Client

The client is a middle-aged married woman with a background in human resources and social work.  Client spent 14 years in the military and graduated with a bachelor’s degree in social work 10 years ago.  Client reports that she enjoys her job and has a happy and stable family life. She reports a good relationship with her husband and one child, significant social support structures, adequate recreation and good amounts of socialization.

The one major concern expressed by the client is that she sometimes feels overwhelmed by the responsibilities she has undertaken. The client works full time, has family commitments, has social obligations and is working of a master’s degree in behavioral psychology. She indicated that she is concerned that she may be trying to do too much and that she may not be devoting adequate resources to all of her obligations.

In the course of her education, client has also begun to question her own perceptions of her happiness. She has expressed concern that what she calls being happy in her job may simply be complacency and that she may be ready for a change in her career options.  Patient has requested an assessment to help her determine if the goals she has set forth for herself are her own or a result of societal expectations. Furthermore, she would like to know if she is adequately pursuing her interests and taking care of her own needs while meeting her other obligations.

The client also recognizes that her current position is very stressful and believes that she deals well with the stress, but would like an assessment to determine if her self-analysis is accurate.  The client questions her own abilities and wonders if she has the necessary tools to accomplish the goals she has set forth for herself. Areas where she believes her skills may be lacking include her educational background and motivation. She also wonders if the career path she has chosen is appropriate for her skills and behavioral patterns.

The client selected to do all five of the assessment tests available because they provide and a variety of different insights into the areas that she is interested in evaluating. She also chose to do all five because it was listed as an option in the instructions and the client is very goal-oriented and conditioned to follow directions. Because the client desires to make a good impression and to excel at the things that she does, the client selected the course of action most likely to satisfy her instructor.  The client, perhaps by virtue of her military career, operates well when taking instruction and measures her success on how well she completes those instructions. If she had chosen a smaller number of assessments, the client would have been concerned that she was not meeting the requirements of the task set before her. It will be intriguing to see if the test results validate this initial impression of the client and her motivations.

Assessments Used:

1)      Occupational Stress Inventory—Revised Edition. The OSI test is best used with individuals over age 18 with at least a fifth grade reading level. It is assumed that respondents have the mental and emotional capability of accurately completing a self-analysis (OSI, 1998).

2)      The Personality Self-Portrait. This test is best used with working adults as it measures behaviors and their relation to the work place.  It is designed to subdivide personality traits according to specific responses and categorize them into dominate personality styles from which the client and moderator can determine patterns and choose areas where a client is likely to excel (Oldham, 2003).

3)      Quality of Life Questionnaire. This assessment is best used with adults over 18 years of age who are not exhibiting clinical findings. The sample which was used to derive this test is relatively small (437) but it does have a built-in validity test which makes it a much more useful assessment tool. (Evans, 2007).

4)      Six Factor Personality Questionnaire.  The SFPQ tests a person’s responses to basic statements and determines their personality traits depending on their responses. (SFPQ,  2000). The test is comparison to others who have taken the test and its reliability is somewhat suspect.

5)      Thoman-Kilmann Conflict Mode—This test compares conflict resolution techniques of 400 managers and uses them as baseline to determine a person’s conflict resolution style. The test emphasizes compromise as the best objective and may be skewed in that direction.
According to the OSI report, the client’s responses indicate that she feels some weight of the responsibilities thrust on her at work, but that she has a very good support structure and takes good care of herself to deal with the stresses of her work.  In most of her work-related stress areas, the client tested in the low to moderate range. It is presumed then that her job is difficult and somewhat stressful, but that the client has sufficient coping mechanisms in place to deal with these stresses. The test would tend to indicate the one area where the client has the biggest stressors related to her job are in the area of responsibility. Her responses indicate that she does not feel she can rely on co-workers or subordinates to adequately do their jobs as assigned and feels some stress related to making sure that things are done appropriately.

The OSI report further indicates that the client deals with these issues through a strong support network and physical exercise. By taking steps to maintain her own health, the client is showing that she is not overwhelmed by the work-related stressors. The client’s responses indicated that she is well-adjusted and has better than average coping mechanisms.  The client scored particularly well in the area of self-care which includes watching her diet, getting proper exercise and avoiding harmful substances (OSI, 2007).

