Reference no: EM133974803
Assignment:
Scenario:
Lauren is a 36 year old Caucasian, heterosexual, single female living in the greater Philadelphia, PA area. Lauren has been living in the greater Philadelphia, PA area since she started her Master's degree program at 31 years old, and prior to that she lived in Pittsburgh, PA while completing her undergraduate program and she grew up in the central Pennsylvania area. During undergrad and prior to completing her Master's degree, Lauren worked various jobs including as an administrative assistant, tutor, bartender/server, receptionist at a bank, in retail, as a Therapeutic Staff Support, and as a substitute teacher. Lauren has always excelled in her studies and participated in many school activities, including soccer throughout high school and college. Lauren's health conditions include seasonal allergies and she experiences migraines. Lauren is currently a high school English teacher and has worked in this position since she graduated with her Master's degree a few years ago.
Lauren also works coaching youth soccer after school and on the weekends. Lauren also volunteers at a local animal shelter once per week, and occasionally fosters a dog or cat. Lauren is of a middle class socioeconomic status, but lives paycheck to paycheck due to bills (rent, student loans, etc.). Lauren has been previously engaged twice. Once from 26-29 and again from 33-34. Lauren broke off both engagements and was living with her significant others at the time of breaking off each engagement. The first breakup occurred 6 months prior to the wedding date, and the second breakup occurred shortly after setting the wedding date. Lauren's second engagement occurred within 6 months into dating. Lauren identifies dating since she was 15 years old, and rarely going more than 3-6 months without being in a relationship. Lauren often loses touch with her friends when she is in a relationship. Lauren has a few friends in her area, but does not consistently maintain contact with them, and only has 2 friends she considers close friends. Lauren identified that sometimes she feels like her friends don't really like her and that she does not have much to offer them, resulting in her not consistently responding in the past several months.
Lauren does not have any children and lives alone (no roommates or pets of her own). Her parents are married and still live in her hometown/childhood home. She speaks to both of her parents. She reports that they have a positive but strained relationship, and she often feels pressure to live up to her parents expectations and this causes tensions in their relationship. Her mother is a retired school teacher and her father is a retired Chief Financial Officer (CFO) at a mid-size central, PA company. Lauren is the middle child and has an older sister and a younger brother. Her sister Kristen is 38 and married with 3 children ranging in ages from 6 to 12 years old; Kristen is a registered nurse (RN) at a large central, PA hospital and her husband is a Physical Therapist. Her brother, Daniel, is 28 and works has in an advanced accounting position as a CPA and is in the process of starting his own business.
Daniel and his wife have been married for 2 years and are expecting their first child. Daniel's wife is a marketing representative at a pharmaceutical company. Lauren visits her parents approximately every 3 months or so and speaks to them on the phone once every 1-2 weeks, as she finds visiting and speaking with them more frequently results in increased arguments. Lauren speaks with her siblings about once per month and visits with them when she goes back to see her parents. Lauren identifies that she often feels overshadowed by her siblings and lost in the mix. Lauren identifies growing up in a relatively strict and religious family, where the expectations were set very high, and education and achievement were highly valued and prioritized. She identified that her parents often placed their values, goals, and wants on her, and this caused her to always chase achievement, feel unsettled, and live her life according to a checklist and strict timeline.
When Lauren does not meet her checklist, timeline, and falls short of her sister and brother, she feels low self-worth, lost, and highly distressed. This can cause Lauren to make impulsive decisions that may not always be safe or in her best interest. Lauren identified that she does not really have a sense of identity, and feels lost in the shuffle and never able to live up to her own or other's expectations. Lauren often doubts her decisions and never feels confident in her decisions. Lauren often finds that she later regrets decisions and is unsure about what she truly wants to be able to make a decision she feels confident in. In relationships, Lauren often feels like her significant other and the relationship as a whole do not live up to her expectations and leave her feeling unfulfilled. Lauren often feels let down by others (family, friends, significant others) and struggles to find relationships that meet her needs or expectations. In the beginning of new relationships, Lauren often rushes into the relationship quickly, and demonstrates patterns of codependency and an insecure-anxious attachment.
Lauren has been single for several months now (her longest stretch), and is finding it difficult to connect with anyone (family, friends, coworkers, etc.). Lauren has been diagnosed with depression and anxiety for approximately 2 years, but her symptoms have increased significantly within the past 6-9 months. She saw a therapist briefly after ending her last engagement, but she stopped about 6 months into therapy. Currently, Lauren has been struggling with feelings of low self-esteem, low self-worth, and feels as though she is unworthy of love and success. Lauren has recently had increased difficulty concentrating and this has caused her to make errors more frequently at work. Lauren has not received any formal disciplinary action, but her supervisor has provided constructive feedback regarding her work, causing Lauren distress.
Lauren is losing motivation for her job and feeling less satisfied in her work, and is questioning a career change. Lauren is ultimately unsure why she pursued this job, outside of her parents constantly questioning when she is going to pursue a "real, successful career." Lauren does not know what she wants her future to look like and is unsure where she belongs in this world. Lauren is filled with self-doubt and uncertainty about her present and future. Lauren feels lost without being in a relationship, inadequate and unmotivated in her career, feels like her family can "never understand her," and that others will never truly accept her for who she really is (even though Lauren admits she is not sure who she even is).
Lauren has very limited coping strategies and has increased her isolation from others, and is feeling more awkward in conversations and as though she cannot successfully build social connections/relationships. Lauren is unsure what her wants and needs are currently, and does not feel like she particularly belongs anywhere. When Lauren tries to connect with her family, friends, and coworkers, she feels like she is a burden and an outsider; and when they try to offer support she shuts down or feels further judged/criticized by their support/constructive feedback/suggestions. Lauren also feels that she is a failure and let down to the students she teaches and players she coaches. Lauren feels like she is an imposter and out of place in her jobs/career.
Lauren is interested in learning who she is and developing her own identity. Lauren identifies that she has trouble in her interpersonal relationships. Lauren identifies that she sets high expectations for others and when others do not meet her needs or support her fully, this causes significant distress for her and trouble in the relationship. In her family and significant other relationships, Lauren identifies that she often blames others and lashes out verbally in interpersonal communications when there is discord and when she does not feel the other party meets her needs or understands her; however, with her friends she cuts them off (without argument or warning) for a while when there are disagreements and discord.
Lauren identifies that her anxiety and depression can become overwhelming at times now and causes significant levels of stress that she does not have adequate coping strategies to manage. Lauren is not really sure of what her triggers are, and she says often her symptoms "come out of nowhere" in many (interpersonal) scenarios/situations. Lauren wants to feel happy, but in the past in therapy she was never fully committed to the changes she needed to take, did not feel she was fully capable of change, and was not fully willing to change (vocalizing on several occasions "this is just how I am" and "I don't want to make these changes, this is just me"). Lauren's current motivation wavers and at times she is still not sure she is capable of change; however, she knows that her life is not working as it is and is willing to come to therapy again to give it a try.
1. How can Cognitive Behavioral Therapy and techniques be used with this client?
2. How can Person-Centered Therapy and techniques be used with this client?
3. How can Motivational Interviewing Therapy and techniques be used with this client?