Case Study
Patient Demographic: Client Age: 20 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Asian Relationship Status: Single Counseling Setting: College counseling clinic Type of Counseling: Individual counseling Presenting Problem: Panic attacks Diagnosis: Provisional diagnosis: panic disorder (F41.0)
Mental Status Exam: Mental Status Exam: The client is oriented to person, place, time, and situation. The client does not appear anxious or depressed and was friendly and eng
Presenting Problem: You are a counselor working in a college counseling department. The client comes in after being late to class several times over the last month due to reported “freak-outs” in the morning. The client experiences the following panic symptoms: accelerated heart rate, sweating, shaking, shortness of breath, and a feeling of impending doom. The client reports a feeling of impending doom when she wakes up on days when she has classes, and this anxiety tends to escalate into fear of having a panic attack on a daily basis, often making her late to her first class. The client is worried that she will have panic attacks every day for the rest of her life. She says that her parents have put a lot of pressure on her to get a high grade point average at college. The client is worried about how this pressure and the panic attacks are going to affect her doing well at college and engaging socially.
Other Contexts: aged. Family History: The client reports that she is close with her parents but that they often have high expectations of her and that she worries about disappointing them. The client has an older brother who is 25 and is a lawyer. The client says some of the pressure is wanting to be as successful as her brother because she thinks her parents are really proud of him

Question: Based on Shawn Shea’s model for the clinical interview, which of the following statements is part of closing the intake session?
(A): “It was great meeting with you today! I think we can do some good work together. I’ll walk you out to the lobby.”
(B): “It seems like your panic attacks are unexpected, but there are some things you can do to improve your management of them. I want you to read this literature on coping skills for panic symptoms.”
(C): “Let’s talk about panic disorder so you understand more about what’s happening to you.”
(D): “You’ve made a great choice for yourself by deciding to start therapy. I think that if we make a good plan together, we can improve management of your panic attacks.”

Correct Answer: “You’ve made a great choice for yourself by deciding to start therapy. I think that if we make a good plan together, we can improve management of your panic attacks.”
Explanation: Validating the client’s choice to be in therapy and instilling hope that you believe that you can improve things are parts of the closing phase of the intake session according to Shea’s model. Stating that you can help is part of closing, but coupling this with recommending interventions is part of the body of the intake session. Providing psychoeducation on the diagnosis is also part of the body of the intake session. The termination phase of the intake session is when you say goodbye to the client for that current session. Therefore, the correct answer is (A)
Competency: counseling skills and interventions