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 would like to measure the effectiveness of the group intervention by administering the same standardized instrument that was used previously to measure social performance and anxiety

Question: You would like to measure the effectiveness of the group intervention by administering the same standardized instrument that was used previously to measure social performance and anxiety. This experimental design is an example of which of the following?
(A): One-group pretest-posttest
(B): One-shot case study
(C): One-group posttest comparison
(D): Two-group nonrandom-selection pretest-posttest

Correct Answer: One-group pretest-posttest
Explanation: This is an example of a one-group pretest-posttest experimental design. Pretest-posttest experimental designs are conducted using the following steps: (1) a pretest is administered to a group (eg, members participating in group therapy for social anxiety), (2) the intervention (eg, group therapy) is administered, and (3) the same assessment used in the pretest is again administered as a posttest. The purpose of the one-group pretest-posttest design is to determine if the intervention has created a change (ie, did it lessen social anxiety and the related performance avoidance?). This design limits internal validity because of confounding factors, such as history, maturation, instrument decay, and regression toward the mean. It has no external validity. Group posttest comparison does not include a pretest. Group posttests are administered to a group after an intervention. One advantage of group pretests is randomization, which allows the experimenter to control for maturation and history. The “one-shot” case study is a design in which one group is observed on one occasion after the intervention. This design is limited because there is no control group. Two-group nonrandom-selection pre-test-posttest designs consist of an experimental group and a control group. One group is given a pretest, followed by treatment or intervention, and then a posttest is administered. The control group receives a pretest and a posttest only. This design also has limitations related to nonrandomization, such as selection and maturation. Therefore, the correct answer is (A)
Competency: treatment planning