HSE-352 Final Project I
Tabbie Bozeman
February 16, 2025
Presenting problem :
Client presents to this appointment under mandatory requirements after obtaining a
DWI. Katie N. a 32-year-old married mother of two. She claims that the DWI wasn’t her
fault, “ she only had three drinks.” (Katie N. case study) Per Kate she has a history of
substance abuse, starting at the age of fifteen. She moved on the marijuana, but feelings of
paranoia stopped her from continuing with that particular substance. She then moved on to
cocaine. Claims to have more fun when high, helping her forget her anxiousness. She even
dabbled in ecstasy for a bit, but went back to cocaine and alcohol. She only quit cocaine
because she had children, and it became too expensive. She did attend cocaine anonymous for
a while but claimed that she didn’t want “God stuff shoved down her throat.” (Katie N. case
study)
Family History:
Katie starts her family history at the age of nine, when her sister Sarah died in a crosswalk
accident. She states she was distracted by a cat and that is why she was on the sidewalk. The
drive wasn’t looking, even though Sarah looked both ways before crossing. She blames
herself for her sister’s death, feeling like if she hadn’t been distracted by the cat, she might
have been able to prevent the accident. She refused her parent’s attempt at counseling when
she was younger. She describes her childhood as darkness. Her mother heavily drank after
her sister’s death and her father had to take care of her. Her other sister Amanda struggled
with an eating disorder. She is married with two daughters. She admits that her and her
husband fight about her drinking and money. She relies on her ten-year-old for physical and
emotional support.
The most pressing problems for Katie include her substance use and her past childhood
trauma. The death of her sister might have been the catalyst to her substance use. Getting her
to understand that her substance use may be an issue is no easy task. Throughout the interview
she makes excuses for why she is drinking or using drugs. Starting at the age of fifteen,
throughout her high school years and currently.
There are two counseling approaches I would use with this client. Cognitive Behavioral
Theory and Person-Centered Therapy. Katie is in denial about her substance abuse, her issues
within her marriage and the trauma of her childhood family life. Cognitive behavioral therapy
will help her come to terms with her thoughts, feelings, behavior, and relationships. (Corey,
2021) I think this approach goes a long way in helping her change her thinking to positive
thoughts. She has a lot of bad feelings about her job, lack of education, where her friends are
career wise and how her dad is with her for not pursuing a medical degree. She is
compounding her issues by adding substances. There may be some depression, guilt
surrounding the death of her sister, issues in her marriage and low self-esteem. If we can get
her to identify her negative thoughts and turn them into positive thoughts and actions, she will
have success. There are some techniques that she can benefit from like;
Breathing exercises: controlled breaths that calm your body
Muscle relaxation : working different muscle groups to release tension
Meditation: full attention on the moment
Journaling: putting your thoughts and feelings on paper, to be able to reflect on later
Cognitive restructuring: identify and change thought patterns
Activity scheduling: plan positive activities, staying away from avoidance behavior
Role-playing: acting out difficult situations and conversations to help build the client
response to them and their confidence
Self-monitoring: tracking to identify triggers
We want to identify Katie’s negative thoughts, challenge them, so that she reevaluates
those thoughts. Develop healthier habits, unlearning negative behaviors. Improving problem
solving, like the issues within her marriage. Build confidence in her own abilities. Improve
resilience and assertiveness when faced with difficult situations.
The second approach would be person-centered therapy. This approach focuses on a non-
judgmental and supportive environment, this helps client’s explore their experiences and start
understanding themselves. You as the therapist provide a safe space in which the client can
speak openly about their thoughts, feelings and experiences. You paraphrase back to the
client so that they know you understand what they are saying. No interpretations or advice is
given, only encouragement for the client to explore their own thoughts and feelings. There
are five key principals to this approach;
Client-centered: the client is the expert in their therapeutic process
Empathy: the counselor listens and tries to understand from the client’s perspective
Unconditional positive regard: accept the client for who they are, without
judgement
Congruence: be genuine and authentic with your client
Self-actualization: belief that the client has the capacity to grow and reach full
protentional.
The goal of person -centered therapy is to help the client feel empowered to live their
most authentic lives. There are some techniques to person-centered therapy that Katie can
benefit from;
Non-directiveness: let Katie lead the session, do not give advice or strategies
Active listening: listen without judgement and verbally respond to what your
client is saying.
Reflection: mirror back what your client is saying, this will help them gain
insight into their feelings
Unconditional positive regard: again, accepting the client for who they are
Empathy: understanding the client’s emotions
Open-ended questions: questions that help your client open up more
We want to develop self-awareness so that she understands herself better. Katie needs
self-acceptance, this helps her understand herself and her feelings. Personal growth, helping
her develop skills and solutions. Self-esteem, helping Katie feel more self-worth.
Empowerment, learning how to manage their lives. Trust, making sure your client trust you,
so that they are open and honest. Congruence, aligning their inner feelings with their outward
behavior.
Katie has a lot of self-doubt and self-esteem issues. These two approaches work best
in my opinion, because it allows her to be in charge of therapy. She is in denial about her
substance abuse, her home life and where she could end up. Getting her to understand that the
DWI could be the first of many instances that she could have further problems. Gaining her
trust and getting her to understand, without judging her. Letting her own her therapy, so she
feels in control of her growth and the choices she is making.
Katie N. case study
Corey, G. (2020). Theory and Practice of Counseling and Psychotherapy, Enhanced (10th ed.).
Cengage Learning US. https://mbsdirect.vitalsource.com/books/9798214354903
