Case Study
Patient Demographic: Clients Age: Husband: 45 Wife: 43 Sex: Husband: Male Wife: Female Gender: Husband: Male Wife: Female Sexuality: Heterosexual Ethnicity: Both Individuals Are Caucasian Relationship Status: Married Counseling Setting: Private Practice Counseling Clinic Type of Counseling: Couples Counseling Presenting Problem: Marital Distress Diagnoses: Couple Diagnosis: Adjustment Disorder with Anxiety (F43.22) and Relationship Distress with Spouse or Intimate Partner (Z62.898) Individual Diagnosis (Wife): Generalized Anxiety Disorder (F41.1)
Mental Status Exam: Mental Status Exam: The husband and wife were both oriented to person, place, time, and situation. Both individuals were dressed appropriately for the season and appeared clean. The husband presented as angry, and the wife presented as remors
Presenting Problem: You are a licensed therapist working at a private practice. The couple comes to counseling in order to work on their relationship following an infidelity. The wife has difficulty expressing what happened, and the husband interrupts her and expresses that his wife had an affair with a coworker 3 weeks ago. The couple states that they are currently talking very little aside from conversations that involve their children. The wife states that she is regretful of what she did and that she does want her marriage “to be saved.” The husband explains that he is very hurt by her infidelity and that he is unsure if he can forgive her and continue being married to her. The couple has been married for 25 years and report that they both are in counseling to see if they can continue to be married following the affair. The husband expresses strong anxiety following the revelation of the affair and questions how he can be in a relationship with his wife following the infidelity. The wife is experiencing anxiety regarding her husband leaving her because she reports regretting the sexual interaction with her coworker and does not want to get divorced.
Other Contexts:    eful. Family History: The couple has been married for 25 years. They have two children,a 14-year-old son and a 17-year-old daughter, and they report good relationships with their families of origin

Question: All of the following are appropriate short-term treatment goals for the couple EXCEPT:
(A): The couple will improve their quality time together in order to improve relationship satisfaction.
(B): The couple will learn and implement effective communication skills.
(C): The couple will identify and process areas of resentment that led to the affair.
(D): The couple will process events leading up to the affair in order to identify problem areas in the relationship.

Correct Answer: The couple will improve their quality time together in order to improve relationship satisfaction.
Explanation: The couple is having difficulty with quality interaction at this point due to breakdowns in communication, so quality time would not be the focus for short-term goals. The couple does need to work on effective communication skills so they can work through what events led up to the affair and also so they can interact in a meaningful manner. The couple would also benefit from processing resentment because this is a common problem that leads to infidelity and is also a current barrier to the counseling process. Therefore, the correct answer is (C)
Competency: treatment planning