James is a community counseling student who is interning with the College Counseling Center at the local university. James is a 25-year-old Caucasian male, who attended a private high school in a small rural town.
In terms of being a counselor, James admits that one of his challenges is that he has not experienced much diversity in his relationships. He states that this is not a significant issue because he plans on opening a private practice in his hometown as soon as he graduates. Since he “knows the town” he doesn’t feel that this is a big deal.
Also, in terms of finding clients, James states that he is sure he will be able to get referrals because his father works for the town newspaper and will run an ad as soon as he moves home. James admits he has no clinical experience but is pleased, upon arriving at his internship site, to see that his ex-girlfriend is going to be his assigned clinical supervisor. Since they have not seen each other in years, James figures that meeting once a week will give them a good opportunity to catch up on “old times”.
James also figures that she could continue to supervise him in private practice until he receives his license. James is relieved because he knows she won’t mind, since he will be graduating in nine months, if he puts her credential, Licensed Professional Counselor, after his name since she is supervising him. After discussing private practice, James asks his ex-girlfriend if he can begin to see clients right away because he is anxious to get experience and begin working on his practice.
Since she figured he would be a pretty good counselor, she agreed and paired him up with Lisa, a 21 year-old Latina female. During the first session, James was running late and was unable to fully cover all of the intake documents with Lisa. He put them aside and said, “We don’t really need to review these. It is just paperwork required by the Center. Please sign here.” As the counseling session continued, James thought he might have recognized symptoms associated with depression including decreased motivation, loss of appetite and overall dissatisfaction. He thought about bringing these up with his supervisor but forgot once he left the session. James continued to meet with Lisa.
The first few sessions focused mainly on her recent break-up with her boyfriend and the resulting academic difficulties. She was very concerned that her career dream of becoming a lawyer may be in jeopardy. In the third session, Lisa casually mentioned that she began to experience depressive symptoms as a child when her mother’s partner began to physically abuse her at the age of 5½ years. Lisa told her mother about the abuse, but she did not intervene. Shortly after the physical abuse began, the man began to also sexually abuse her.
Once again, Lisa reported this to her mother and also to a teacher at her school, but nothing was ever done. Lisa reported that when she was 7, she placed an unknown prescription medication of her mother’s into this man’s alcoholic drink. Later that same day, the man experienced a stroke and was rushed to the hospital where he later died. Lisa also reported learning that her mother’s partner’s stroke and subsequent death were related to the combination of prescription medication and alcohol. The client has never told anyone other than James that she had placed medication in this man’s drink.
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