Case Study
Patient Demographic: Client Age: 35 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Hispanic Relationship Status: Divorced Counseling Setting: Private Practice Clinic Type of Counseling: Individual Counseling Presenting Problem: Anxiety; Depressed Mood, Difficulty with Changing Relationship Roles Diagnosis: Adjustment Disorder with Mixed Anxiety and Depressed Mood (F43.23)
Mental Status Exam: Mental Status Exam: The client presents as oriented to person, place, time, and situation. The client appears anxious because he avoids eye contact often and expresses that he has never been in counseling and is ner
Presenting Problem: You are a licensed counselor in Texas in a private practice. A 35-year-old male client comes to counseling for support during a recent divorce. The client says that he and his wife separated a year ago and had to wait a year for divorce per state law; therefore, they finalized the divorce recently. The client says that his wife decided she married him because she was lonely and that, after 8 years of being married, she wanted to find someone she loved. The client states that he still loves his ex-wife and that he has a hard time with his new relationship with her because he shares custody of his children and still has to communicate with her regularly. He continues saying that his wife often calls him for emotional support and he does not know how to respond when this happens because he loves her and wants to support her, but this is confusing for him. The client says that he knows he “shouldn’t be with someone who doesn’t want to be with him and that things won’t go back to how they were.” The client identifies that anxious and depressive symptoms are present and that they affect his ability to engage socially, engage with his children, and perform at work. The client wants to work on navigating his new relationship with his ex-wife, his relationship with his children, and being single again.
Other Contexts:    vous. Family History: The client was married for 8 years, has been separated for a year, and was divorced within the past month. The client reports a good relationship with his family of origin and with his ex-wife’s family. He has two children, a 5-year-old son and a 6-year-old daughter. The client’s children stay at his house every other week.  The client states that he still loves his ex-wife and that she often reaches out for support

Question: The client states that he still loves his ex-wife and that she often reaches out for support. Based on the information provided, which of the following would be an appropriate goal regarding his new relationship with his ex-wife?
(A): The client will continue to engage in supporting his ex-wife because this is a positive interaction.
(B): The client will explore boundaries to establish what his new role is with his ex-wife.
(C): The client will continue to work toward reconciling his relationship with his ex-wife to see if they can make the relationship work.
(D): The client will stop engaging in supporting his ex-wife.

Correct Answer: The client will explore boundaries to establish what his new role is with his ex-wife.
Explanation: Exploring boundaries will be beneficial because the client does care about his ex-wife, which is part of who he is, and he also must maintain a relationship with her because they share custody of their children. Further engaging in supporting his ex-wife will continue to make the new roles confusing for the client and would not benefit him in identifying his new role in her life. The client reports that he continues to love his ex-wife, and, although not emotionally supporting her might be beneficial, he likely would not be ready to do this all at once. The client states that he “knows the relationship won’t return to where it was”; therefore, it likely would put the client in a situation in which he could get hurt if you encourage him to try to reconcile. Therefore, the correct answer is (B)
Competency: treatment planning