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 arrives twenty minutes late for his appointment today. He explains that Mondays are the days he does laundry, and he cannot come again on a Monday. You review the required components of informed consent with the client. He expresses an understanding of the counseling process and provides written consent. The client states he has re-considered counseling because he believes you can help him find another girlfriend who will have sex with him. You tell him about a small group you run with other neurodiverse men, most of whom are on the autism spectrum. He expresses an interest in joining after hearing that sexual intimacy would be part of the curriculum. He provides a more solid commitment when you tell him the group is not held on Mondays

Question: Because of his history with the campus police, you focus on helping the client regulate angry emotional outbursts using which one of the following techniques?
(A): Systematic desensitization
(B): Mapping
(C): Cognitive reappraisal
(D): Rolling with resistance

Correct Answer: Cognitive reappraisal
Explanation: Cognitive appraisal is a technique used to help with emotional regulation. The client’s difficulties with emotional regulation led to the run-in with campus police. Cognitive reappraisal is a staged process beginning with the client examining his initial perception of the associated stressor, discerning if he has the skills and resources to cope with the stressor, and understanding if the solution lies in changing the situation or in his reaction to the situation. Systematic desensitization is used with anxiety and involves replacing a fear response with a relaxation response in counterconditioning. Reciprocal inhibition uses the new relaxation response to replace the fear response. MI uses “roll with resistance” as a nonconfrontational means for lessening opposition to change. The counselor is attempting to regulate outburst, rather than committing to a change. Mapping is a structural family technique used to creating a visual representation of family patterns of interaction, including family rules and family structures. Therefore, the correct answer is (B)
Competency: counseling skills and interventions