COUN6041 – Assessment 2 – Case Scenarios

UAU

For Assessment 2, please choose one of the following four scenarios.

Case scenario 1

Jonah, 25-year-old student complains to his counsellor about difficulty completing his doctorate and has concerns about relationships with women. He believes his thesis topic will have a profound impact on the area he is working within and will make him famous, however he has been unable to move beyond the 3rd chapter. His mentor does not express that same level of enthusiasm towards the topic, and Jonah is furious with him, but also self-doubting and ashamed. Jonah blames his supervisor for his lack of progress, thinks he deserves more help, and his supervisor should contribute with the research. Jonah brags about his creativity and complains that people are jealous of his insight. He describes the other students who are further in their research as ‘dull drones and ass-kissers’ but is envious of their progression. He describes his classroom participation as brilliant and imagines he will become a great professor.

Jonah becomes rapidly infatuated with women and has powerful and persistent fantasies about each new woman he meets, but after several experiences of sexual intercourse he feels they are disappointing and then finds them dumb, clinging and physically repugnant. He has many ‘friends’ but they turn over quickly, and relationships don’t last long. His continual self-promotion and lack of consideration tends to wear thin. For example, he was going to be alone at Christmas, so he insisted his best friend stay in town rather than visit his family. The friend refused, expressing he found the request self-centred, at which time Jonah decided to never see this friend again.

Case scenario 2

Oskar is a 19-year-old university student who was brought to the campus counsellor by campus security. He was picked up sitting on a ledge on the second floor of a building, talking to doves, and reporting that he can understand the doves’ communication and they talk to him. He denies that he wanted to jump off the ledge and states that, on the contrary, roofs and ledges are “some of the few safe spaces left”. He says that he enjoys the doves’ company and that he no longer trusts people since he his car and unit were bugged, and since he is being monitored by secret agents. He said that he no longer uses his phone or laptop so that he cannot be tracked easily.

Oskar successfully completed his first year at university, but his grades declined over the last six months and he has all but withdrawn from his courses. He says that secret agents started following him sporadically about a year ago but increased their surveillance after he moved into his own place about six months ago. He says that he stopped seeing his friends around that time as he suspects that they were feeding information to the secret service before he moved out. At the counsellor’s practice, Oskar speaks with a monotone voice and has restricted affect. He sometimes seems to look up at the corners of the room as if searching for something. He assures the counsellor that he does not use alcohol or illicit drugs because “I need to stay on the top of my game”. He states that his uncle had been “murdered by secret agents at a psychiatric hospital” and that he needs to be alert so that he will not suffer the same fate.

Case Scenario 3

Jane is a 42-year-old woman who is worried about losing her employment and is seeing a workplace counsellor. She says that she was always somewhat anxious, even as a child, and has been worrying about things all her life. One of her worries is that she will contract a fatal disease when touching a lift button, a door handle, or a railing. She says that she knows that his fear is irrational but that she cannot help being afraid of touching things that hundreds of other people have touched. She reports that she was under considerable stress about 5 years ago, when she had to retrain at work, felt financially insecure and, at the same time, had health concerns. At that time, she developed an intense fear that her home was unlocked and would be broken into. She started having intrusive thoughts that it would be her fault if the house was burgled if she did not repeatedly check all the locks.

Jane says that she now checks the doors and windows twice in the morning and at least twice at night, each time in a specific sequence. She says that checking in a specific sequence usually reduces her fear of making a mistake. However, sometimes she gets up in the

middle of the night to check the doors and windows again. Jane reports that her intrusive thoughts about making mistakes are getting worse and that her checking rituals are taking up more and more of her time, leading her to be late for work most days of the week.

Sometimes she feels compelled to drive home from work to check whether doors and windows are properly locked. Her colleagues have noticed that she arrives late in the morning and sometimes disappears for an hour during the day without explanation. Jane is worried about losing her employment and a colleague encouraged her to see the workplace counsellor.

Case scenario 4

Joe is a 48-year-old male who works in electrical retail, who came to counselling because his long-term male partner Adam had presented him with the ultimatum that either he would seek help, or he would leave him. Joe says that he does not want to lose his partner but, at the same time, thinks that Adam is worrying too much and blowing things out of proportion. Joe reports that is enjoys social gambling, namely horse racing, and has done so when he was in his early 20’s. He more recently moved to using the Sports Bet App and enjoys connecting with his other mates who gamble using the same App.

Sometimes they place bets together. He reported that he can lose up to $500 a week but also has occasional wins and takes himself and his partner out for dinner. Joe reports that he has had bouts of depression all his life and is currently overweight. He finds that eating and gambling give him pleasure and some enjoyment when things are not going well with his work or with his partner. He describes being in a rut at work and not achieving promotions. He also enjoys drinking socially and finds that he can easily lose track of his gambling when he has had several drinks at the races.

Joe recalls gambling when he was younger, in his early 20’s with his uncles and older brother at the local TAB and horse races. He described these times as the ‘happiest days of his life’ and felt close to his family. His parents never approved of his gambling and were critical of Joe for not doing better academically at school and at university. He is currently taking an anti-depressant which he has been on for several years and is not sure if its still effective. Joe reported also using cannabis for several years in his 20’s and only smokes occasionally now. He describes his relationship with Adam as loving and supportive, although they have not been sexually intimate for the last few years and he feels unattractive and rejected. Adam is increasingly concerned about money that is being withdrawn for their joint account as a result of Joe’s gambling.

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