MODULE 17 Practicum
MODULE 17 Practicum
MODULE 17
PRACTICUM
Counselling Case studies
Counselling case studies are useful tools for understanding how therapy works in real-
life situations. They describe a client’s challenges, the methods a counsellor uses, and the
results of therapy. By studying these cases, professionals can learn about different mental
health issues, how effective various therapies are, and the complexities of helping people with
emotional and psychological problems. Case studies also help counsellors improve their skills
and better understand their clients' needs. They are valuable learning resources for students and
professionals, showing how theory can be applied in real-world therapy.
Introduction:
This case study examines a counseling session with a client, “Sarah,” a 32-year-old
woman who presented with issues related to work-life balance, anxiety, and strained personal
relationships. The following is an outline of the key details of her case, including her
background, presenting complaints, goals for counseling, the intervention process, and the
outcomes achieved during the counseling sessions.
Case Background:
Sarah is a mid-level manager at a large corporate firm. She has been in her current role
for the past five years, and although she enjoys her work, she has found it increasingly difficult
to manage the stress that comes with her position. Sarah is married, and she has two children
aged 6 and 3. She and her husband, Mark, both work full-time and are experiencing a lot of
strain in their relationship, primarily because of Sarah’s long hours at work and her difficulty
in managing household responsibilities.
Sarah grew up in a high-achieving family, where academic and career success was
heavily emphasized. From a young age, she learned to prioritize her work and personal
achievements, often at the expense of her emotional well-being. Over the past year, Sarah has
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begun to feel overwhelmed by her responsibilities both at work and home, and her physical
health has started to suffer, including insomnia, fatigue, and headaches.
Presenting Complaints/Issues:
1. Work-Life Balance Issues: Sarah reports feeling that her work demands have
overtaken her personal life. She regularly brings work home and spends evenings and
weekends working on reports or catching up on emails. She struggles to find time for
her family or for herself.
2. Anxiety and Stress: Sarah frequently experiences feelings of anxiety, especially when
it comes to balancing her job with family obligations. She has trouble relaxing and often
feels like she is failing in multiple areas of her life. She also experiences occasional
panic attacks when she is under particularly high stress at work.
3. Strained Relationships: Sarah’s marriage has been strained due to her constant focus
on work. She feels disconnected from her husband and has noticed that they have very
little quality time together. Additionally, her relationship with her children is suffering,
as she often feels too tired or preoccupied to engage with them meaningfully.
4. Physical Symptoms: Sarah mentions experiencing chronic headaches, trouble
sleeping, and low energy. She attributes these issues to stress but is unsure how to
alleviate them.
Goals of Counseling:
1. Improve Work-Life Balance: To help Sarah set boundaries between her work and
personal life, ensuring that she has time for both her family and herself.
2. Reduce Anxiety and Stress: To develop strategies for managing stress and anxiety,
including relaxation techniques and cognitive-behavioral strategies to reduce negative
thinking patterns.
3. Strengthen Relationships: To improve communication and emotional connection
between Sarah and her husband, and enhance her bonding with her children by creating
quality time together.
4. Address Physical Health Concerns: To provide Sarah with tools to address her
physical health problems, particularly insomnia and fatigue, through stress
management techniques and self-care practices.
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Intervention:
Counsellor: So Sarah, let’s take a moment to talk about the relationship between your
thoughts and the stress you’ve been feeling lately. Can you recall a recent situation where you
felt overwhelmed, perhaps with work or your personal life?
Sarah: Yes1. Last week, I had a big project deadline at work, and I ended up staying late
every night to finish it. I thought I’d have time to relax once it was done, but then I came
home and immediately had to handle household chores, and I just felt like I was running on
empty.
Counsellor: I can imagine that must have been really exhausting. How did you feel during
that time?
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Sarah: I felt drained, frustrated, and honestly, a little resentful. I kept thinking, "I’m doing
everything, and it’s still not enough."
Counsellor: That sounds really heavy. And what was going through your mind when you
were feeling that way?
Sarah: I think I kept telling myself that I’m failing at everything. Like, I’m not being a good
mom, wife, or employee. I just couldn’t manage it all.
Counsellor: Ah, okay. What you’ve described is an automatic thought. It’s a thought that
pops up quickly, almost without you even realizing it, and it really shapes how you feel.
These thoughts are often so fast that we don’t pause to question them, but today, that’s what
we’re going to do: question the validity of that thought.
Counsellor: Together, let's pinpoint your automatic thought here. From what you said, your
automatic thought seems to be: “I’m failing at everything.” Does that sound right?
Counsellor: Now, let’s take a moment and think about the impact of believing that you’re
failing at everything. What does that belief do for you, Sarah?
Counsellor: I see. So, if you continue to believe that you’re failing at everything, what do
you think happens to your stress levels and how you interact with others?
Sarah: I guess I become more irritable and tense. And then I feel guilty because I know I’m
not being the best version of myself for my family.
Counsellor: Right. Now, what if you started to challenge that belief? What would happen if
you didn’t think you were failing at everything?
