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.”  Your client’s treatment plan goals address socio-emotional communication skills required for the diagnosis of ASD

Question: Your client’s treatment plan goals address socio-emotional communication skills required for the diagnosis of ASD. Based your last exchange, has the client made progress on his treatment plan goals?
(A): No, he exhibits an intrusive social approach.
(B): Yes, he has made emotional connections with peers and is motivated to help others.
(C): No, he did not consider your emotional welfare when responding to your offer.
(D): Yes, he exhibited improvement in reciprocal social engagement.

Correct Answer: Yes, he exhibited improvement in reciprocal social engagement.
Explanation: When the client was offered a position as your assistant, he listened to your request and paused while awaiting a response. He also used eye contact. This illustrates social-emotional reciprocity. The client responded to the request by saying, “Absolutely, I see that you really need help with offering better refreshments and teaching certain skills” Since there is no evidence indicating that you found the comment to be derogatory, nor was there feedback provided indicating hurt feelings, answer A is incorrect. An intrusive social approach involves intrusive or inappropriate touching. Shaking someone’s hand as an agreement and acceptance of an offer does not qualify as intrusive. Motivation to help others is not a diagnostic criterion for ASD and is therefore, incorrect. Additionally, it is unclear if he has motives to help others (eg, rather than receive better refreshments or gain social prestige). Therefore, the correct answer is (B)
Competency: treatment planning