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: rded. Family History: Most of the clients report distressed relationships with their parents or guardians and that they have not had stable relationships throughout their lives

Question: All of the following are important factors when considering the setting of this counseling session, EXCEPT:
(A): Ensuring that the building’s janitorial staff knows not to interrupt sessions when the door to your personal office is closed
(B): Minimizing outside distractions such as telephones
(C): providing different seating options within the office and allowing the client(s) to choose their own seat
(D): Sitting directly in front of the clients

Correct Answer: Sitting directly in front of the clients
Explanation: Because this is a group therapy session, it will not be possible to sit directly in front of each client, although that is usually a helpful way of making clients feel comfortable. You must ensure that everyone who could potentially enter your office, from clients to support staff, knows that if your door is closed, they should not enter. Allowing clients to choose the location of their seat and the type of seat provides them with a sense of comfort and control during the counseling session, while you as the counselor can still maintain some control by selecting the types of seating arrangements available. You should also make the effort to minimize distractions in the counseling setting by controlling interruptions by phones (requesting that all cell phones be placed on silent mode and considering removing or silencing any office telephones). Therefore, the correct answer is (B)
Competency: counseling skills and interventions