I’m trying to learn for my Health & Medical class and I’m stuck. Can you help?
Please read the case study below and reflect upon the following questions:
1. What is your assessment of this client (Assessment)?
2. What are the most important problems in the case (Boiling Down the Problem)?
3. Identify one good SMART goal for the client (Goal Setting).
4. What makes the goal you identified Specific/Measurable/Attainable/Realistic/and Time Oriented (Goal Setting)?
Case Study by: Deirdre Stevenson
Fritz is 42 years of age and has been in Australia for the past 25 years. He migrated from Germany with his immediate family, comprising of his mother, father and two sisters. At the age of 17 Fritz was filled with great dreams and aspirations for his new life in a new country and until recently had been quite happy with the life he had carved out for himself.
Fritz has sought counseling largely due to the persistence of his wife. Fritz does not really understand why his wife is so upset with him but states that she thinks he is going through a “mid life crisis”. A summary of the sessions is as follows. For ease of writing the Counsellor is abbreviated to “C”
In the first session ”C” focused on establishing a clear understanding of the presenting concerns before moving any further with the client. Fritz was having difficulty explaining the details of the present situation and why his wife seemed so concerned about him. Basically he didn’t see much of a problem and simply wanted to try something new because he was feeling bored and restless. “It’s not like I’m having an affair” he asserts. From this first session “C” was able to elicit useful background information and began to build much needed trust and rapport with Fritz as he was quite skeptical towards the benefits of counseling.
Essential Case Information
Fritz is a Personality Need Type A with moderate to strong needs for self recognition. He has been married for 19 years and until recently has had a reasonably happy relationship with his wife Anna. “Of course we have had the usual ups and downs like most couples”, Fritz explains, “but overall things have been all right”. Fritz finds it hard to describe what the discord is about and simply states that “Anna believes I am neglecting my family responsibilities and says that I appear distant and uninterested in her and the boys”.
Fritz has two boys, Ric (13) and Hans (15). Fritz describes them as generally good boys who are developing their own interests and he feels that they don’t need him as much any-more. He believes that they would prefer to hang out with their friends rather than their “old” dad anyway. Hans the oldest son has been getting himself into a bit of mischief lately, not attending school some days, causing disruption when he does attend and he has also been caught shop-lifting on a few occasions. Fritz dismisses this behavior as “kids stuff” and thinks that his wife is over reacting. He simply states that “Hans will grow out of it”.
When “C” encourages Fritz to discuss the situation with Hans further, Fritz states that he has more important things to worry about. He goes on to explain that he is a Butcher by trade and runs his own delicatessen. Business has been slow lately and he is afraid that the large chain stores are finally going to ruin his business. Fritz has not discussed his financial concerns with his wife or the disappointment he feels at never being able to achieve his long term dream of expanding and establishing other shops in the surrounding areas. Rather he has decided to sell up and is thinking about moving away from the city.
Fritz continues to explain that when Anna found out that he had approached buyers for the shop she was furious and could not understand why he had not discussed it with her first, after all it was her inheritance money that enabled Fritz to purchase the shop in the first place and besides, he had always consulted her in the past on important decisions. “C” clarified with Fritz that this was indeed correct, that in the past both he and Anna discussed important decision and came to an agreement. Fritz replied “yes, that’s right”.
Over the past few weeks Fritz has been withdrawing more and more from the family hoping to avoid further conflict, he has busied himself finalizing details with the sale of the shop (he is determined to go through with it despite his wife’s resistance) and arranging alternative plans. He does not see that such avoidance behavior is actually creating more conflict and simply asserts that “Anna will come round when she gets used to the idea”. Anna has threatened Fritz with a divorce and states that she is not going to let him drag the boys out of school and away from friends and family.
Fritz has entertained the thought that perhaps life would be much simpler if he did go it alone, shake off all his responsibilities and simply do those things he has always wanted to. “It’s not to late” he stated “I’m still young enough to enjoy myself”. However, Fritz knows that he still loves his wife and a divorce would make him feel like an even bigger failure.
It is obvious to “C” the amount of stress that Fritz is under and the fact that he does not share his fears and anxieties with anyone only heightens the sensation. At the conclusion of the first session “C” runs through some relaxation techniques with Fritz which he can implement immediately to help alleviate some of the symptoms of stress.
It is also apparent that Fritz needs to communicate with his wife and family, however “C” will endeavor to teach him some effective communication skills in the next session.
Author: Deirdre Stevenson
Related Case Studies: A Case of Stress (Links to an external site.), A Case of Stressful Life Change (Links to an external site.), Case Management of Anxiety and Stress