have lasted for the long term. An acquaintance can also be a natural support. This one is an especially good support because he is in the client’s Bible study and can provide further support for his spiritual needs. Therefore, the correct answer is (D)
Competency: counseling skills and interventions