Sarah: I imagine I’d feel a lot lighter and less stressed. I’d probably be able to enjoy time
with my family more. I’d have more patience, and I wouldn’t be so hard on myself.
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Counsellor: That sounds like a healthier way to think about it. Now, I want you to look over
this list of common false beliefs and see if any of them resonate with you. (Hands Sarah a list
of false beliefs).
Sarah: (Reading the list) Hmm, I can definitely relate to number six: “I must be perfect in
everything I do.” I always feel like I need to get everything right, whether it's work, being a
mom, or taking care of the house. It’s exhausting.
Counsellor: That’s a great observation, Sarah. These are what we call “false beliefs,”
because they’re extreme and all-or-nothing thinking. Life isn’t black and white, and we don’t
have to be perfect all the time. It's okay to not get everything right. Perfectionism can actually
lead to more stress and frustration, which we definitely want to avoid. Does this shift in
thinking feel like something you’d be willing to try?
Sarah: Yes, I think so. I mean, I know I’m only human, and I can’t do it all. Maybe it’s about
accepting that I can’t be perfect in every role and still be enough.
Counsellor: Exactly. By accepting that and challenging those extreme beliefs, you’ll be able
to release some of that pressure and reduce your stress. We’ll work together to build healthier
thought patterns that allow you to feel more balanced and present in your life.
Counsellor: Great! We'll take this one step at a time. And remember, change doesn't happen
overnight, but with practice, these new ways of thinking can help you feel much better in the
long run.
Outcomes of Intervention:
Presenting Complaints/Issues:
1. Work-Related Stress: Tom feels immense pressure at work and is constantly worried
about meeting deadlines and maintaining a high level of performance. This leads to
burnout and exhaustion.
2. Anxiety: Tom experiences constant worry about his job performance, often
catastrophizing about what might go wrong. He struggles with an underlying fear of
failure.
3. Insomnia: Due to his excessive worrying, Tom has trouble sleeping. He often lies
awake, unable to turn his thoughts off, which exacerbates his stress levels.
4. Lack of Relaxation: Tom feels like he never has time to relax. He is unable to enjoy
personal activities or hobbies because his thoughts are consumed by work.
Goals of Counseling:
1. Reduce Work-Related Stress: Help Tom identify triggers that contribute to his stress
and develop strategies to manage them.
2. Address Anxiety and Negative Thinking: Use CBT techniques to challenge irrational
thoughts and replace them with more realistic, balanced thinking.
3. Improve Sleep Patterns: Implement relaxation techniques to address insomnia and
create better sleep hygiene practices.
4. Increase Leisure and Relaxation: Encourage Tom to engage in activities outside of
work to foster relaxation and a sense of balance in his life.
Intervention:
1. Cognitive Restructuring:
o Identify and challenge negative thoughts like "I’m not good enough" or "I’ll fail
if I don’t work late."
o Replace them with balanced thoughts: “I can manage my workload without
overworking.”
2. Exposure Therapy:
o Gradually expose Tom to anxiety-provoking situations, such as taking breaks
or sharing work in meetings.
o Teach him to tolerate anxiety and reduce avoidance.
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3. Relaxation Training:
o Teach deep breathing and progressive muscle relaxation to manage stress and
improve sleep.
4. Behavioral Experiments:
o Test beliefs like “I must work late to succeed” by experimenting with taking
breaks and observing the outcomes.
5. Activity Scheduling:
o Schedule pleasurable activities (e.g., walks, hobbies) to balance work and
promote relaxation.
These interventions will help Tom manage stress, challenge negative thoughts, and
regain a healthy work-life balance.
Counselor: "Tom, I understand you're feeling overwhelmed at work. Can you share some of
the thoughts you have when you're stressed about your job?"
Tom: "I often think that if I don’t work late, I’ll fall behind and disappoint my boss. And
sometimes, I feel like I’m just not good enough at my job."
Counselor: "It sounds like you're having some negative thoughts. Let’s work together to
challenge them. Let’s start with the thought, 'If I don’t work late, I’ll fail.' What evidence do
you have that supports this belief?"
Tom: "Well, sometimes I do miss deadlines if I don’t stay late, and that feels like failure."
Counselor: "I see. But do you have any evidence that contradicts this? Has there been a time
when you completed your tasks successfully without working late?"
Tom: "Yes, there was a time last month when I completed everything on time, even though I
didn't stay late. I was just more focused during the day."
Counselor: "Great! So based on that, is the belief that you have to stay late to avoid failure
completely true?"
Tom: "No, I guess not. Maybe I can manage my time better during the day."
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Counselor: "Exactly! So next time you have the thought, 'If I don’t work late, I’ll fail,' try
reminding yourself of the times when you were able to succeed without overworking. We’ll
practice this over the next week."
Counselor: "Tom, today we’re going to work on exposure. You mentioned feeling anxious
about sharing your work in meetings. Let’s break that down into manageable steps. What
would be a small step you can take toward that?"
Tom: "I guess I could start by sharing a small part of my work in a meeting instead of
presenting the entire project."
