Case Study #4
Belinda is a 20-year old female. During the past 8 months, she was in a multiple, car wreck due to a drunk-driver passing her on the way home for summer break from college. As a result of this wreck, Belinda sustained a spinal cord injury, a mild Traumatic Brain Injury, and a broken left wrist. At last report, there were no injuries to the other driver. When she comes to see you, her wrist has healed and she continues to participate in out-patient physical therapy twice a week.
Belinda comes to see you for counseling because she notices several personal issues and concerns starting to surface and reports feeling discouraged, angry, and overwhelmed. Prior to her accident, Belinda completed her first year of college and was taking core classes required of all students, but expresses an interest in business. In addition, she states that her boyfriend of 3 years has left her because he does not want to deal with her “situation”. She has also noticed some so-called close friends disappearing one-by-one. Furthermore, her father is not handling her injury very well and from time-to-time makes negative and hurtful comments about her disability and her ability to not yet be fully independent. He also, on occasion, when he thinks she is not listening, makes comments to her mother that “No one will ever probably want to marry her……..” Complicating matters is the notion that her parents ascribe her accident as something negative due to the fact that they are highly religious and do not feel they have done anything to deserve this.
At the end of your initial session, you realize there are probably many more layers of this story and of emotional hurt which has not surfaced and Belinda is in tears as she continues to express feelings of guilt and shame. On occasion through the session, Belinda states that she is angry at God for her injury and feels she did not deserve this. She is also struggling with negative feelings towards the person who hit her and changed her life forever, particularly given the fact that the other driver’s life has not really changed much. In her opinion, he wasn’t really legally reprimanded for his actions and choices to drive drunk.
Before, Belinda leaves the session, she wants you to know that she desires to cope better and have a better way of life; however, she is surrounded by all this negativity and feels as if she has little support.
- Given what you know about Belinda, what else would you like to know so that you can best help her heal and move beyond her disability and current situation? Consider the effects of SCI and TBI as well as the emotional/psychosocial ramifications of each and the personal issues described. Explain how you are making your assessment of what is missing and possibly taking place with Belinda.
- Over the course of the semester, we have studied a number of theoretical approaches. Choose 2 to 3 theories that you could use in an integrated fashion along with the theories’ associated techniques to help Belinda. How would these theories and counseling techniques to help Belinda cope and improve her situation? Describe in detail how these theories and techniques would help Belinda as well the specific techniques you use. Choose at least three techniques and specifically explain how you would use them.
- What are Belinda’s primary issues and concerns? How would you determine which
areas to address first?
- Identify the potential barriers Belinda may encounter as she tries to heal. What are some things that may take place within her life realistically as well as barriers she may face mentally and emotionally?
- After working with Belinda for a couple of session, what are three therapeutic goals she might want to explore as a part of her counseling? Explain how reaching these goals will potentially improve her coping and present situation.
Source: Stuntzner, S., & Hartley, H. (2014). Disability and the Counseling Relationship: What counselors need to know. VISTAS Online, Winter Issue, Appendix A.
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