Case Study
Patient Demographic: Client Age: 26 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: African American Relationship Status: Single Counseling Setting: Community Mental Health Center Type of Counseling: Individual Presenting Problem: Depressive Symptoms Diagnosis: Persistent Depressive Disorder (PDD) (Dysthymia) Diagnostic Criteria 300.4 (F34.1)
Mental Status Exam: Mental Status Exam: The client is dressed in age-appropriate clothing and is well groomed. His affect is blunted and anxious at times. The client denies anxiety but discloses that he is nervous about the counseling process and doesn’t know what to expect. He is cooperative but hesitant to offer more information than is asked. The client is tearful when discussing his breakup and states that there are days when it is a struggle to get out of bed and go to work. He denies suicidal ideation, and he says that he has had no previous attempts. The client is oriented to person, place, time, and situation, and his thought content is organized. Fam
Presenting Problem: You are a counselor working in a community mental health center. Your initial intake appointment is with a 26-year-old African American male who presents with symptoms of depression. The client states that he has felt depressed since his teens, with symptoms increasing within the last couple of months. He reports feelings of worthlessness, fatigue, and occasional bouts of insomnia. In addition, the client indicates that his symptoms worsened after his girlfriend of 2 years broke things off with him. He explained that she grew tired of his low energy and pessimistic outlook on life. As a result, he has been hesitant to seek help, believing that he just needed to “man up” and handle his problems privately. The client is unsure of his insurance benefits but thinks his policy allows for a limited number of counseling sessions.
Other Contexts:    ily and Work History: The client grew up in a home with his mother, father, and maternal grandmother. He has a 22-year-old sister who he believes also experiences depression, but he is unsure if she has received treatment. The client says that he attends church “most Sundays” with his family, primarily because he knows it is important to his grandmother. The client holds an associate degree in information technology and is a computer network support specialist. He has worked for the same company for the past 4 years

Question: Which approach would you implement to help understand the influence of the client’s social and cultural factors, including systemic racism, gender, religion, and birth order?
(A): Rogerian
(B): Freudian
(C): Gestalt
(D): Adlerian

Correct Answer: Adlerian
Explanation: Adlerian therapists emphasize the importance of social connection, asserting that all individuals strive for “superiority,” which is achieved through a purposeful, goal-oriented “lifestyle” Adlerian therapists contextualize each client’s social and cultural factors, initially shaped by family constellation, including birth order. Adlerians focus on each individual’s lifestyle as it is influenced by multiple factors, including systemic racism, gender, religion, and sexual orientation. Adlerian and Freudian therapists are categorized as psychoanalytic, and both emphasize early childhood influences; however, Freudians differ in that they also emphasize unconscious processes whereas Adlerians do not. Gestalt therapists are categorized as experiential or relational. Gestalt therapists stress the integration of mind and body through increased awareness of the present moment. For gestalt therapists, wholeness involves the integration of one’s cognitive, emotional, and behavioral factors. As their name suggests, person-centered, or Rogerian, therapists allow the client to become fully functioning in the context of the therapeutic experience. The goal of Rogerian therapy is to facilitate congruence between the client’s self-image and idealized self. Therefore, the correct answer is (A)
Competency: counseling skills and interventions