Therapy Case Study


For your final paper you will write a 5-6-page paper on the following case scenario. In this case, you will be the counselor who sees a middle-aged female for treatment. The client is in a state of crisis.

As you write your paper follow these instructions:

  1. What social and environmental stressors have affected the client? Explain their effects on the client.
  2. Using the theoretical orientation of Cognitive Behavioral Therapy, how would you approach and help the client?
  3. Using a Psychodynamic theoretical orientation, how would you approach and help the client?
  4. Using an Eclectic (from diverse range of sources) approach in your theoretical orientation, how would you approach and help the client?
  5. Explain how diversity might potentially affect how you view and treat this client.
  6. Provide at least eight scholarly citations, not including assigned course readings, to support your perspectives.

Linda is a 42-year-old Hispanic female, originally from NYC where she grew up. She lives in a Southern State because she married a man she met at a university she attended in the area. She works in middle management of the Human Resources department of her company. Her company has given her a 6 month leave of absence to focus on taking care of her personal life issues.

sample paper


           A number of social and environmental stressors have affected the client. One of the social stressors is rejection by her husband. Linda found out that his husband was no longer interested in her and to make matters worse, he was clearly seeing other women. She could no longer live with him. The apparent betrayal by her husband has led to negative feelings of anger, resentment, and disgruntlement. Rejection is also contributing to her stress and anxiety problems. The other social stressor is loss of a loved one. Linda recently lost her father, a scenario contributing negative feelings of grief. Another social stressor is lack of support from her family members. Linda feels that she is the only one helping her live-in mother with her legal issues. This makes her feel emotionally disconnected from the others.

            Unresolved social stressors are also affecting her life. Unresolved issues can be a major source of stress and anxiety (Buchwald, 2008). For instance, she is has not yet got over the fact that her dream boyfriend at age 16 did not really love her. This elicits feelings of resentment towards the boyfriend.  A number of environmental stressors have made life difficult for Linda. Linda has developed fear of leaving her house. The outside environment seems to affect the client, causing much anxiety and stress. She is also suffering from lack of sleep, which may increase her anxiety levels. At age eight, a truck killed her puppy. This led to feelings of fear, loss and grief. The 9/11 terrorist attack also seems to affect her life. The terrorist attack she witnessed makes her feel agitated and anxious especially at night, and thus contributing to her insomnia.

Cognitive Behavioral Therapy

            Cognitive Behavioral Therapy (CBT) postulates that an individual’s belief and behaviors are the ones that contribute to the underlying problem. CBT approach aims at changing the behavior and thought patterns of the client attributed with the negative or distressing emotions (Cully & Teten, 2008). The major aim of CBT is to help a client develop skills that can enable him or her recognize negative thoughts and emotions; learn how behaviors influence own emotions; better their feelings by altering the dysfunctional behaviors and thoughts; and to know how thoughts, behaviors or various situations influence their emotions. In Cognitive Behavioral Therapy, the therapist thus aims at not only discussing the maladaptive behaviors of the client but also aims to impart critical skills that the client can use to address the challenge or problems. In this CBT approach, the client will receive specific treatment approaches in order to quickly recover.

            The first step in this approach is to orient the client concerning Cognitive Behavioral Therapy and its effectiveness. Orienting the client will involve discussing the theories underlying CBT; a brief about the structure and what to expect during therapy; and a clear description of how the CBT approach will work in treating the problem. This step will also involve assessing the client concerns and identifying the treatment goals. The importance of assessing client concerns is that it enables the therapist to better understand the client. Goal setting in this process involves identifying specific treatment outcomes (Somers & Queree, 2007). For instance, Linda can set the goal to go out of her house like once in a day. The therapist and the client should collaborate in goal setting.

            The second step to outline an intervention technique. In this step, I will first identify all the maladaptive thoughts and beliefs affecting the client. Linda is having maladaptive automatic thoughts. For instance, she believes that everyone wants a piece of her, which may not be the case. Various intervention techniques such as relaxation and other problem solving techniques are suitable. The next step is to refine the intervention techniques adopted. The basis of this is on the progress report from the previous intervention approaches adopted. If her moods have not improved, a different approach should be adapted. If her moods have improved, it is important to identify a relapse prevention strategy.

Using a Psychodynamic theoretical orientation

            The psychodynamic therapy focuses on underlying psychological forces of the self that affect behavior and relate to the early childhood experiences. The psychodynamic approach investigates the relations between conscious and unconscious thoughts, and their effects on behavior (Leichsenring & Leibing, 2007). The main role of psychodynamic therapy is to identify the aspects of self that have not fully come to reality, especially in relation to the way they are manifest themselves in the therapy relationship. Psychodynamic therapy can enable therapists assess the psychological responses of the client. In the Psychodynamic approach, the therapist must focus on the interpersonal relationship with the client (Leichsenring & Leibing, 2007). Establishing a good interpersonal relationship can help the client open up hidden feelings and thoughts that could be affecting behavior.

            In applying the psychodynamic theoretical orientation, the first step is to help the client identify affects and emotions that may be causing the problem (Shedler, 2011). Linda should outline all conflicting feelings that she experiencing. The therapist should also help her establish inner conflicting feelings that she may not be aware of. The second step is to help the client identify the instances when they behave in a particular manner as a way of avoiding the negative thoughts or feelings. For instance, Linda hardly leaves her home as a way of avoiding the negative feelings of anxiety. The third step is to identify any recurring themes. For instance, Linda is unable to sleep due to recurring thoughts about the 9/11 incident. The next step is to focus on her past experiences that could be affecting the present. For instance, the death of her puppy has profound impacts on her present behavior. The next step is to focus on Linda’s interpersonal relations. It is important for Linda to analyze how interpersonal relations affecting her behavior.

Using an Eclectic approach

            The Eclectic approach involves a combination of two or more treatment approaches. The eclectic approach entails devising a new theory of knowledge from other preexisting theories (Ahmadi, 2015). The eclectic approach entails explaining behavior of client by analyzing multiple perspectives and coming up with appropriate applications. For instance in the case of Linda, the eclectic approach may entail using two or three therapy/treatment approaches in order to achieve a holistic approach. The eclectic approach is important since it enables the therapist to borrow ideas from multiple perspective (Ahmadi, 2015). The eclectic approach provides an avenue for the therapist to generate new ides during the therapy session. The eclectic approach is also important since it provides the therapist with a clear understanding of the clients underlying behavior.

            The eclectic approach will borrow from the psychodynamic and Cognitive Behavioral Therapy. The Cognitive Behavioral Therapy focuses on creating awareness of the thoughts and emotions that affect the behavior and emotions of individuals. The focus of cognitive therapy is to create awareness of the thoughts and beliefs affecting the client behavior (Karim, 2013). On the other hand, the psychodynamic approach focuses not only on the awareness of thoughts and beliefs, but also on inner feelings that the client may not be able to recognize. By combining the elements of the two approaches, the therapist can be able to fully document all the thoughts, beliefs, and inner underlying psychological problems that may be affecting the client. In using the two approaches, it is important to establish and maintain good relationship with the client. This can enable the client to feel free and express all the underlying issues.

Effect of diversity on my view

            Diversity may significantly affect how the therapist view and treat the client. The therapist should acknowledge the differences in ethnicity with the client. Failure to acknowledge the differences may lead to feelings of anxiety when discussing issues relating to race (Patel, 2014). The therapist may then avoid such discussions with the client. Ethnic stereotypes may affect the way the therapist treats the client. For instance, the therapist may assume that the client behaves in some way because of belonging to some particular ethnic group commonly attributed with the behavior. This may not be entirely true leading to wrong diagnosis and treatment approaches. Clash of cultures between therapist and the client may affect the way each of them views the world. For instance as a therapist from a culture that believes in women’s submissiveness, I would advise Linda to forgive her philandering husband.


Ahmadi, A. (2015). Developing an Integrated Art and Cognitive Behaviour Therapy Program      for ‎Approach to Paediatric Anxiety ‎Disorders International Journal of Fundamental    Physical Sciences. International Journal of Fundamental Psychology and Social Sciences       IJFPSS, 5(3), 23-27. doi:10.14331/ijfpss.2015.330051

Buchwald, P. (2008). Stress and anxiety: Application to life span development and health             promotion. Berlin: Logos-Verl.

Cully, J.A., & Teten, A.L. (2008). A Therapist’s Guide to Brief Cognitive Behavioral Therapy.    Department of Veterans Affairs South Central MIRECC.

Karim, S. (2013). Hypnosis in the management of stress & anxiety: A practical guide to personal             control. United Kingdom, UK: Shahid Publishers.

Leichsenring, F., & Leibing, E. (2007). Psychodynamic psychotherapy: A systematic review of   techniques, indications and empirical evidence. Psychology and Psychotherapy: Theory,         Research and Practice, 80(2), 217-228. doi:10.1348/147608306×117394

Patel, M. (2014). Counsellor-client ethnic difference: the therapeutic process, relationship and    competence (Doctoral dissertation). Retrieved from

Shedler, J. (2011). The Efficacy of Psychodynamic Psychotherapy. Psychodynamic          Psychotherapy Research, 9-25. doi:10.1007/978-1-60761-792-1_2

Somers, J., & Queree, M. (2007). Cognitive Behavioral Therapy. Centre for Applied Research in             Mental Health and Addiction. Retrieved from      Therapy.pdf

Related: Reflections on Course Coverage