Counselor: "Great! That sounds like a good starting point. How do you feel about trying this
next week?"
Counselor: "That’s excellent. Remember, you don’t need to be perfect. The goal is to
gradually build up your confidence. We’ll talk about how it went in our next session."
Counselor: "Tom, I know you’ve been struggling with insomnia and stress. Let’s work on
some relaxation techniques today. First, let’s try deep breathing. I want you to breathe in for
four counts, hold for four, and then exhale slowly for six counts. Let’s try it together."
Counselor: "Good job. Now, let’s do it again a few more times. Breathe in... hold... and
exhale. How does that feel?"
Counselor: "That’s great! Now, I want you to practice this for 10 minutes before bed every
night. This should help you wind down and reduce the racing thoughts that affect your sleep."
Counselor: "Tom, let's talk about a belief you mentioned last time: 'I need to work late to
succeed.' I’d like you to conduct an experiment. Try taking a night off from working late and
focus on a relaxing activity instead. Afterward, observe how it affects your performance and
your stress."
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Counselor: "Exactly. You could go for a walk, read a book, or engage in something that
helps you unwind. Then, we’ll evaluate if not working late really affects your productivity or
success."
Counselor: "Tom, we’ve been working on reducing your stress, and now let’s plan some
activities that can help you relax. Let’s start by scheduling a few enjoyable activities this
week. What are some things you like to do outside of work?"
Tom: "I used to enjoy playing guitar, but I haven’t done it in a while. I also like going for
walks."
Counselor: "Those are great choices! Let’s schedule time for them. How about you try
playing guitar for 20 minutes tomorrow after work and take a walk on Thursday evening?"
Tom: "I can do that. It will be a nice change from working all the time."
Counselor: "Perfect. We’ll also add some activities throughout the week to ensure you’re
balancing work and relaxation. Let’s check in next session to see how it went."
Counselor: "Tom, how has the week gone with your experiments and relaxation
techniques?"
Tom: "I tried taking a break from working late a couple of times, and it was actually fine. I
didn’t feel like I failed, and I felt more refreshed the next day. I’ve also been practicing deep
breathing, and it’s really helped with my insomnia."
Counselor: "That’s fantastic progress! How about the activity scheduling? Have you been
able to engage in the hobbies we planned?"
Tom: "Yes, I played guitar and went for a walk. It felt good to do something non-work-
related."
Counselor: "Great! It sounds like you’re making great strides in managing your stress. Keep
practicing the cognitive restructuring, relaxation, and exposure techniques. In the next
sessions, we can focus on maintaining this progress and continue building your confidence."
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In these sessions, the counselor works with Tom to help him challenge his negative
thoughts, face his anxieties, use relaxation techniques, test his beliefs through behavioral
experiments, and engage in pleasurable activities to reduce stress.
Outcomes of Intervention:
Conclusion:
Through the use of Cognitive Behavioral Therapy, Tom was able to identify negative
automatic thoughts, challenge irrational beliefs, and develop healthier coping strategies. His
overall stress and anxiety levels decreased, and he found a better balance between work and
relaxation. The intervention allowed Tom to regain control over his thoughts and emotions,
leading to significant improvements in both his professional and personal life.
Introduction:
This case study focuses on “Emma,” a 45-year-old woman seeking counseling after the
sudden death of her mother. The counselor uses a Humanitarian Approach to provide support,
focusing on empathy, emotional validation, and a holistic understanding of Emma’s emotional
and psychological needs as she navigates her grief.
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Case Background:
Emma is a middle-aged woman who was very close to her mother, who passed away
unexpectedly from a heart attack. Emma lives alone in a small town and works as a teacher at
a local school. She had been the primary caregiver for her mother for the last two years after
her mother developed health problems. The suddenness of her mother’s death has left Emma
feeling disoriented, overwhelmed, and isolated.
Emma’s grief has been complicated by feelings of guilt, as she believes that she could
have done more to prevent her mother’s death. She also feels abandoned and is struggling with
a lack of support, as most of her friends and family members live far away. Emma has become
withdrawn and has been unable to focus on her daily responsibilities, particularly at work.
Presenting Complaints/Issues:
1. Intense Grief and Sadness: Emma is experiencing profound grief following the death
of her mother. She often feels a deep sense of emptiness and sadness, which interferes
with her ability to engage in daily activities.
2. Guilt and Self-Blame: Emma feels guilty that she couldn’t prevent her mother’s
sudden death. She constantly ruminates about the things she could have done
differently.
3. Isolation and Loneliness: Emma feels isolated and disconnected from others,
particularly because her friends and family live in different cities and are unable to offer
regular emotional support.
4. Difficulty Focusing: Due to her grief, Emma finds it hard to concentrate at work and
often feels emotionally distant from her students.
Goals of Counseling:
o Provide a safe space to express emotions and work on overcoming the emotional
burdens of losing her mother.
3. Building Resilience:
o Help Emma regain her emotional balance, focus on self-care, and develop
strategies to manage day-to-day responsibilities (work, socializing, etc.).
