Case Study
Patient Demographic: Client Age: 25 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Counseling Clinic Type of Counseling: Individual Presenting Problem: Depression and Suicidal Ideation Diagnosis: Major Depressive Disorder, Recurrent, Mild (F33.0)
Mental Status Exam: Mental Status Exam: The client appears to not have bathed recently because his hair is greasy and unkempt. The client has food stains on his clothing; however, he is dressed appropriately for the season. His motor movements are within normal limits. He is engaged in therapy, but he appears anxious as evidenced by hesitating before speaking and by his hand wringing. The client reports suicidal ideation with no plan or intent. The client reports a depressed mood more often than not and difficulty enjoying most activities. The client is oriented to person, place, time, and situation. The client reports that his appetite has increased lately and that he is experiencing hyperso
Presenting Problem: You are a resident in counseling practicing in a private practice agency. During the initial counseling session, the 25-year-old single male client reports feeling depressed and hopeless. He has difficulty enjoying activities that he has enjoyed in the past and feels unsatisfied with most areas of his life. The client identifies that he is not happy at work and wants to make a career change. The client verbalizes feeling sad more often than not, and that this has been going on for about 2 years. The client decided to start counseling when he began experiencing suicidal thoughts. The client reports no plan or intent to attempt suicide but is concerned about his own well-being.
Other Contexts: The client reports that he has been sleeping more than usual and that this is affecting his ability to get to work on time. He reports that his boss started noticing his tardiness and has given him a verbal warning. Combined with the fear of losing his job, he expressed worry regarding increased conflict with his girlfriend and feeling more “on edge.”  You were a supervisor in a previous job and have experience supervising employees who are tardy

Question: You were a supervisor in a previous job and have experience supervising employees who are tardy. What should you do to support this client with improving his situation at work?
(A): Provide the client with psychoeducation on sleep hygiene.
(B): Encourage the client to explain his struggle with managing sleep to his supervisor in order to increase the supervisor’s empathetic response.
(C): Tell the client about your experience as a supervisor and ways that you supported employees in improving attendance.
(D): Reinforce the message that the client needs to improve his attendance or his job may be affected further.

Correct Answer: Provide the client with psychoeducation on sleep hygiene.
Explanation: Personal experience may be helpful in providing insight from the point of view of a supervisor; however, the main focus should be on sleep hygiene because this is the issue that is affecting the client’s functioning. Encouragement to talk to their supervisor would not solve their problem with sleep, encourages the client to disregard the causative issue, and may cause more issues at work. A counselor should be aware of their own personal experiences and how they may affect objectivity. Therefore, the correct answer is (C)
Competency: professional practice and ethics