Case Study
Patient Demographic: Client Age: 22 Sex: Male Gender: Male Sexuality: Homosexual Ethnicity: Latino American Relationship Status: Single Counseling Setting: Community Mental Health Center Type of Counseling: Individual Presenting Problem: Depression Diagnosis: Major Depressive Disorder, Moderate
Mental Status Exam: Mental Status Exam: The client is pleasant and dressed in age-appropriate attire. He is tearful when discussing his family and states this has been difficult for him. The client has had no previous suicide attempts. He is observed biting his nails. He describes feeling sad daily and states he sleeps during the day because he cannot sleep at night. He is slightly underweight but denied any difficulties with appetite. The client’s speech is coherent and clear. He denies suicidal ideation but often questions his worth and purpose. Fam
Presenting Problem: You are providing counseling services at a Community Mental Health Center. A 22-year-old Latino male, accompanied by his aunt, presents with symptoms of depression. The aunt is concerned about the client’s social isolation, feelings of hopelessness, and excessive daytime sleeping. Four months ago, the client’s parents kicked him out of their home after discovering a suggestive social media post of him with another male. He is close with his aunt and uncle, who have allowed him to stay in their basement. The client’s father refuses to speak to him and has told him he is “less than a man” and an embarrassment to the family. The client’s symptoms worsened last month when he was laid off from his job as a server.
Other Contexts: The client reports fewer symptoms of hopelessness and depression. He discloses that he has been seeing a guy he met at his previous job. He is happy with this new relationship but says he’s still “fighting against” feelings of guilt and shame surrounding his sexual orientation and his parents continued rejection of him. The client says he has attended Metropolitan Community Church (MCC) with his boyfriend and was surprised to hear their messages of acceptance and inclusion. He has stopped going to bars and nightclubs since dating and reports less substance and alcohol misuse. The client states it has been quite some time since he felt like he had no purpose in life.  When the client shares recent developments, you find yourself tearing up as you tell him you are happy that he is starting to experience a level of peace in his life

Question: When the client shares recent developments, you find yourself tearing up as you tell him you are happy that he is starting to experience a level of peace in his life. Which core counseling attribute does this represent?
(A): Cultural attunement
(B): Empathetic responding
(C): Metacommunication
(D): Genuineness

Correct Answer: Genuineness
Explanation: Counselors show genuineness by responding in a manner that is consistent with the client’s and their own internal emotional experiences. Genuineness is about responding authentically, in the present moment, in a way that is verbally and emotionally congruent; ie, there is consistency between the counselor’s words and non-verbal behaviors. Empathetic responding occurs when counselors convey an understanding and non-judgmental acceptance of a client’s expressed and underlying feelings. It consists of perceiving, understanding, experiencing, and responding. Empathetic responding differs from genuineness in that it refers to the counselor’s response to the client’s, not the counselor’s, emotional expression. Metacommunication refers to the counseling process as it is unfolding. It is communication about communication, including verbal or non-verbal cues, that carry depth and meaning. Counselors who show cultural attunement skillfully communicate that they both know and do not know the cultural realities of those we treat. Cultural attunement is about remaining teachable and having the desire, humility, and curiosity to acknowledge things such as privilege and oppression, for example. Therefore, the correct answer is (A)
Competency: counseling skills and interventions