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Name: Aaron B. Gender: Male Age: 17

Ethnicity: Syrian-American Religion: Jewish

Relationship Status: Single

Description of Presenting Issue:

Aaron was referred for counseling by his physician. Aaron is a star athlete on the high-school track team and attributes all his symptoms to his efforts to be the best possible runner that he can. He eats little, limiting his diet severely, and now weighs only 120 pounds, even though he is 5'10" tall. He believes that if he can lose another 10 pounds, he will be able to run even faster. Aaron keeps lists of everything he eats, weighing each food item and computing its fat content. In addition, he tracks his daily training by keeping a record of how many minutes he runs and how many steps he takes, counting his steps as he runs. Aaron also has many other lists that guide his life, including a list of every possession he owns and every person he talks to each day. If he forgets to include an item on one of his lists, he becomes very anxious and only calms down when he has recopied the list with the forgotten item at the top of the list. He tends to check his lists repeatedly, making sure that words are in alphabetical and size order. Despite his youth, he has few friends and activities other than his running, but is able to work delivering pizzas.

Occupation History: Part-time pizza delivery

Education History: Currently attends high school; maintains a B+ average

Medical History: Aaron acknowledges that he has developed osteopenia (thinning of the bones) and also tells you that he has knee and shin pain.

Family History: Aaron is an only child. His mother and father divorced when Aaron was 10 due to his father's infidelity. Aaron lives primarily with his mother. She owns a successful interior design business and travels frequently. Aaron describes his mother as hard-working, with high standards and expectations. Aaron's father works in the finance industry, was remarried four years ago, and has two children (ages 1 and 3) with his second wife.

Alcohol / Substance Use: Aaron does not smoke, drink alcohol, or use illegal substances. He occasionally takes Vicodin (a painkiller) prescribed by his physician for his knee and shin pain.

critically evaluate the client Aaron using either a cognitive or RET approach. Make sure you address:

The strengths and limitations to using this approach with this client

The specific cultural/gender/age issues that need to be attended to with this client

The ethical or legal issues that need to be attended to with this client

The overall therapeutic goal with this client

How you would proceed with this client:
How would you begin?
What would be the goals of therapy?
What specific strategies and/or techniques might you use?

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Solution Preview

Critically evaluate the client Aaron using either a cognitive or RET approach.

Aaron appears to be suffering from a form of depression related to irrational thinking. For example, in his desire to be the best runner, he is eating less and limiting his diet in the belief that it would help him to run faster. In addition, he meticulously keeps a list of every possession he owns, and every person that he talks to. He also tracks his daily training, and counts the steps he takes as he runs. Thus, in exhibiting this behavior, Aaron is setting unrealistic expectations, of what he should do to be the "best". Moreover, his behavior is counterproductive evidenced by symptoms that have brought him to therapy. His irrational behavior is affecting his mood.

Thus, Aaron may be able to be treated from a behavioral perspective such as Rational Emotive Behavior Therapy (REBT, Ellis, 1987). According to Ellis (1987) distorted thinking and cognitive patterns damage one's happiness as a result of irrational beliefs. The REBT approach proposes that individuals are happiest when they have realistic expectations and goals. The rational approach implies that individuals achieve basic goals with clearly defined purposes, and the irrational suggests that certain behaviors prevent the individual from achieved their goals and purposes (Dryden, l984 as cited in Capuzzi & Gross, 1007, p. 271).

The strengths and limitations to using this approach with this client

Ellis ...

Solution Summary

This solution evaluates the case of a specific client.

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Evaluating a client's profile is modeled.

Name: Patrick Gender: Male Age: 33

Ethnicity: Caucasian Religion: None

Relationship Status: Divorced

Description of Presenting Issue:
Patrick is a firefighter who was present at the September 11 collapse of the World Trade Center. Several of his colleagues were killed on that day despite Patrick's heroic efforts to rescue them. Patrick received serious burns and has scars on his face and arms. Since September 11, he has experienced considerable anxiety, difficulty concentrating, and hyper vigilance, as well as intrusive and recurrent images of the towers collapsing. He has found it difficult to fight fires in tall buildings since that time and has become detached from his work. This has left him feeling very isolated because his colleagues at the fire station are his only friends. Patrick has been a loner as long as he can remember. Although he often fantasizes about having close friends, he is fearful that others would reject him if they came to know him well, and so he tends to reject others before they have the chance to reject him. He views himself as having poor social skills and rarely risks meeting new people.

Occupation History: Patrick became a firefighter in his early twenties. Prior to September 11th, he was very happy with his career choice.

Education History: Patrick graduated high school with honors. He briefly considered military service upon graduation, but was eager to begin work as a firefighter.

Medical History: Aside from the injuries suffered at work, Patrick is in good health. He maintains a regular exercise regime for his job.

Family History: Patrick had an older brother who was killed in an automobile accident when Patrick was 6. His parents divorced shortly after the death of his brother, and his mother remarried a man who had two daughters from a previous marriage. Patrick married shortly after high school graduation, but the relationship ended the subsequent year due to mutual dissatisfaction with the marriage. He is not currently dating.

Alcohol / Substance Use: Patrick drinks 3ââ?¬"4 times per week, 3ââ?¬"5 drinks per occasion. He does not smoke or use illegal substances.

Critically evaluate this Client Profile using either a Gestalt or Existential approach. Make sure you address:

The strengths and limitations to using this approach with this client

The specific cultural/gender/age issues that need to be attended to with this client

The ethical or legal issues that need to be attended to with this client

The overall therapeutic goal with this client

How you would proceed with this client:
How would you begin?
What would be the goals of therapy?
What specific strategies and/or techniques might you use?

* Please include an introduction and a summary conclusion.

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