Case Study
Patient Demographic: Client Age: 42 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Divorced Counseling Setting: Agency Type of Counseling: Individual and Group Presenting Problem: Social Anxiety Diagnosis: Social Anxiety Disorder (Social Phobia), Provisional 300.23 (F 40.10)
Mental Status Exam: Mental Status: The client is meticulously dressed and well groomed. She is cooperative and periodically exhibits a nervous smile. The client is fidgety and frequently repositions herself when seated. Her mood is anxious, and she becomes tearful when discussing feeling “stupid” during job interviews. She exhibits cohesive thinking, and her insight and judgment are intact. The client is oriented to person, place, situation, and time. Her affect is reserved. She denies suicidal and homicidal ideation as well as audio/visual hallucinations.
Presenting Problem: You are a certified mental health counselor working in a community mental health center. Your client is a 42-year-old white female who presents today with symptoms of social anxiety disorder. The client reports debilitating anxiety when interacting with others, particularly when meeting unfamiliar people or going somewhere for the first time. She states that she cannot sleep and has a poor appetite on the days leading up to social events. When encountering anxiety-provoking situations, she says that her hands shake, she sweats excessively, and her voice trembles. The client is recently divorced and, after more than 15 years of being out of the workforce, she is seeking employment. She explains that job interviews have been “humiliating” because of what she perceives as an “inherent lack of knowledge and a substantially impaired skill set.”
Other Contexts: The client participates in her last group therapy session today. You and the client review her treatment plan goals, and she reports an overall decrease in anxiety and says that she possesses a greater awareness of social anxiety disorder and the associated interventions. She has recently completed a job interview after previously scheduling and canceling two interviews. She plans to stay in touch with two group members. The client is ready to begin termination but is anxious about ending counseling. You and the client review the psychoeducation material reviewed in the group, including factors associated with social anxiety disorder and learned coping strategies.  You previously measured the effectiveness of the group intervention by administering the same standardized instrument that was once used to measure social performance anxiety

Question: You previously measured the effectiveness of the group intervention by administering the same standardized instrument that was once used to measure social performance anxiety. Which one of the following serves as your independent variable?
(A): The instrument used in the posttest
(B): The instrument used in the pretest
(C): The group intervention
(D): Social performance and anxiety

Correct Answer: The group intervention
Explanation: The group intervention serves as the independent variable. An independent variable is the variable that the experimenter manipulates. Social performance anxiety serves as the dependent variable. Dependent variables are what is observed or measured as being directly affected by the independent variable. In this scenario, you wish to determine the effectiveness of the group intervention (ie, the independent variable) on social performance anxiety (ie, the dependent variable). In this study, you use the same instrument for your pretest and posttest, neither one of which serves as the independent variable. Therefore, the correct answer is (A)
Competency: treatment planning