Utilizing one of the following: the Gestalt, Reality, Behavior, Existential or Person-Centered Therapy
Approach, complete the following assignment.
Case Study
Client Name: Roberta Windmill
Age: 34
Problem Endorsed: Relationship Problems, Loneliness, Depression, Dissatisfaction with Work, Identity
Referred By: Newspaper ad
Client Description
R. is a 34-year-old, slightly overweight, female, Caucasian carpenter who lives in a rural part of Oklahoma.
She wore loose clothing and spoke very slowly. Her mood was reported as being sad and somewhat
anxious. During the interview she was engaged but had trouble staying focused on the questions (would
become tangential and then ask “What did you ask me again?”). Motivation for counseling appears high.
Level of insight appears low to moderate. She reported no previous counseling experience and denied
having any suicidal/homicidal ideation.
Presenting Concerns
R. referred herself to the community counseling center to discuss several concerns. She reported her most
pressing concern as being her difficulty finding and maintaining a boyfriend. She added that she “only feels
good and fulfilled” when she is with someone else. When alone, she reports feeling “isolated, insecure, and
unattractive.” When she is with a man, R. feels “appealing, happy, and energized.”
R. also said that she “has never been completely comfortable” with herself. In particular, she said that she
has always felt “more masculine” than other women and more intrigued by interests and hobbies that are
appealing to men. She was quick to point out, however, that she is “very secure” in her heterosexuality and
hates hearing accusations that she might be a lesbian. R. has not had a date for six months, but reported
that in high school she had a steady boyfriend and in college she met the “love of her life.”
R. lived with her college boyfriend for a few months, but then moved out when he dropped out of school.
This departure was very difficult for R., especially when she heard that he immediately started to date a
model. Now, R. said she feels it is “almost impossible” to meet men because she has very high standards
and she fears that if she starts a relationship the man will “definitely be a control freak.”
A second concern for R. is her dissatisfaction with her work and her continued difficulty attending to details.
She described her work as “boring” and noted difficulty relating to her co-workers who are all men. In
addition, she reported struggling with connecting with the women at work who are mainly in administrative
positions. She stated, “They just want to talk about make-up and hair styles.” In general R. reported longstanding difficulty maintaining friendships and romantic partners.
At work, R. considers herself to be doing well but recently denied a promotion because of her distaste for
paperwork. When required to read, R. becomes quite anxious. Consequently, she has ignored several
recent memos. She is convinced that her co-workers “are aware” of her anxiety. She stays at her job
because she is “certain” that she will not find something else.
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Family and Developmental Background
R. is the oldest of three children. Her younger sister is a 28-year-old law student at Yale University and her
brother is a 31-year-old web page developer in Herndon, Virginia. Her sister is married and has one child.
R.’s brother, described as “my parents’ favorite,” is single. R. reported “civil” relationships with both siblings,
but said she gets “furious” at them for making fun of her career and treating her like a child. She described
her parents’ relationship as “pretty good” but added that they “always seem to be keeping things secret”
and that “little gets talked about in our family.” Her father was formerly a general in the army but is now a
school teacher, as is her mother. R. talks with her parents on a weekly basis. These conversations are
described as “tense and short” as R. tends to lose her temper towards her parents over some of her
frustrations.
R. feels that her mother is the cause of all her difficulties. R. stated that her legs are “bowed” because her
mother pushed her to walk too soon during infancy. R.’s impression is that her mother tried to control her
and her father did not stand up for her. She also has vivid memories of being told she has to “work harder
and longer” to succeed, which she considers to be the cause of her high expectations and frequent
disappointment in her own performance. As a child, R. and her family moved frequently because of her
father’s position in the military. An especially difficult memory for R. was leaving the security and
acceptance she felt at her small junior high school to attend a considerably more competitive high school.
R. noted that she has many hobbies including canoeing, jogging, and making furniture. However, she has
noticed that she doesn’t stick with one thing and frequently becomes bored. As a furniture maker, she
received several offers from others interested in buying her work, but declined them as she felt her work
was not “good enough ” to sell.
The following is the written transcript of your session with Roberta.
T–Therapist
C–Client
T: Roberta, could you tell me about some of the reasons why you’re here today?
C: Well, I am having some trouble with relationships. I just can’t seem to find a man.
And it seems whenever I do find one, it never lasts. The only time I seem to be happy
is when I have a boyfriend. Lately, I’ve just felt really unfulfilled.
T: What is it like for you to be fulfilled? I wonder if there are any other moments in your
life, besides being with a man, when you might feel at least somewhat fulfilled?
C: To me being fulfilled means that you know others are caring and thinking about you.
I love to be told that I am beautiful and attractive. Sometimes I’ll even ask these
questions directly to my boyfriends—just because it feels good to hear the answers.