4. Social Support and Reconnection:
o Support Emma in rebuilding her social connections, increasing her sense of
belonging, and reconnecting with her community.
Intervention:
• Trauma-Informed Therapy:
• Grief Counselling:
• Provide empathic listening to validate Emma’s grief and help her process the
sudden loss of her mother.
• Introduce grief stages and explore the emotions Emma may be experiencing
(shock, denial, anger, guilt, etc.).
• Guide Emma in finding meaning in her loss, offering her opportunities to honor
her mother’s memory.
• Psychoeducation:
• Educate Emma about the grieving process, common emotional reactions to loss,
and the physical and psychological impact of trauma and grief.
• Empower Emma with coping strategies, such as mindfulness techniques, self-
compassion, and healthy outlets for processing emotions.
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• Resource Coordination:
• Community Engagement:
Counselor: "Emma, I’m so sorry for your loss. Losing your mother so suddenly must have
been incredibly difficult. How have you been feeling since her passing?"
Emma: "I feel like everything is out of control. I miss her so much, and I can’t stop thinking
that maybe I could have done more to save her. I just feel so alone."
Counselor: "It sounds like you’re feeling overwhelmed by grief and also burdened by guilt.
It's completely natural to feel like this after such a sudden loss. Let’s talk through these
feelings together. First, I want to acknowledge your grief. It's okay to feel all these emotions.
You’re not alone in this."
Emma: "I just keep thinking that if I had been more alert, maybe she would still be here."
Counselor: "I hear that, and I know it’s hard, but it’s important to remember that her death
wasn’t your fault. Sometimes, no matter what we do, certain things are out of our control. We
can explore these feelings together and work through them."
Counselor: "Emma, I know the grief is overwhelming, but it sounds like there might also be
a sense of trauma. Losing your mother so suddenly must have been very shocking. How are
you coping with the memories or the way you’ve been feeling since?"
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Emma: "I keep replaying the moment I found out, and it makes me feel anxious. Sometimes,
I feel like I can’t breathe. It’s like a constant knot in my chest."
Counselor: "It sounds like you’re experiencing some intense physical reactions to this
trauma. One way we can work through this is by using Trauma-Focused Cognitive
Behavioral Therapy (TF-CBT), which can help you understand the connection between
your thoughts, feelings, and physical symptoms. Would you be open to trying this?"
Emma: "I’m willing to try. I just don’t know how to move past this feeling."
Counselor: "I understand, and we’ll take it step-by-step. The goal is to gradually help you
process those difficult moments and the emotions tied to them. For now, let’s focus on the
guilt you feel. Can you tell me more about what’s been going through your mind?"
Emma: "I feel like I could have done more… maybe I didn’t take her to the doctor enough or
give her better care."
Counselor: "It’s common to have thoughts like that in grief. But the truth is, you did
everything you could. We’ll work on shifting those thoughts. In TF-CBT, we’ll also help you
understand and process the trauma you’re feeling from her sudden death. I want to remind
you that your guilt is part of the grieving process, but it’s important not to hold onto it."
Counselor: "I want to focus a bit more on your grief today, Emma. We’ll go through some of
the stages of grief, like denial, anger, and bargaining. These are all normal. What’s been
hardest for you so far?"
Emma: "The hardest part is not having her around to talk to. I feel so empty. I keep asking
myself, ‘Why did she have to leave so soon?’"
Counselor: "That’s completely understandable. You’ve lost someone who was a huge part of
your life. It’s okay to feel lost. This grief you’re going through is not something you need to
rush. We can also explore finding meaning in your relationship with her. What are some
things she taught you or moments that bring you comfort?"
Emma: "She always taught me to be patient, and we had some good talks about life. I think
I’ll hold onto those moments."
Counselor: "That’s beautiful, Emma. Holding onto those memories can be a way to honor
her. I know it’s hard, but part of this grieving journey will also involve letting go and
accepting that it’s okay to feel the pain and love simultaneously."
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Session 4: Psychoeducation
Counselor: "Today, I want to share some information about grief and trauma. Many people
who go through a loss experience intense emotions, and sometimes these emotions can affect
our physical health, sleep, or ability to concentrate. I’ve noticed you mentioned struggling
with focus at work. This can be a natural reaction to grief."
Emma: "Yes, I can’t focus on anything. It’s hard to concentrate on teaching, and my students
have noticed."
Counselor: "Grief can make it difficult to focus, and it’s okay to acknowledge that.
Sometimes, people experience fatigue or a lack of energy, even when they’re trying to push
through. One thing we can work on is self-compassion, being gentle with yourself as you
navigate through these emotions."
Emma: "That makes sense. I haven’t really allowed myself to take a break."
Counselor: "It’s important to give yourself permission to rest and take small steps. We’ll also
talk about relaxation techniques like deep breathing or mindfulness, which can help you
manage the intense emotions."
Counselor: "Emma, I know you’ve mentioned feeling isolated and having a lack of support
nearby. I want to help you with this by connecting you to some community resources. There
may be local grief support groups, and I can also help you find online support if that’s
easier."
