Case Study
Patient Demographic: Client s Age: Client 1: age 12 Client 2: age 14 Client 3: age 14 Client 4: age 16 Client 5: age 13 Client 6: age 16 Sex: Males Gender: Males Sexuality: Varying Ethnicity: Multiracial Relationship Status: Single Counseling Setting: Juvenile Justice Facility Type of Counseling: Group Counseling Presenting Problem: Involvement with the Justice System That Includes Various Mental Health Disorders and Crimes Diagnosis: Imprisonment (Z65.1)
Mental Status Exam: Mental Status Exam: All of the clients appear to maintainappropriate hygiene, and they are all oriented to person, place, time, and situation. They are all somewhat reserved with regard to going into deeper topics, but theyparticipate f
Presenting Problem: You are a licensed counselor working in a juvenile justice facility for teenage males. The group comprises six males that are required to attend as part of their incarceration with the expectation that it will shorten their sentences. The purpose of the group is to work on emotional regulation and to work together to share common experiences and identify goals that can be helpful in preventing reincarceration. During the intake session, you explained the purpose of the group and started with an ice-breakeractivity. The clients participated in the ice-breaker activity that required you to redirect them back to the activity several times because they would joke and get off task. You attempt to go a little deeper by encouraging your clients to start talking about what happened to get them incarcerated, and they appear to be taking pride in the reasons they were in juvenile detention and making fun of those with lesser sentences. You redirect the clients to another topic.
Other Contexts: You meet with the group, and they appear to be starting to become more comfortable with one another. You noticed that throughout the past week, when you saw your clients on their unit, they were spending more time together and that they are all talking when they come in for the session. During the session, you and the clients discuss past experiences that led to them engaging in the crimes that led to their incarceration. During this conversation, client 1 is talking about his father and how he killed a pedestrian while driving. Client 4 then asserts that client 1’s father is going to hell for killing someone. You cut off client 4 and redirect the attention back to client 1

Question: Which of the following would demonstrate appropriate use of “cutting off” for client 4?
(A): Ignore what was said by client 4 because you do not want to give it attention and reinforce his desire for conflict.
(B): Remind client 4 that what he said was against the goals of the group and that he might be asked to leave if he continues.
(C): Engage with client 4 in conversation about the beliefs he holds and then return to client 1.
(D): Tell the client that what he said was not helpful or supportive regarding the goals of the group and then encourage client 1 to continue.

Correct Answer: Tell the client that what he said was not helpful or supportive regarding the goals of the group and then encourage client 1 to continue.
Explanation: Cutting off would be telling client 4 that what he said was not acceptable in the group setting and then redirecting back to client 1. Engaging with client 4 about his beliefs would likely cause more harm, and this would not be a helpful intervention. You should not ignore client 4’s statements because you want to support client 1 and set a precedent for what is acceptable in the group. Telling client 4 that what he said was against the group goals is helpful; however, threatening expulsion from the group does not support client 4 and might not be indicated at this point. Therefore, the correct answer is (C)
Competency: counseling skills and interventions