In the client’s Personality Self-Portrait, we learn that her primary personality style in conscientious. Dramatic and adventurous were her secondary and tertiary personality styles, with both receiving equal value in her self-assessment. This test asks the client to describe their actions and uses those responses to determine which personality mode the client uses most often. This client uses the conscientious personality style almost twice as often as any other. Her other responses were split more evenly with dramatic and adventurous being used slightly more of than other personality styles. The conscientious style fits very well with what we presumed about this client in our initial assessment.

“Everything must be done right and the conscientious person has a clear idea of what that means” (Oldham, 2007). Whether this is a learned behavior from her time in the military or an inherent part of the client’s personality, the test does not indicate. However, what we can see is that the client prefers things to be done in an orderly fashion and expects others to do likewise. This makes her particularly good at detail-oriented, precision work which must be done in a specific order. Her second personality styles, dramatic and adventurous, seem somewhat at odds with her primary style. The dramatic personality style likes to be the life of the party and have a good time. It appeals to the emotions. This is aspect of her personality is probably hat attracted the client to counseling and social work. Her flair to try something new is reflected in the adventurous style. This desire to learn and try new things explains her desire to return to school at 40 and leads to her questions about her career choice. It is not that she is particularly dissatisfied with her current career options; instead, it is that she sees the potential and interesting aspects that can be in other career options (Oldham, 2007).

The client’s Quality of Life Assessment Questionnaire is the most troubling of the client’s assessment tools. The validity test within this assessment indicates that the client may not have been completely with herself or the test when assessing her situation. In short, the client’s social desirability scores were much skewed towards trying to make others happy. In this case, it may indicate that she chose to paint a rosier picture of her happiness than is actually the case. All her other self-assessments in this test grouped together in a fairly reasonable range, but the social desirability scores were abnormally high. This does not mean that the test is invalid, but it does mean that the interpreter needs to discuss with the client her need to try to make people around her happy (Evans, 2007).

This too fits without initial impression of the client. It appears that perhaps many of the client’s motivations are not her own so much as they are a desire to do what she perceives as being expected of her or the right thing to do. Given the self-doubt the client expressed regarding her schooling efforts and the feeling of being overwhelmed with her responsibilities, it is probably important to discuss with the client her reasons for pursuing her education at this time and her personal goals. It is completely plausible that the client’s dissatisfaction lies in something other than her schooling, but that she has been unable to express it.

The client’s responses to the SFPQ also give rise to questions regarding her sense of self-worth. The client’s SFPQ indicates above average rates in many good personality traits, but show distinctively low scores in autonomy and self reliance. This would tend to indicate that the client tends to take direction rather than lead and that she does not have enough faith in her own abilities.

According to the TKI assessment, the client reported no behaviors indicating competitiveness in conflict resolution and only a small amount of avoidance. In general, her responses indicate that she will compromise, accommodate or collaborate. This tends to back up previous assessments which indicate that the client lacks self-reliance.

Based on the assessment’s given, as a counselor, I would be concerned that the client was not being completely honest with herself regarding her motivations and feelings and desires. As the client, I am concerned that these assessments may indicate that I am something of a pushover. I like being a people pleaser and I think that is reflected in the dramatic personality style. I think being the life of the party can also mean that you are driven to make sure that everyone is having a good time, no matter what self sacrifice is involved. I believe that I have exhibited a clear tendency to put the needs of others above my own needs. While this is a trait I value in myself, I believe it also needs to be handled in moderation so that I am achieving self-fulfillment as well. Perhaps I need to re-evaluate social commitments while I am in school and learn to say no to the demands of others.

As far as a treatment plan is concerned, I would recommend that this client learn to be more assertive of her own needs. She needs to be taught that saying no is acceptable and that the world will not end if she is unable to do her homework and make it to the PTA meetings. I would also recommend that she consider retaking the QLQ, even if she has no desire to share those results with anyone else, for her own edification.

It is clear that this client is intelligent and driven, though it seems many of her goals are external and not internal. I would recommend that the client seek counseling to help identify her own goals and then, if necessary, to help her align those goals with the needs of those around her. If, for example, she believes that school and work and having a life are too much for her to complete at once, then she should be encouraged to cut back in the one of these areas that would be least detrimental for her and for her family. There is nothing inherently wrong with the client’s desire to please her friends, family and society as a whole, but there are significant indicators in the assessment and in her reasons for requesting the assessment to indicate that the client has lost sight of her self needs. I believe counseling would be appropriate to help her to determine those needs and to balance them with her other life goals.

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