Case Study
Patient Demographic: Client Age: 35 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Hispanic Relationship Status: Divorced Counseling Setting: Private Practice Clinic Type of Counseling: Individual Counseling Presenting Problem: Anxiety; Depressed Mood, Difficulty with Changing Relationship Roles Diagnosis: Adjustment Disorder with Mixed Anxiety and Depressed Mood (F43.23)
Mental Status Exam: Mental Status Exam: The client presents as oriented to person, place, time, and situation. The client appears anxious because he avoids eye contact often and expresses that he has never been in counseling and is ner
Presenting Problem: You are a licensed counselor in Texas in a private practice. A 35-year-old male client comes to counseling for support during a recent divorce. The client says that he and his wife separated a year ago and had to wait a year for divorce per state law; therefore, they finalized the divorce recently. The client says that his wife decided she married him because she was lonely and that, after 8 years of being married, she wanted to find someone she loved. The client states that he still loves his ex-wife and that he has a hard time with his new relationship with her because he shares custody of his children and still has to communicate with her regularly. He continues saying that his wife often calls him for emotional support and he does not know how to respond when this happens because he loves her and wants to support her, but this is confusing for him. The client says that he knows he “shouldn’t be with someone who doesn’t want to be with him and that things won’t go back to how they were.” The client identifies that anxious and depressive symptoms are present and that they affect his ability to engage socially, engage with his children, and perform at work. The client wants to work on navigating his new relationship with his ex-wife, his relationship with his children, and being single again.
Other Contexts: The client comes into your office and says hello in a quiet voice and then sits down, slumps his shoulders, and does not make eye contact. You inquire about what you see, and the client says that he has been feeling more depressed over the past week. The client says that he is experiencing low appetite, a down mood, fatigue, and irritability. You empathize with the client and discuss coping skills for depressive symptoms. The client expresses frustration with his church because he worked part-time in the church office until recently when they encouraged him to resign because he is divorced and he is now unable to work in the church because of this. You empathize with the client regarding his situation at church.  You do not share the same religious views as the client

Question: You do not share the same religious views as the client. Which of the following would be the most helpful approach when considering the impact of your own beliefs in counseling?
(A): You support the client’s beliefs and do not impose your own values
(B): You encourage the client to assess his own beliefs and if he really does believe them because he is currently feeling that they are incongruent with those of the church
(C): You continuously assess how your beliefs may affect the counseling process
(D): You explain to your client that you do not share his beliefs; therefore, you may not be very helpful in supporting him

Correct Answer: You continuously assess how your beliefs may affect the counseling process
Explanation: It would be most helpful to continuously assess how your own values and beliefs affect the counseling process. Although it is important to support your client’s beliefs and not impose your own, there is a level of self-reflection that is important in the process of counseling to ensure that you are not unintentionally imposing your own beliefs. Although it might be helpful to explain that you do not share beliefs with the client, it also undermines your own ability to help him because it invalidates your ability to connect with him. It may also be helpful to support the client in assessing his own beliefs because it appears that he is feeling the conflict; however, your goal is to support his beliefs and values. Therefore, the correct answer is (C)
Competency: core counseling attributes