Case Study
Patient Demographic: Client Age: 15 Sex: Female Gender: Female Sexual Orientation: Heterosexual Ethnicity: African American Counseling Setting: Agency Type of Counseling: Individual and Group Presenting Problem: Anxiety Diagnosis: Generalized Anxiety Disorder (GAD) 300.02 (F41.1)
Mental Status Exam: Mental Status Exam: The client is dressed in age-appropriate clothing and is neat in appearance. She is cooperative and, at times, overly compliant with the interview questions, which is exemplified by apologizing unnecessarily for “not answering questions in the right way.” Her eye contact is poor, but she is engaged in the interview process. The client is restless and fidgety, and her tone of voice is soft. She states that she gets between 5 and 6 hours of sleep each night, which makes her irritable at times. Her affect is anxious, and she reports poor concentration. Her excessive worry has resulted in exhaustion and feeling like she is “always playing catch-up” with sleep and schoolwork. She denies any suicidal or homicidal ideations. The client also denies drug or alcohol use. Family History and History of th
Presenting Problem: You are a counselor working in a child and family outpatient mental health center. Your client is a 15-year-old African American female enrolled in the 10th grade at a predominately white private high school. She presents today with her father, who says she “has not been herself lately.” The client reports that she is under an enormous amount of pressure to excel academically and athletically. She is the number-one ranked player on the varsity tennis team and is in the school’s honors program. The client states that she perseverates the night before a tennis match and worries that her performance will be subpar. She reports excessively practicing her serves and backhands in her spare time because she is constantly dissatisfied with her less-than-perfect performance. The client says that she feels like she doesn’t fit in with her peers, which she attributes to being the only person of color on her tennis team, and one of few in the student body.
Other Contexts: The client is responding well to your therapeutic interventions. School has ended, and her summertime athletic and academic commitments have lessened. The client reports that she is happy to be out of school and spoke again about not fitting in with her peers. She states that there are limited opportunities for sustaining friendships and worries that she will never find a romantic interest. She reports that her mother has suspended her social media account because the client was overly consumed by the number of “likes” that she received for her online posts. You explain that you will be starting a 12-week group of diverse teens who also experience anxiety and would like her to join. She agrees and is eager to participate.  Your responsibility as the group leader is to establish group rules, set limits, and develop a plan for group termination

Question: Your responsibility as the group leader is to establish group rules, set limits, and develop a plan for group termination. In doing so, which leadership skill are you exhibiting?
(A): Fostering autonomy
(B): Emotional stimulation
(C): Meaning attribution
(D): Executive functioning

Correct Answer: Executive functioning
Explanation: Group leaders demonstrate the skill of executive functioning when establishing rules, setting limits, and developing a group-specific termination (ie, discharge) plan. In other words, the group leader must remain vigilant of the group dynamics and set boundaries appropriately. Members are clear on the number of sessions held, and counselors establish the minimal discharge criteria. Lieberman et al. (1973) identified core group leadership functions as executive functioning, caring, emotional stimulation, and meaning attribution. Fostering autonomy and differentiation are therapeutic considerations for the middle stage of group development. Leaders execute meaning attribution when promoting insight and understanding among group members. Group leaders exhibit emotional stimulation at varying intervals by assessing emotional exchanges and stimulating or controlling levels of emotional expression. Therefore, the correct answer is (C)
Competency: professional practice and ethics