Other times when I really feel fulfilled? None that I can think of right now. That’s one
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thing I would like to work on, not being so in need of admiration to feel good about
myself.
T: You mentioned having problems sustaining relationships. I’m curious if you could you
give me more of a feel for the actual pattern of your relationships? That is, how do they
usually start and end? And what is the middle phase like for you?
C: I think I tend to stay the same—well for the most part. It doesn’t take much for me
to fall for someone. If he treats me right I will give my all to him. I guess after dating a
guy for a while, I start to wonder why it is that he is going out with me. I don’t say that
to him or anything, but I think he can kind of sense it. I know that was the case with my
last boyfriend. So after about a month or two things tend to get rocky. And then at the
end, I find myself feeling desperate asking the guy not to leave me. And then I get real
depressed.
T: Given the tensions that you described in your family relationships, I am curious about
your current support system. Can you tell me more about your relationships with friends?
Who do you look to when you need someone to lean on?
C: Well I don’t have too many friends right now. Women seem to be intimidated by me
and men don’t seem to understand me either. I have two friends from my hometown
that call me all the time. But they always want me to solve their problems. The irony
is that I have more troubles than both of them—I guess I just hold it inside more than
they do.
T: Can you tell me a little more about your work right now, including your relationships
with the other carpenters?
C: Well, like I said, I’m the only woman at work. So they make a lot of cracks about
women they see at the jobs. They’ve never said anything really offensive to me. In
all honesty, I think they are kind of funny. The only thing that bugs me is that I think I
could be friends with them but I’m definitely not “one of the guys.” So I feel kind of
isolated and lonely at work. There are a few of the guys that I would like to go out
with, but I’m sure they wouldn’t be interested.
T: You mentioned having a difficult time attending to details and reading. Have you ever
had any testing done to identify your strengths and limitations in these areas?
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C: I had some testing when I was in high school. I took some achievement tests and
everything was “normal” as far as I know. I don’t really know my strengths and
limitations as far as school goes.
T: Was there a specific time in your life when you felt that your problems attending
to detail and listening became more intense?
C: I guess maybe in the last few years it has been worse. I’ve had a lot more
responsibility, which is kind of overwhelming. If there is too much to handle, my
mind will just kind of shut down. But I think that I’m the only one who notices. Everyone
else thinks I’m doing just fine.
T: I was wondering if you could tell me a little more about your decision to leave college
after your sophomore year?
C: College was all right. I mean now that I think about it, the dorms were a blast. But
academically, I didn’t really fit in. One of my teachers told me I was better suited for
a vocational school. I was mad at him, but then I realized that maybe he was right.
And the girls in college were way too “prissy” for me. So I decided to bail.
I didn’t think about it that much.
T: What was it like for you in school?
C: I’m sorry, what did you ask me?
T: I’m just wondering what your school years were like for you.
C: I actually did pretty well in high school, mainly A’s and B’s — especially in math
and science classes. I think I was just a little more focused during high school. In
college, I questioned myself more. I didn’t think I was smart enough to do well.
T: What do you do for fun?
C: Hmm… that’s a good question. I guess it’s not all that easy for me to have fun
these days. For the past four years or so, I feel I’ve really aged and I have a hard
time not worrying about things. I tell myself that there is always something to do-
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so relaxing is not that easy. I think that is related to all of my attention problems.
I can’t focus on things because I start worrying about everything else that I’m not doing.
I really wish I could have more fun
T: You mentioned that you currently drink alcohol three to four times a week, and up to
four to six drinks on each occasion. Do you tend to drink with others or alone? And what
are your feelings about drinking?
C: Well I usually have a few beers after work with the guys, just to take the edge off. I
‘m pretty tense most days and alcohol helps me to relax. I usually drink with others, but
if there are beers around the house I will often drink them alone. It helps me to fall
asleep. I don’t think I have a drinking problem or anything. I’ve never thrown up or
passed out if that’s what you are trying to get at.
T: And lastly, what was this session like for you? How are you feeling about entering
counseling?
C: Well, I guess I feel pretty good about the session. We got to cover a lot of ground.
I’m a little nervous about what’s ahead, but I’m pretty motivated to change some things
in my life.
Review Corey (2019) chapter 6,7, 8, 9 or 11. After your review, answer the following questions.
1. Briefly define your the approach you chose. Then based on that approach what is your preliminary
conceptualization of this case? From what evidence have you formed this conceptualization?
2. What additional information would you seek with this client to aid in your
conceptualization? Why would this information be useful given your selected
approach?
3. Identify any pertinent multicultural concerns in this case. How, if at all, might your
selected approach account for these multicultural concerns?
4. What are your preliminary treatment goals?
5. What role do you consider the therapist/client relationship to have with this
particular client?
6. What facets of this theoretical framework do NOT seem to fit with this particular
client and the case material? How would you account for what might be missing?