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: What other sources of information would be the most helpful at this time?
(A): A collateral meeting with the school guidance counselor who called 911
(B): A collateral meeting with her friend who is engaging in cutting
(C): A family session with Molly and her mother to discuss her consideration of cutting
(D): Past evaluations for developmental history

Correct Answer: A collateral meeting with the school guidance counselor who called 911
Explanation: With Molly's permission, meeting with the school guidance counselor would provide more information about what led to the recent hospitalization, especially since Molly does not want to speak about it. Also, one of the areas that Molly has shown decreased functioning in is school. By collaborating with the school social worker, strategies can be discussed to help support Molly in school. The meeting with her friend does not seem warranted at this time. However, her friend is one of her only supports. Molly has alienated herself from her softball team friends and has a tenuous relationship with her mother, so the counselor may want to bring the friend in at a later time. Although a family session may be something to explore at a further time, the question asks about sources of information that would be important at this time. Additionally, she does not seem to have a good relationship with her mother currently and she may not want to speak to her mother about this. If Molly is still considering cutting after she is provided psychoeducation, this may be warranted as an intervention. There is no indication that there are any developmental delays or history of delays. Molly was doing well in school prior to the death of her father and was in Advanced Placement classes. There are no issues with cognitive functioning. Therefore, the correct answer is (A)
Competency: professional practice and ethics