Case Study
Patient Demographic: Client Age: 25 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Counseling Clinic Type of Counseling: Individual Presenting Problem: Depression and Suicidal Ideation Diagnosis: Major Depressive Disorder, Recurrent, Mild (F33.0)
Mental Status Exam: Mental Status Exam: The client appears to not have bathed recently because his hair is greasy and unkempt. The client has food stains on his clothing; however, he is dressed appropriately for the season. His motor movements are within normal limits. He is engaged in therapy, but he appears anxious as evidenced by hesitating before speaking and by his hand wringing. The client reports suicidal ideation with no plan or intent. The client reports a depressed mood more often than not and difficulty enjoying most activities. The client is oriented to person, place, time, and situation. The client reports that his appetite has increased lately and that he is experiencing hyperso
Presenting Problem: You are a resident in counseling practicing in a private practice agency. During the initial counseling session, the 25-year-old single male client reports feeling depressed and hopeless. He has difficulty enjoying activities that he has enjoyed in the past and feels unsatisfied with most areas of his life. The client identifies that he is not happy at work and wants to make a career change. The client verbalizes feeling sad more often than not, and that this has been going on for about 2 years. The client decided to start counseling when he began experiencing suicidal thoughts. The client reports no plan or intent to attempt suicide but is concerned about his own well-being.
Other Contexts: The client contacted you to reschedule a session sooner than the one you had originally scheduled. The client reported that he continues to have difficulty getting to work on time and was told that he needs to meet with his supervisor on Friday. The client expresses anxiety surrounding this because he worries about getting fired. The client began to cry during the session when talking about worry regarding being unemployed. The client came to the session in clothes that had stains on them, and his hair was messy and appeared greasy.  Due to increased anxiety and depressive symptoms, you choose to use CBT techniques

Question: Due to increased anxiety and depressive symptoms, you choose to use CBT techniques. Which of the following would be an intervention used in CBT?
(A): Cognitive restructuring or reframing
(B): Assess for readiness for change
(C): Operant conditioning
(D): Reality acceptance

Correct Answer: Cognitive restructuring or reframing
Explanation: CBT is based around cognitive restructuring and reframing, which can be a very effective intervention for anxiety or depression. Reality acceptance is part of dialectical behavior therapy and would not be as beneficial for this client because the anxiety is based around an unknown outcome. Assessing readiness for change is part of motivational interviewing, and it is not clear at this point whether the client is willing or able to change. Operant conditioning is a behavior therapy approach that involves positive/negative reinforcement and punishment. Therefore, the correct answer is (A)
Competency: counseling skills and interventions