Emma: "That sounds good. I don’t have many friends or family nearby, so it’s hard to talk
about this."
Counselor: "You don’t have to go through this alone, and it’s okay to seek out help. I’ll help
you get connected with people who can understand what you’re going through. Also, let’s
talk about reconnecting with activities you used to enjoy, such as social events, hobbies, or
volunteering, to help build a support network."
Emma: "I used to enjoy going on walks, and maybe I could look into some group activities. I
just haven’t had the energy to do that."
Counselor: "It’s understandable. We’ll take it slowly, but remember, taking small steps like
this can help you feel more connected. I’ll provide information on grief support groups and
other resources."
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Counselor: "Emma, we’ve talked a lot about grief and healing, and now I’d like to encourage
you to think about connecting with others who are going through similar experiences.
Community support can be really helpful. How do you feel about joining a grief support
group?"
Emma: "I’m nervous about sharing, but I know it might help. I just don’t know where to
start."
Counselor: "It’s natural to feel nervous, but joining a group of people who understand what
you’re going through can be very healing. I’ll help you find a local or online group that fits
your needs. Sharing your experience might help ease some of that isolation."
Emma: "I think I’m ready to try. It feels like the right time."
Counselor: "That’s a great step. I’ll also check in with you next session to see how it went
and how you’re feeling."
This step-by-step dialogue follows a structured process where the counselor helps
Emma navigate through grief, guilt, trauma, isolation, and reconnection with her community
and support systems. The approach is compassionate, focused on providing Emma with the
tools and support she needs to heal emotionally.
Outcomes of Intervention:
1. Grief Processing: Emma reports that she feels more at peace with her grief after
validating her emotions and expressing her sadness.
2. Reduced Guilt: Through exploring her actions and intentions, Emma begins to
understand that her guilt is misplaced, leading to emotional relief.
3. Decreased Isolation: Emma starts reaching out to friends for support and reconnects
with her social network, alleviating feelings of loneliness.
4. Improved Functionality at Work: By adopting a more manageable approach to her
work, Emma finds it easier to focus and feel productive again.
Conclusion:
By employing the Humanitarian Approach, the counselor provided Emma with a safe
space to express her grief, process her emotions, and receive the validation she needed to begin
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healing. The intervention focused on empathy, emotional support, and providing practical tools
for Emma to cope with her grief and reintegrate into her daily life.
Introduction:
This case study centers on “Maria,” a 34-year-old woman who has recently left an
abusive relationship and sought counseling to heal from the emotional and psychological
effects of domestic abuse. The counselor applies a Humanitarian Approach to support Maria’s
journey toward empowerment, safety, and emotional healing.
Case Background:
Maria had been in a relationship with her partner, James, for eight years. Over the years,
the relationship became increasingly abusive, both emotionally and physically. Maria had
experienced verbal insults, intimidation, and physical violence, leading to feelings of
worthlessness and fear. Despite the abuse, Maria stayed in the relationship, hoping it would
improve.
After a violent incident that left her with injuries, Maria finally made the decision to
leave the relationship and move into a shelter. She is now living independently, but she
struggles with feelings of shame, low self-esteem, and difficulty trusting others.
Presenting Complaints/Issues:
1. Emotional Trauma from Abuse: Maria experiences intense emotional pain from the
abuse, which has led to feelings of shame, guilt, and anger.
2. Low Self-Esteem and Self-Worth: Maria feels that she is unworthy of love or respect,
believing that the abuse was her fault.
3. Fear and Trust Issues: Maria finds it difficult to trust others, especially in new
relationships. She fears that she will be hurt again.
4. Difficulty Moving Forward: Maria is having trouble imagining a future where she is
happy and free from abuse.
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Goals of Counseling:
1. Trauma Recovery:
o Help Maria process and integrate her traumatic experiences of abuse, reduce
symptoms of PTSD, and promote emotional healing.
2. Empowerment and Self-Esteem Building:
o Support Maria in rebuilding her sense of self-worth and developing a more
positive self-image, free from the emotional scars of abuse.
3. Coping with Shame and Guilt:
o Help Maria understand that the abuse was not her fault and work on reducing
feelings of shame and guilt that arise from leaving the relationship.
4. Trust and Relationship Building:
o Assist Maria in overcoming difficulties with trust and establishing healthy
boundaries in future relationships, whether platonic or romantic.
5. Safety and Independence:
o Encourage Maria to build and reinforce her independence, giving her tools to
maintain her emotional and physical safety.
Intervention:
• Trauma-Informed Therapy:
• Building Trust:
• Help Maria explore her fears related to trust and work on gradual exposure to
situations that help her rebuild her capacity for trusting others in healthy ways.
• Focus on boundary-setting as an essential part of forming healthy relationships and
maintaining personal safety.
Counselor: "Maria, I want to first acknowledge how strong you are for leaving that situation.
Making the decision to leave after so many years took a lot of courage. How have you been
feeling since you’ve moved into the shelter?"
Maria: "I feel conflicted. Part of me feels relief, but another part of me feels like I failed
somehow. I’m ashamed of what happened."
