1. Case Study One: The Case of Mary

Presenting Information: Mary is a 29-year-old white female. She is divorced with two children, a four-year-old daughter and a 10-year-old son. She is currently in a relationship with John; they have been together for about a year. John was recently laid off from his job with a small local manufacturing company.

Mary presents to counseling with multiple concerns. She reports feeling tired and lethargic most of the time and does not sleep well. She feels decreased motivation in general and a discontent in her life, feeling like a dark cloud follows her around. She does not enjoy her life as she once did. She states, "I feel like every day is just a struggle, and I do not know where to turn." She also reports having a lot of relationship problems and challenges with her son. In her relationship with John, she feels that he ignores her and puts everything else first. She says that he just stays with her because he has no where else to go, and that he does not even want to talk to her about how she is feeling in her life or about her financial concerns. She says that she loves him, but she is worried about his lack of ambition, and she is not sure she wants to stay in the relationship. She states that she cannot trust John even though she has no reason not to trust him. She also reports that her son is getting in trouble in school and that she is at a loss for what to do. He has been sent home a few times in the past three months for fighting physically and verbally, and she feels like she is a bad mother because she does not know what to do to help him.

Social History: Mary has lived all her life in a small rural town outside a larger city. Mary was first married at age 19, when she and her boyfriend discovered she was pregnant. She was married to Mark for six years and got divorced just after having their daughter, her second child. She states that her ex-husband was controlling and says, "He kept me on a tight leash and never gave me any slack." She reports that he had bouts of using drugs and had an affair early in their marriage. She says she tried to get over the affair but could not, stating, "I could never get the image of catching them together in our bed out of my head." She states that the decision to divorce was mutual but that he made it very difficult as he helped minimally with the kids. He is now seeing the kids twice a month and pays a small amount of child support through the state, but she says that she worries about what is going on at his house when he has the kids. She reports that her son comes back angry and defiant after staying at his dad's house for the weekend.

Mental Health and Addictions History: Mary states that she used marijuana in her early 20s but has not used it in five years. She only drinks alcohol occasionally, having a few beers once or twice a month. She reports that she felt she was depressed while in her marriage but never sought counseling or treatment because her husband would not have let her.

Family History: Mary is an only child. She states that her mother and father were divorced when she was 14, and she feels like she never got over that. She says, "I can just remember how they fought and yelled like I wasn't even there. I hated that time in my life and I hated my parents." She reports that she ran away from home several times during her early teen years and that there was never enough money for her to do the things she wanted to do in school or for extracurricular activities. She states that her relationship with her mom is supportive now, but she has little contact with her dad. Mary later found out that her dad was having affairs while he was married to her mom, and Mary states that she just cannot forgive him for putting them through that. Although Mary's mother is now sober and supportive, she lives about an hour away and works full time. Mary states, "I don't want to burden my mom with my problems or my kids."

Occupational and Educational History: Mary went away to college but dropped out when she got pregnant and married. She got a CNA license and started back to school a year ago to work toward a nursing degree. She works full time and lives paycheck to paycheck. She is worried about her job, saying, "I just can't get the motivation to do a good job ... and sometimes I can't even get out of bed to go in." She is also ambivalent about being a nurse. She states that she should since she has been a CNA, but that she has no motivation to go to school anymore and her grades have been dropping.

Question

1. For this discussion, you will apply either psychoanalytic or Adlerian theory to the client Mary (see the case study narrativeThe Case of Mary in the Resources). Specify how the theory conceptualizes Mary's problem, identify key concepts that can be applied, and discuss two specific interventions you would use with Mary. Identify a limitation of applying the theory to this case.

2. Refer to your readings and the mini-lecture by Dr. Sue and prepare a posting that describes your understanding of MCT and review the implications of MCT for counseling practice. How does MCT expand the practices and roles of counselors as therapists, as compared to traditional practices and roles? What is the significance of a client's social and cultural context within MCT and how does MCT challenge counselors to intervene at the systems level?

3. Sue and Sue (2016) illustrated similarities and differences among people, and the powerful influence of perceived group membership on how we view others and how we view ourselves. Considering the article you read for your specialization area, discuss the impact of group membership or memberships as they relate to the population you read about and your specialization area.