Case Study
Patient Demographic: Initial Intake: Age: 16 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Private Practice Type of Counseling: Individual
Mental Status Exam: Molly muttered one-word answers during the intake session, made little eye contact and frequently rolled her eyes. She started to warm up towards the middle of the intake session, with some prompting from her mother. She reluctantly agreed to continue counseling sessions- only due to the fact her mother stated that she could not use the family car unless she went to counseling.
Presenting Problem: Molly is a 16-year-old female who was referred to an outpatient mental health clinic after a two-week admission at a local psychiatric hospital. Molly was brought to the hospital by ambulance after she disclosed to the school psychologist that she wanted to kill herself.
 
History:
When asked what brought the family to the session, Molly’s mother was tearful as she disclosed that her husband died in a car accident 11 months ago. Molly and her father had been close, spending time together as Molly played recreational softball and her father was the coach. Since her father’s death, she has been distant with her mother, and often picks fights with her. Additionally, Molly frequently complains of stomach aches, stating that the pain is so severe, she cannot go to school. Before her father’s death, Molly was in Advanced Placement classes and maintained a high average. Recently, Molly’s grades have been declining and she is no longer interested in softball. She states that when she goes to the softball field, she can almost hear her father speaking to her.

Question: The best modality of therapy to utilize with Molly would be?
(A): Gestalt Therapy
(B): Psychoanalysis
(C): Cognitive Behavioral Therapy
(D): Humanistic Therapy

Correct Answer: Cognitive Behavioral Therapy
Explanation: Cognitive Behavioral Therapy would be beneficial for Molly at this time as it is short term, structured and task oriented. It can address her irrational/rational thoughts and help her to examine the narrative she has in her head surrounding her father's death. Psychoanalysis is a long-term therapy which examines how the past influences current issues. In this case, we know that the factor which influenced Molly's symptoms is the death of her father. Also because of her recent hospitalization and consideration of cutting, it is important to address those things immediately. Some techniques in Gestalt therapy may be beneficial, such as the empty chair technique. However, it is important to address Molly's declination in functioning as well as the consideration of cutting which requires more immediate interventions. Additionally, the therapist's role in Gestalt therapy is more of a facilitator and it seems that Molly needs a more directive modality at this time. Although Humanistic Therapy is a positive approach which could be beneficial, it is typically unstructured and may not provide immediate relief of specific complaints. Currently Molly needs a short term, directive form of therapy. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis