Case Vignette

Aida is a 10-year-old 5th grade female. She presents as significantly underweight and short for her age.  Her facial coloring is sallow with dark circles under her eyes and her hair is a bit disheveled.  She is new to the school and one morning comes to your office for the first time crying.  Aida presents her issue as a friend problem; she feels left out and that some kids are purposefully ignoring her.  After further exploration her story becomes tangential and difficult to follow.  When asked if she would like to have a peer mediation she starts to backtrack her story and quickly wants to go to class.  Later that day, you see her and she seems happier and talking with friends.  Three days later, she comes back in the morning again crying.  This time she begins talking about how she feels picked on at home and ignored.  This discussion exposes the lack of food and scarce conditions of the home.  Both parents have low-level paying jobs and have a difficult time making ends meet with three children.  After speaking with the teachers, you have discovered that she often sleeps in class and has a hard time staying focused.  Yet on other days, she is completely alert, attentive and happy. 
Discussion Questions
Review and apply therapeutic skills, case understanding, empathy, psychotherapy, and counseling theories to the case vignette.
1) What are your main concerns with this client? The immediate needs of the client, how you would provide for those needs? 
2) Why do you think the client is seeking help, from the client’s perspective?
3) What would be some counseling goals for this client? Explain. 
4) Provide sample counseling questions you would ask to gain a better understanding of the whole client. 
5) Based on your prior knowledge of theoretical foundations up to this point, what theoretical approach would you apply while working with this client? 
6) What, if any, necessary follow-up (i.e. individual, family contact, consultation, referral, CPS, medical evaluation, etc.) would you recommend? Why?