Case Scenario #3: Mental Health Interview Using the ABC Model
Scenario
You are a community support worker at a local crisis intervention centre. Tina is a 42-year-old woman who came in today after promising her best friend Kat that she would seek some help. Kat is concerned about Tina and her two daughters, as none of them have cried since her husband Jack’s death. Tina tells you that she doesn’t think about his death. When probed a little more, Tina begins to cry. Jack died from a major heart attack three and a half weeks ago. They had been married quite happily for twelve years and had two daughters aged ten and seven. The heart attack was completely unexpected. Tina thinks that if she cries, it will upset her daughters. By not allowing herself to cry, she thinks it will show her daughters that she is strong.
As the meeting progresses, Tina shares that everything feels surreal. The lives of the people around her are continuing normally, but for her, it feels as though time has stopped, and she finds herself living in a fog of confusion. Tina indicates that she feels so numb, she is incapable of feeling connected to anything, especially anything overwhelming. She works full-time as a registered dietitian and will now need to manage as a single-parent.
When asked about work and life at home, Tina reports that she is finding it very difficult to concentrate at work. She loses her sense of time, often finding herself staring blankly at her computer as hours pass her by. At home, she feels exhausted and easily oversleeps. She finds it difficult to eat and struggles with a loss of appetite. Her daughters often brought smiles and joy to her day, however, lately she has to push herself to play with them. When she does, she is unable to experience the joy she once had. When Jack was alive, they were a very active family, both physically, through jogging and cycling, and in the community, through volunteering at festivals and church events. Since Jack’s passing, Tina has not engaged with any of those activities or friends. Both she and Jack were only children and have no family left. Her best friend Kat is the only person with whom she has been connecting. Kat visits two to three times a week, sitting with Tina and drinking tea while the children play downstairs. Tina says she doesn’t quite know how she will get through this.
1. Based on the scenario above, provide two examples for each of the following:
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- Open-ended question
- Clarifying question
- Paraphrase
- Reflection of feelings
- Summarization
2. Answer the following questions for Boiling Down the Problem:
a) Based on what Tina shared, identify each of the following:
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- The precipitating event
- Cognitions
- Emotional distress
- Impairments in functioning
- Pre-crisis level of functioning
b) Complete the following ethical checks:
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- How would you bring up the subject and ask about suicide?
- How would you bring up the subject of substance use and ask about alcohol and drugs?
c) Provide one example of what you could say to Tina for each of the following therapeutic interaction statements:
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- Validation statement
- Educational statement
- Empowering statement
- Reframing statement
3. Answer the following questions on coping:
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- What are Tina’s current coping strategies?
- Based on her life prior to Jack’s death, what other coping strategies could you explore with Tina?
- What are two referrals that you could provide Tina?
Case scenario by Nadine Konyk
