Case Study: Demonstrating Counseling Competencies in Trauma and Cultural Sensitivity

Case Study: Demonstrating Counseling Competencies

Client Background:

Sophia, a 32-year-old woman, sought counseling due to persistent anxiety and difficulties forming close relationships. She described feeling emotionally distant from her young child, echoing the lack of warmth she experienced from her own mother. Sophia lost her father unexpectedly at the age of 3 and was subsequently placed in a boarding school. This early childhood bereavement and separation contributed to her anxious attachment style and ongoing struggles with trust and intimacy.

Sophia is a practicing Muslim who emigrated from Lithuania 14 years ago to start a new life. This move involved leaving behind two children, which continues to be a source of profound guilt and emotional conflict. Her faith plays a significant role in her identity and coping mechanisms, providing both comfort and a framework for understanding her struggles.

Sophia’s primary complaint on the intake form was her difficulty in dealing with phone calls. She reported feeling overwhelmed and experiencing panic attacks when required to speak on the phone. During the sessions, she disclosed a traumatic childhood memory—when she was sent by her mother to the village to answer a phone call, she learned of her uncle’s death. This uncle had been a father figure to her, and the shock of receiving the news left a profound emotional scar, contributing to her current anxiety and avoidance of phone communication.

Counseling Student’s Approach:

The counseling student, under the supervision of a licensed counselor, employed a client-centered approach while adhering to ethical and professional standards. Throughout the counseling process, the student demonstrated core competencies, including genuineness/congruence, unconditional positive regard, and empathic understanding, to establish a strong therapeutic alliance.

1. Critiquing the Nature of Presenting Problems (5%): The counseling student recognized that Sophia’s presenting issues stemmed from unresolved childhood trauma, bereavement, and the impact of early attachment disruptions. Additionally, the student explored the emotional impact of Sophia’s migration experience and the distress linked to being separated from her two children. The student also identified the phone-related anxiety as a manifestation of traumatic memories and panic symptoms, rooted in the distressing experience of receiving her uncle’s death news as a child. By examining how these factors interact with her anxiety and distant parenting style, the student developed a comprehensive understanding of her psychological distress.
2. Professional Leadership and Ethical Guidelines (5%): The student demonstrated professional leadership by adhering to ethical guidelines, including informed consent and confidentiality. Ethical dilemmas, such as the emotional impact of revisiting childhood trauma and addressing culturally sensitive issues related to Sophia’s faith, were discussed in supervision to ensure best practices. The student clearly explained the limits of confidentiality, particularly regarding Sophia’s mental health and the well-being of her child.
3. Capacity to Undertake Comprehensive Assessments of Need (20%): A thorough assessment was conducted through structured clinical interviews and the use of evidence-based anxiety measures. The student explored Sophia’s attachment history, migration-related stress, religious beliefs, and current relational patterns. Special attention was given to understanding the phone-related anxiety and its origins in childhood trauma. This comprehensive approach allowed for a nuanced understanding of Sophia’s psychological needs, informing a personalized intervention plan that acknowledged the intersection of trauma, culture, and faith.
4. Managing Contexts of Difference (5%): The student acknowledged and respected the influence of Sophia’s cultural and religious background on her identity and emotional experiences. By adopting a culturally sensitive lens, the student explored how her Muslim faith shaped her understanding of grief, guilt, and familial obligations. Special attention was given to the emotional challenges of leaving two children behind while navigating life in a new country. Additionally, the student was mindful of the stigma surrounding mental health within some cultural contexts and worked to provide a supportive, non-judgmental space.
5. Capacity to Critique a Range of Models of Professional Practice (5%): The student integrated a range of theoretical models, including attachment theory, trauma-informed care, and cognitive-behavioral approaches. This eclectic framework allowed the student to adapt interventions to Sophia’s evolving needs, blending relational techniques with cognitive restructuring and mindfulness practices. The student also considered faith-sensitive counseling approaches to honor Sophia’s spiritual beliefs. Specific interventions for addressing phone-related anxiety included graded exposure techniques and grounding exercises to manage panic symptoms.
6. Fostering and Maintaining Therapeutic Relationships (20%): The student prioritized building a trusting therapeutic alliance through genuineness, unconditional positive regard, and empathic understanding. Consistent attunement to Sophia’s emotional responses and providing a safe, non-judgmental space strengthened the therapeutic bond, enabling Sophia to explore painful memories, migration-related guilt, and relational difficulties. The student validated Sophia’s fear of phone calls while helping her to process the traumatic memory associated with this anxiety.
7. Critiquing Therapist Factors in the Therapeutic Alliance (10%): Through reflective practice and supervision, the student critically examined their own emotional responses and biases. For instance, when Sophia expressed maternal guilt regarding the children she left behind, the student recognized the importance of maintaining a balanced stance—offering validation while gently challenging self-critical narratives to promote growth. The student reflected on how cultural humility and faith sensitivity were essential to building a meaningful therapeutic connection. Furthermore, the student was mindful of their emotional response to Sophia’s traumatic phone-related memory and sought supervision to maintain an objective and supportive stance.
8. Analyzing Values in Multi/Interdisciplinary Contexts (10%): The student collaborated with other professionals when appropriate, ensuring holistic care. For instance, when Sophia reported severe anxiety symptoms, the student considered referring her to a medical professional for a comprehensive evaluation, recognizing the value of interdisciplinary collaboration in addressing complex psychological issues. The student also remained open to consulting with faith leaders to better understand the role of religious practices in Sophia’s healing process.
9. Managing Emotional Content in Professional Work (10%): The student demonstrated emotional regulation by managing the emotional intensity of Sophia’s grief, migration-related loss, and attachment-related distress. Regular supervision and self-reflective journaling were utilized to process countertransference and maintain emotional balance throughout the therapeutic process. The student remained mindful of the emotional complexity of Sophia’s dual identity as a mother living apart from her children and as a caregiver to her child in her new life. Special care was taken to address the emotional impact of the phone-related trauma and its continuing effects on her day-to-day functioning.
10. Managing Therapeutic Endings (10%): As Sophia achieved her therapeutic goals, the student facilitated a structured termination process. This included reviewing progress, reinforcing coping strategies, and providing resources for continued self-exploration. The student validated the emotional complexity of ending therapy while empowering Sophia to continue her personal growth journey. Special consideration was given to Sophia’s ongoing relationship with her children abroad and how she could foster emotional connection despite physical separation.