Counselor: "I hear that, and I want to tell you that leaving an abusive relationship is not
failure—it’s a powerful step toward your own safety and healing. The shame you're feeling is
very common for survivors, but it's important to recognize that the abuse you experienced
was never your fault. You deserve peace and happiness, and we’ll work on understanding that
together."
Counselor: "I know that the abuse you endured left emotional and psychological scars.
Today, I’d like to start working on processing some of that trauma. Would you feel
comfortable sharing some of your experiences with me?"
Maria: "I don’t know if I can. The memories are so painful, and I’m afraid of breaking
down."
Counselor: "It’s completely understandable to feel that way. We’ll go at your pace.
Remember, it’s not about reliving the trauma, but about understanding how it has impacted
you and finding ways to heal. Would it feel safer for you to start with small steps? Perhaps
we can begin by talking about one specific memory, when you feel ready."
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Counselor: "Maria, as we talk about your experiences, I want to remind you that you’ve
already demonstrated incredible strength by leaving the relationship. That is not an easy thing
to do. How do you feel about yourself now that you’re living independently?"
Maria: "I feel like I’ve lost who I was. I’m struggling with self-worth. I was always made to
feel like I wasn’t good enough."
Counselor: "I can hear the deep pain in your words, Maria. But here’s the truth: your worth
was never determined by someone else’s mistreatment. You are strong, and you’ve made it
this far. I want to work with you to rebuild that sense of self, starting with recognizing your
courage and resilience. What are some small things you do for yourself that bring you peace
or joy?"
Counselor: "That’s wonderful. Let’s keep building on those moments of peace. Recognizing
these small, positive actions will help you rebuild your confidence and self-esteem."
Counselor: "Maria, I can tell that trust is a big issue for you, especially after everything
you've been through. Can you tell me a little more about your feelings around trusting
others?"
Maria: "I’m afraid of being hurt again. I’m scared that people will take advantage of me or
treat me the same way he did."
Counselor: "That fear is very real, and I respect how protective you’re feeling right now.
Trusting again is a gradual process, and it’s important to take small, manageable steps. We
can work together on setting healthy boundaries, which will help you regain control in
future relationships and gradually rebuild trust."
Counselor: "I’d like to share some information with you today about the dynamics of
abusive relationships. Many survivors feel confused and even question their own role in the
abuse. This is common, but it’s important to understand that abuse is about control, not love.
You did nothing to deserve what happened."
Maria: "I’ve always wondered if maybe I could have done something differently to avoid the
abuse."
Counselor: "It’s a natural response, but please remember, the abuser’s behavior is never your
fault. Now, I’d like to make sure you have access to additional resources, such as support
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groups for survivors and legal assistance if you feel ready. This will help you continue on
the path to healing."
Outcomes of Intervention:
1. Trauma Recovery:
o Maria begins to process her traumatic experiences with the help of TF-CBT
and Narrative Exposure Therapy. Over time, her symptoms of PTSD begin
to reduce, and she experiences less emotional distress when recalling past
incidents of abuse.
2. Increased Self-Esteem:
o Maria gradually rebuilds her sense of self-worth, acknowledging her strength
and resilience in leaving the abusive relationship. She begins to identify herself
as someone capable of creating a positive future.
3. Reduced Shame and Guilt:
o By processing her feelings of shame and guilt, Maria realizes that the abuse
was never her fault. She starts to forgive herself, understanding that her
decisions were made under duress and fear, and that she did what she could to
survive.
4. Improved Trust and Boundaries:
o Maria works on rebuilding trust at her own pace. She becomes more
comfortable with the idea of healthy boundaries and begins to engage with
people who show her respect and kindness.
5. Increased Safety and Independence:
o With psychoeducation on abuse dynamics and self-care strategies, Maria feels
more equipped to navigate her independent life. She becomes more confident
in her ability to keep herself safe and begins to explore new possibilities for
community engagement and social support.
Conclusion:
Introduction:
This case study revolves around "Clara," a 35-year-old woman seeking counseling due
to ongoing relationship difficulties. Using the Person-Centered Approach, the counselor
provides a supportive, empathetic environment where Clara can explore her feelings and gain
deeper self-awareness, leading to healthier relationship dynamics.
Case Background:
Clara is in a long-term relationship with her partner, Jake, and they have been living
together for four years. Recently, Clara has been feeling distant and disconnected from Jake.
She has noticed that they argue more often and struggle with communication, particularly
around topics such as household responsibilities and future goals. Clara feels unheard in their
discussions and believes that Jake doesn’t fully understand her emotional needs.
In addition to relationship concerns, Clara feels insecure about her role in the
relationship and fears that Jake may not be as invested as she is. She struggles with feelings of
inadequacy, often questioning whether she deserves to be in the relationship, despite Jake
showing affection in his own way. Clara is unsure whether to continue in the relationship or let
go, and this indecision is causing her emotional distress.
Presenting Complaints/Issues:
Goals of Counseling:
1. Improving Communication:
o Help Clara and Jake develop healthier communication patterns, where both
partners feel heard, respected, and understood, especially when discussing
sensitive topics such as household responsibilities and future goals.
