Case Study
Patient Demographic: Client Age: Client 1: Age 18 Client 2: Age 21 Client 3: Age 22 Client 4: Age 19 Client 5: Age 18 Sex: Male and female Gender: Male and female Sexuality: Heterosexual Ethnicity: Multiracial Relationship Status: All members are single Counseling Setting: Counseling clinicType of Counseling: Group and individual counseling Presenting Problem: All individuals are seeking support for struggles related to borderline personality disorder. Diagnosis: Borderline personality disorder (F60.3)
Mental Status Exam: Mental Status Exam: All clients appear to be oriented to time, situation, location, and person. The clients are all dressed appropriately for the weather. No clients appear to experience any visual or auditory hallucinations. Most of the clients are presenting as friendly but gua
Presenting Problem: You are a licensed therapist running a dialectical behavior therapy (DBT) group for young adults. You also provide a weekly individual counseling session for each group member, which is common practice for DBT group therapy. During the first session, you provide psychoeducation on DBT and the group process. Most of the members seem closed off and sometimes aggressive in response to being asked to speak during the first session, which can be consistent with borderline personality disorder. Client 3 becomes upset about halfway through the session, stating that he does not need to participate because the group will eventually end, so he does not need to build relationships with the group members. You end the session by planning individual therapy sessions with each group member.
Other Contexts: You meet with client 3 for his individual therapy session. The client continues to be resistant, stating that he does not need to meet with you. You spend the session trying to build rapport with the client and are successful in taking down some of his walls. The client says he knew client 2 from back when he was in high school and began telling you that she slept with a bunch of guys and did a lot of drugs. You redirect the client back to focusing on himself. The client starts to open up about his relationship with his parents growing up and how he thinks they did not really try to show him affection and this made him sad talking about it. The client concludes by saying “I feel overwhelmed sharing all of this because I’ve never talked about it before.” You thank the client for sharing and you empathize with him

Question: Which of the following statements demonstrates the use of empathy regarding the client’s disclosure about his relationship with his parents?
(A): “I’m sorry to hear that you had little affection from your parents, but I’m proud of you for talking about it now even though it’s hard.”
(B): “Correct me if I’m wrong, but it sounds like you didn’t feel a connection with your parents growing up and this is hard to talk about.”
(C): “I can imagine that it’s hard to talk about something so personal and that it would be sad to not be close with your parents.”
(D): “It sounds like talking about this is difficult for you.”

Correct Answer: “I can imagine that it’s hard to talk about something so personal and that it would be sad to not be close with your parents.”
Explanation: The use of the wordimagineand attempting to connect with the client’s situation would best demonstrate empathy. Empathy is focused on connecting and relating to the emotions expressed by the client and demonstrating your understanding to the client. Expressing sorrow with the client demonstrates an expression of sympathy because it is a reaction to someone else’s distress. The response stating that it sounds like talking about the topic is difficult is an example of paraphrasing because it identifies the client’s feeling and restates it. The statement stating that it sounds like the client did not feel much of a connection with his parents and acknowledging that it must be hard to talk about this topic is an example of summarization because it identifies the major elements of what was shared by the client. Therefore, the correct answer is (D)
Competency: counseling skills and interventions