Case Study
Patient Demographic: Client Age: 18 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: University Counseling Center Type of Counseling: Individual and Group Presenting Problem: Interpersonal relationships Diagnosis: Autism Spectrum Disorder. 299.00 (F84.0)
Mental Status Exam: Mental Status Exam: The client is sloppily dressed and appears his stated age. He exhibits pressured speech at times; otherwise, he speaks in a monotonous tone. The client becomes irritable when discussing the incident with campus police, and brightens when expressing his passion for snakes. He displays poor eye contact and there is difficulty with normal back-and-forth conversation. The client denies suicidal or homicidal ideation. He lives on campus in sober student housing and denies drug or alcohol use. History of th
Presenting Problem: You are a counselor a university counseling center. The university has a program providing limited assistance to students diagnosed with Autism Spectrum Disorder (ASD). The ASD program director has referred an 18-year-old white male enrolled in the program. She is concerned over his recent run-in with campus police. The client arrives to his scheduled counseling session today and explained that he has a girlfriend who “now apparently wants nothing to do with me.” Campus security has been involved due to the client showing up at his girlfriend’s dorm, yelling and creating a disturbance. The client explains that his peers told him he would have sex in college once he got a girlfriend. When his girlfriend refused to have sex, he said he didn’t understand and only wanted to talk. The client continues to express a desire to have sex now that he is in college by stating matter-of-factly, “I haven’t had much luck, but I’m going to keep trying.” When asked about interests, the client spoke at length about his love for snakes and knowledge of all 300 worldwide species.
Other Contexts: The client has attended and actively participated in all group therapy sessions. You are preparing the group for termination and discussing a “graduation” ceremony. The client has taken on a leadership role in the group, and you have asked him if he would be your “assistant” for the next group of neurodiverse men. The client approaches you, shakes your hand, and uses eye contact as he politely thanks you for the offer. You state you are pleased he has accepted. He then says, in a matter-of-fact tone, “Absolutely, I see that you really need help with offering better refreshments and teaching certain skills.”  You conduct a pre-test and post-test measuring each group member’s social skills and conclude that the group was ineffective

Question: You conduct a pre-test and post-test measuring each group member’s social skills and conclude that the group was ineffective. If COVID-19 occurred between the pre-test and post-test, which factor likely served as a threat to the study’s internal validity?
(A): History
(B): Attrition
(C): Maturation
(D): Statistical regression

Correct Answer: History
Explanation: The One Group Pre-test Post-test design is a non-experimental design. Non-experimental designs do not have a control group and lack internal validity due to the possibility for an unaccounted third variable, known as a spurious variable. Internal validity measures the cause-and-effect relationship between the independent variable and the dependent variable. In this study, the independent variable is the group intervention. The dependent variable is the pre-test/post-test outcome measure associated with improved social skills. The spurious variable is known as history. History influences outcomes when an event occurs between the first and second outcome measure. COVID-19 is the event that likely affected outcome variables in this study, particularly one on social skills. Statistical regression occurs when subjects score extremely high (or low) on the pre-test and show improvement simply due to the passage of time between each measure. Maturation affects internal validity when subjects are impacted by the passage of time (ie, in projects lasting several years). Attrition, or subjects dropping out of the study, also serves as a threat to internal validity. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis