Background
Bonnie is the eldest of two children with a sister 2 years younger. Bonnie has grown up in a happy, middle-class home. Her father is a building contractor and her mother works in a bank. Her parents are happily married and have always been quite supportive of her. At the time of her first appointment, Bonnie was a 15-year-old white girl in the 9th grade.
Interview
At the start of the interview, Bonnie states that her problem is that she gets nervous about everything, particularly things at school, doing anything new and a fear of social situations. When asked to give an example, Bonnie says that she is very fearful of situations such as eating in public, using public restrooms, being in crowded places and meeting new people. She claims that she will almost always try to avoid these situations. At school, Bonnie reports fear and avoidance of such activities as speaking up in class, writing on the white board and talking to her teachers. Although she is very good at playing the flute, she has dropped out of the school band because of her anxiety over participating in band performances.
In addition to anxiety about talking to teachers, she reports a fear of talking to unfamiliar adults such as shop assistants. In fact, Bonnie says that she will never answer the phone at home. She is also very hesitant to use the phone when she has to interact with strangers to do such things as ask for information or order pizza. In most of these situations, Bonnie says that her fear and avoidance are related to her worry that she might say the wrong thing or she does not know what to say or do and she thinks this will lead others to think badly of her. Quite often, her fear of these situations is so intense that she would experience a full-blown panic attack. Bonnie also reports getting headaches and stomach aches when she is anticipating a situation that she finds difficult.
Despite her problems with anxiety, Bonnie has two or three close friends and a number of acquaintances. Her parents say that Bonnie could always make friends; she just would never make the first move. Bonnie prefers to spend time with her close friends with whom she feels safe because they are also extremely shy. Each day at school, the group eats lunch together apart from the other students between classes.
Bonnie’s grades at school were usually in the mid-range. Her parents said that Bonnie achieved these grades with little effort. Interestingly, while Bonnie was often quite fearful of school, she had not missed many days over the past school years. Her parents noted that Bonnie always had stomach aches before school, but that she never asked to stay home.
Questions for case study
1. Describe the problems/issues that Bonnie is experiencing and name the mental health condition that this could indicate. Explain the reasons for your selecting the mental health condition.
2. Identify and describe two theories (DO NOT USE EGAN) that would help you assess Bonnie’s situation. Describe how each theory would guide your intervention plan?
3. From your selected theories, what techniques could you suggest that Bonnie use to relieve her anxiety and explain why you think these would be helpful? Name and explain two skills you would use to ensure the session is person-centred?
4. Research two different agencies that could be helpful to Bonnie. Select the most appropriate agency and explain why the one selected would be more helpful than the other. Attach a link to the selected agency web site.
5. If Bonnie’s class teacher approached you to ask about your session with Bonnie, what ethical issue/s would you need to consider before replying to the teacher?
Background