Background Information
Karen Black decided to enter counseling after an initial intake session where you assessed her as having low self-esteem and a possible Major Depressive Disorder. During the initial intake, she told you that she is going off to college in the fall and that she just doesn’t feel good about herself anymore. She stated that she has never felt she is very pretty; however, it didn’t really bother her that much until this year, her senior year at Golden High School. Karen appears to be an attractive girl of average weight and height. She stated that her parents are divorced. She lives with her mother and two younger brothers, Mike, age 15, and Scott, age 13. Her parents divorced about 2 years ago, and her father lives in an apartment on the opposite side of town. Karen gets along well with both parents although she confessed that the year her parents separated was chaotic. Her mother accused her father of seeing another woman. Karen doesn’t feel that allegation was true although she thinks her father may be dating someone else now.
First Session
After you discuss issues of confidentiality, Karen tells you that her biggest problem is being worried about going to college and nobody liking her there. She feels like the “ugly duckling” at school and doesn’t have a boyfriend. She has had boyfriends in the past and just recently broke up with someone she says was more of a “friend” than a “boyfriend.” Nevertheless, it bothers her to have no one to call on the phone or go out with, and the loss of the relationship with her boyfriend makes her feel even worse about her already poor self-image. With some pride, she tells you that she is a straight-A student and has received a scholarship to Golden State University for the first year of college. She indicates that she doesn’t like sports and isn’t athletic, but she does ride bikes with her brothers occasionally and enjoys walking her golden retriever, Nugget. Karen thinks that she and her mother have a good relationship. However, Karen states that her mother is always nagging her about what she wears, how she fixes her hair and makeup, and what she eats. She likes to go shopping with her mother, and sometimes they go to lunch and a movie when her mother isn’t working. Her mother is a buyer at a large department store, Canary’s, at one of the malls and often has to work on the weekends or go on buying trips for 3 or 4 days during the week. Karen is expected to stay home and take care of her brothers when her mother is gone.
1. At this point, what are the issues that you consider important in assessing Karen?
Q