Conclusion:

This case study demonstrates how a counseling student effectively employed core competencies—genuineness/congruence, unconditional positive regard, and empathic understanding—to foster a therapeutic alliance. The student’s ability to critically assess needs, manage emotional content, and integrate theoretical models within a trauma-informed and culturally sensitive framework was pivotal in supporting Sophia’s journey toward healing. Through adherence to ethical guidelines and reflective practice, the student showcased professional competence across key areas of counseling practice while honoring Sophia’s unique cultural and religious context.

Marking Criteria for Case Study Presentation 40% Component

Students are expected to be able to manifest Core Competencies as set out above within their Case Study (40% weighting). Students will be assessed on their ability to demonstrate their professional competence in a range of areas as set out below relevant to their domain of practice within their professional placement work.

• Critique the nature of presenting problems                                                                         (5%)
• Provide evidence of professional leadership in the use of Professional and ethical guidelines                                                                                                                   (5%)

• Capacity to undertake comprehensive assessments of need                                  (20%)
• Manage contexts of difference (e.g. cultural and therapeutic competence)                (5%)
• Capacity to critique a range of models of professional practice                                (5%)
• Capacity to foster and maintain productive therapeutic/interpersonal relationships                                                                                                (20%)

• Ability to critique therapist factors associated with the therapeutic alliance                                                                                                        (10%)

• Ability to critically analyse the values of working in multi/interdisciplinary contexts                                                                 (10%)

• Capacity to manage emotional content associated with Therapeutic/Professional work                                                                  (10%)

• Ability to manage therapeutic endings                                                          (10%)

Case study

• Who is my client?
• What type of contracting and assessment do I disseminate? (Appendix)
• What is my philosophy of treatment intervention?
• How do I show this? What techniques/strategies/Frameworks do I use?
• What is/was the therapeutic Alliance moving towards the Therapeutic Relationship like for me (How did I do it/ What did I do/not do) (Safety-Respect-Warmth-Trust-continuation of hope moving from the instillation of hope or dealing with therapeutic rupture-contamination-collusion)
• What helps me understand cultural awareness deficiencies/Strength? (ADDRESSING)
• What did/Does Clinical supervision represent to me?
• What did/do I notice about my ability to take from supervision and implement within my case session?