Case Study
Patient Demographic: Client Age: Client 1: Age 18 Client 2: Age 21 Client 3: Age 22 Client 4: Age 19 Client 5: Age 18 Sex: Male and female Gender: Male and female Sexuality: Heterosexual Ethnicity: Multiracial Relationship Status: All members are single Counseling Setting: Counseling clinicType of Counseling: Group and individual counseling Presenting Problem: All individuals are seeking support for struggles related to borderline personality disorder. Diagnosis: Borderline personality disorder (F60.3)
Mental Status Exam: Mental Status Exam: All clients appear to be oriented to time, situation, location, and person. The clients are all dressed appropriately for the weather. No clients appear to experience any visual or auditory hallucinations. Most of the clients are presenting as friendly but gua
Presenting Problem: You are a licensed therapist running a dialectical behavior therapy (DBT) group for young adults. You also provide a weekly individual counseling session for each group member, which is common practice for DBT group therapy. During the first session, you provide psychoeducation on DBT and the group process. Most of the members seem closed off and sometimes aggressive in response to being asked to speak during the first session, which can be consistent with borderline personality disorder. Client 3 becomes upset about halfway through the session, stating that he does not need to participate because the group will eventually end, so he does not need to build relationships with the group members. You end the session by planning individual therapy sessions with each group member.
Other Contexts: rded. Family History: Most of the clients report distressed relationships with their parents or guardians and that they have not had stable relationships throughout their lives.  Client 3 is resistant to the group process

Question: Client 3 is resistant to the group process. Which of the following would be a helpful tactic in engaging the client?
(A): Process with the client about his feelings by taking him aside during the session, reminding him that other group members may feel similarly.
(B): Provide psychoeducation on the effectiveness of groups with borderline personality disorder.
(C): Encourage client 3 and the other clients to process their hesitancy about therapy.
(D): Use dyads to encourage the client to share his feelings with a peer.

Correct Answer: Use dyads to encourage the client to share his feelings with a peer.
Explanation: Using dyads (breaking away into groups of two to discuss prompted topics) can be helpful in this scenario because they provide the client an opportunity to speak with a peer, a context that may be more comfortable to hesitant group members than speaking to the therapist, whom they are yet to trust. Processing with the client alone may take up valuable group time, and processing with all clients about resistance might align them against the group process. Psychoeducation about groups might be helpful; however, this happened already during the start of the intake session and was not beneficial in preventing resistance for client 3. Therefore, the correct answer is (B)
Competency: counseling skills and interventions