2. Addressing Emotional Needs:
o Facilitate Clara’s ability to express her emotional needs more clearly and work
on building mutual understanding between her and Jake.
3. Building Self-Esteem and Insecurity:
o Support Clara in increasing her self-worth and confidence, reducing feelings of
inadequacy, and learning to appreciate her role in the relationship.
4. Decision-Making About the Relationship:
o Assist Clara in gaining clarity about her relationship with Jake, addressing her
doubts and helping her make a more informed and balanced decision about
whether to stay or move on.
5. Strengthening the Relationship:
o Work towards creating a more balanced, trusting, and secure partnership where
both Clara and Jake feel valued and connected.
Intervention:
Counselor: "Clara, I want to first acknowledge that you’re reaching out because something
feels off in your relationship. It takes a lot of strength to recognize when things need to
change. Can you tell me more about how you’ve been feeling with Jake lately?"
Clara: "I just don’t feel heard anymore. We argue about everything—household chores, our
future together. When I try to talk about how I’m feeling, I feel like he doesn’t really get me."
Counselor: "It sounds like you’re not feeling emotionally connected, and when you try to
communicate, it leads to frustration. Let’s talk about how you express your needs to Jake. Do
you feel that you’re able to communicate what you want and need in the relationship
clearly?"
Clara: "Not really. It’s like I try, but it’s always coming out wrong. He just doesn’t seem to
understand what I’m saying."
Counselor: "That’s very important to address. Sometimes, it’s not about what we say but
how we say it. Let’s work on some communication tools that can help you both hear each
other more clearly, starting with active listening."
Counselor: "Clara, you’ve mentioned feeling insecure in the relationship. Can you tell me
more about where that’s coming from?"
Clara: "I just feel like I’m not good enough for him. He’s affectionate in his own way, but
sometimes I wonder if he’s as invested as I am. I don’t know if I deserve this relationship."
Clara: "I don’t know. I guess I’m caring and I always try to make things work."
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Counselor: "Those are wonderful qualities, Clara. I want to help you see that you are
deserving of love and connection, and that your feelings matter. Let’s work on building your
self-worth, starting with recognizing the value you bring to the relationship."
Counselor: "Clara, now that we’ve started working on your self-worth, let’s talk about your
emotional needs. Can you describe what you feel you need from Jake, emotionally, that you
aren’t currently getting?"
Clara: "I just need him to listen to me, to show me that he cares in a way that makes sense to
me. I also need to know that we have the same future goals, but we never talk about it."
Counselor: "It seems like you need reassurance, connection, and clarity about your shared
future. It might help to have a conversation with Jake where you express your needs clearly,
and also listen to his perspective. Would you be open to exploring how to approach this
conversation?"
Clara: "I’m nervous, but I know I need to have that conversation. I just don’t want to make
things worse."
Counselor: "It’s understandable to feel nervous, but with some tools, we can make sure that
conversation is productive. We’ll practice assertive communication so that both of you feel
heard and understood."
Counselor: "Clara, it seems like part of the emotional distress you’re feeling is around not
knowing whether to stay or leave. Let’s take some time to explore what’s most important to
you in this relationship, and what you envision for your future."
Clara: "I’m not sure anymore. Part of me loves Jake, but I’m afraid that we’re not on the
same page. What if this isn’t what I want long-term?"
Counselor: "This is a tough decision, but it’s important to reflect on what you need for your
own happiness. Let’s break down your goals and values and compare them to what the
relationship currently offers. This might help you gain clarity on whether it aligns with your
future aspirations."
Clara: "I think it will help me to know what I truly want. I just don’t want to make the wrong
choice."
Counselor: "Let’s take it step by step. We’ll work through a decision-making process so that
you can feel more confident about your choice, knowing that whatever you decide will come
from a place of clarity and self-awareness."
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Outcomes of Intervention:
1. Improved Communication:
o Clara and Jake begin to use active listening and assertive communication
strategies, allowing for more constructive conversations about sensitive topics
like household responsibilities and future goals.
o They both feel more understood and respected in their discussions.
2. Increased Self-Esteem:
o Clara experiences a significant increase in self-worth and confidence,
recognizing her value in the relationship and her emotional contributions. She
feels more empowered to voice her needs.
3. Clarity on Emotional Needs:
o Clara gains clarity about her emotional needs, including the desire for
reassurance, connection, and shared future goals. She is able to communicate
these needs effectively to Jake.
4. Decision-Making Confidence:
o Clara feels more confident in her ability to make decisions about her
relationship. She gains clarity about her desires for the future and whether her
relationship with Jake aligns with those aspirations.
5. Strengthened Relationship:
o Clara and Jake’s relationship becomes stronger as they work through their
communication issues and align on shared goals, creating a more balanced and
fulfilling partnership.
Conclusion:
Using the Person-Centered Approach, Clara was able to explore her feelings of
insecurity, communicate her needs, and gain self-awareness, leading to healthier relationship
dynamics. The non-judgmental and empathetic counseling environment empowered Clara to
take ownership of her emotions and her future decisions, improving both her self-esteem and
her relationship with Jake.
