Case Study
Patient Demographic: Client Age: 38 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: Private Practice Type of Counseling: Individual Presenting Problem: Marital Difficulties Diagnosis: Obsessive-Compulsive Personality Disorder 301.4 (F 60.5)
Mental Status Exam: Mental Status Exam: The client is meticulously dressed and immaculately groomed. He frequently checks his watch and states he has owned his watch since adolescence and it “still works like new.” His speech is even, and his affect is blunted. At times, he is defensive and attempts to talk over you. He exhibits poor insight into his marital problems and is excessively preoccupied with perfectionism, structure, and order. Fam
Presenting Problem: You are a counselor working in private practice and meeting your client for the first time today. The client is here at his wife’s insistence, who has threatened divorce if he does not seek and comply with therapy. The client explains that he is swamped at work and has already lost an hour of productivity traveling to your office. He discloses that he has been married just over four years and has a daughter who is 3½. The couple dated briefly and married when the client’s wife discovered she was pregnant. The client believes that if he didn’t leave his wife a schedule and checklist, “things would never get done.” He states that they would be in “so much debt” if it weren’t for his detailed household budget. In his estimation, conflict occurs each time his wife tried to do things “her way” because “it is never the right way.” You paraphrase and clarify the client’s concerns.
Other Contexts:    ily and Work History: The client works as a web designer and developer. He allows you to obtain collateral information from his wife. You reach his wife by phone, who explains that the client has “an explosive temper when I don’t do things exactly how he asks.” The client’s wife states he can be controlling, overly critical, and irrational at times\. This is the client’s first marriage. The client’s wife wants to participate in couples counseling but says the client is adamant about her not joining

Question: What is the value in clarifying and paraphrasing the client’s presenting problem?
(A): It enables expressions of immediacy
(B): It assists in clarifying values.
(C): It helps promote an egalitarian relationship.
(D): It fosters the creation of discrepancy.

Correct Answer: It helps promote an egalitarian relationship.
Explanation: By clarifying and paraphrasing the client’s presenting problem, you allow the client to correct any inaccuracies and inconsistencies by rephrasing what the client has stated. A counselor’s use of these skills can help promote a sense of partnership with the client, which can serve as a foundation for conceptualizing and creating treatment plan goals. Immediacy is grounded in the here-and-now experience of the counseling process and is generally facilitated by self-disclosure. The skill of immediacy is used to reflect a parallel experience or address what is going on between the counselor and client in real-time. Immediacy is best used after the counselor establishes a therapeutic alliance with the client. Values clarification differs from the communication skill of clarification. Counselors use values clarification to help clients recognize, understand, and prioritize personal ethical and moral values. Creating discrepancy is a motivational interviewing technique used to promote change talk by pointing out the disconnect between where the client is currently and where they would like to be. Therefore, the correct answer is (A)
Competency: counseling skills and interventions