Introduction:
This case study examines "James," a 42-year-old man who is struggling with a career
transition after being laid off from his job. With the Person-Centered Approach, the counselor
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creates an empathetic and accepting space for James to explore his fears, uncertainties, and
goals as he navigates the challenges of starting anew.
Case Background:
James has been struggling with feelings of self-doubt and fear about the future,
worrying that his skills might not be applicable to other industries. His loss of job stability has
caused anxiety, and he feels overwhelmed by the decision-making process. Despite his
concerns, James is eager to explore new opportunities but is unsure where to begin.
Presenting Complaints/Issues:
1. Fear of Career Change: James feels uncertain about transitioning to a new career path
and fears failure due to his age and lack of experience in other fields.
2. Low Self-Esteem: James doubts his abilities and feels insecure about his value in the
job market, especially after being laid off.
3. Anxiety About the Future: James experiences anxiety about the future and feels
overwhelmed by the possibilities of starting over.
4. Indecision and Lack of Clarity: James struggles with indecision regarding which
direction to take and lacks clarity on how to begin his job search.
Goals of Counseling:
1. Reduce Fear of Career Change: Help James explore his fears and gain clarity about
his career transition.
2. Increase Self-Confidence: Foster James’s sense of self-worth and value, regardless of
his previous job or industry.
3. Provide Clarity and Focus: Support James in identifying his career goals and creating
a plan for moving forward.
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4. Reduce Anxiety About the Future: Help James manage his anxiety and approach his
future with confidence and a positive mindset.
Intervention:
The counselor uses the Person-Centered Approach to create a space where James feels
heard and understood, allowing him to reflect on his emotions and identify his needs and
desires for the future.
Counsellor: James, I can imagine that losing your job has been a big shock, and it must be
difficult to navigate all the emotions that come with such a transition. How are you feeling
about everything?
James: Honestly, I’m scared. I’ve been in the same job for so long, and now I’m not sure
what I’m even qualified to do anymore. I feel like I’ve lost my identity in a way.
Counsellor: It sounds like you’re feeling a lot of uncertainty and maybe even some fear
about where you fit in now. That’s completely understandable. What would you say is the
most difficult part of this transition for you?
James: I think it’s the fear of not finding anything, or worse, not being good enough to get
hired again. I’ve been in this field for so long, but I don’t know if I can change or adapt to
something new.
Counsellor: It sounds like you're worried about your value and whether or not you can
transition into something different. Those fears are real, but I want to explore them with you
and see what options feel most aligned with your values and strengths.
Counsellor: James, I want to talk about your skills and experience. What are some things
you’ve done in your career that you feel proud of?
James: Well, I’ve managed some large projects, worked with diverse teams, and helped
improve systems that saved time and money. I suppose I’ve learned a lot along the way.
Counsellor: Those are impressive accomplishments! It’s clear you’ve developed valuable
skills that can be transferable to other roles. The fact that you’ve contributed to improvements
and managed teams speaks to your capabilities. How does that make you feel when you
reflect on your accomplishments?
James: Honestly, it makes me feel a little better. I hadn’t really thought about how much I’ve
actually done. I guess I do have something to offer.
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Counsellor: I hear that you’re feeling anxious about what the future holds. I wonder if it
might help to take small, manageable steps towards your next career. What would be a first
step that feels comfortable for you?
James: Maybe I could start by updating my resume and looking into what skills I might need
for the fields I’m interested in. That doesn’t feel too overwhelming.
Counsellor: That sounds like a great first step. Breaking it down into smaller tasks will help
reduce the pressure and make the process feel more manageable.
Counsellor: Now that we’ve talked about some of the skills you’ve developed, do any
specific career paths come to mind that you feel excited or curious about?
James: I’ve been thinking about project management in a different industry, maybe
healthcare or education. I like the idea of helping organizations run smoothly, but I don’t
know if my experience will translate.
Counsellor: Your skills in managing projects and working with teams are highly
transferable. Exploring these fields could be a great way to build on your strengths while also
allowing you to learn new things. It sounds like there’s potential for a fulfilling next chapter.
Outcomes of Intervention:
1. Reduced Fear of Career Change: James gains a clearer perspective on his transferable
skills, reducing his fear of career transition.
2. Increased Self-Confidence: Through exploring his past accomplishments, James starts
to believe in his abilities and feels more capable of adapting to a new career.
3. Increased Clarity and Focus: James identifies potential new career paths that align
with his interests and skills, providing him with direction.
4. Reduced Anxiety: By breaking the process down into manageable steps, James feels
less overwhelmed and more confident in moving forward.
Conclusion:
Through the Person-Centered Approach, James was able to explore his career transition
with empathy and support, overcoming self-doubt and anxiety. The counselor’s non-directive
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approach helped James identify his strengths, clarify his goals, and build confidence in
pursuing new career opportunities. James is now on a path toward a fulfilling and rewarding
career transition.
7. CASE 7-