As a social work intern at the University Child Health and Wellness Center

Models of Psychotherapy
As a social work
intern at the University Child Health and Wellness Center, you are scheduled to
conduct an initial interview with Mrs. Carlson who has not been seen in the
Center previously. You know that her baby’s pediatrician referred Mrs. Carlson.
(The baby is 10 months old.) The pediatrician has some concerns about Mrs.
Carlson’s mood.
The Initial
Interview with Mrs. Carlson
Social Worker:
Good afternoon, I am Doctor Johnson. How can I help you today?
Mrs. Carlson:
I am so glad to meet with you. The holidays are approaching and I am getting so
anxious. We are meeting with my husband’s family, and I am just not sure I want
to go. And besides that, my family wants us to visit, too. Who should we go see
first? What am I to do?
Social Worker
Statement 1

A.So, you are kind of in a conflict right now.
You are feeling on the one hand maybe some kind of obligation to do what
your husband wants and see his family. And yet, you would really like to
see your family over the holidays.
B.This indecision you are having. What kind of
thoughts are you having about this decision? What will happen if you
decide one way or the other? What are you thinking about it?
C.Let us see. If I could wave a magic wand and
all your problems were solved so that you could have everything you want
in this situation, what do you think the situation would look like?

Response to
Choice A
Mrs. Carlson:
You sure have that one right. I get so tense just thinking about what to
do…which family to go to.
Coach Comments:
You have chosen a Client Centered response. If you like that approach, let us
see if you can be consistent throughout the therapy session. I will tell you
the approach you have picked after each of your choices.
Response to
Choice B
Mrs. Carlson:
I have to think about it a lot. It is real hard to think about how I can get to
both places. How can I be true to my husband? We have only been married two
years. So, I just have not been able to get to a place where I can make a
decision. I just seem to spin my wheels.
Coach
Comments:
You have chosen a Cognitive approach. If you like that approach, let us see if
you can remain consistent throughout this therapy session. I will tell you the
approach you have picked after each of your choices.
Response to
Choice C
Mrs. Carlson:
Oh my, I kind of have to, you know, think about that because I am not sure I
know what things to pick out. Can you help me? Seems to me I have just got
these two things. I need to go to my family and I need to go to my husband’s
family. And I cannot get past it. I just get stuck.
Coach
Comments:
You have chosen a Solution Focused approach. If you are happy with this
approach, let us see if you can use it consistently throughout this therapy
session. I will tell you the approach you picked after each of your choices.
Social Worker
Statement 2

A. So, in other words, you would like to feel
unstuck. You would like to have a decision made so that you know if you
are going to one place or the other or if you are going to both places.
You would like to know that and have it decided already.
B. You are kind of tied in knots—like you are
torn between the two of the them…and cannot move in either direction?
C. Do you think something bad will happen if
you decide one way or the other? What do you think will happen?

Response to
Choice A
Mrs. Carlson:
Oh, you know that might help. Because I get so tense when I think about where
we should go first for the holidays. And, if I have it scheduled ahead of time,
you know, I think that might decrease my anxiety. Do you think that would work
though?
Coach
Comments:
Solution Focused.
Response to
Choice B
Mrs. Carlson:
Yeah, how do you know how to say that so well? because you really describe what
is going on in my stomach!
Coach
Comments:
Client Centered.
Response to
Choice C
Mrs. Carlson:
Oh I think so! I mean, I do not know what—but I think something bad is going to
happen. Only, well, I am not sure what the bad part would be. It is hard for me
to think about being with my family and going to my husband’s family. And, I
just cannot seem to make the difference between them. So, I would just get so
anxious. I just do not think that I can get that done! What do you think about
that?
Coach
Comments:
Cognitive.
Social Worker
Statement 3

A. Well, you are saying you feel anxious when
you start thinking about it. You think something bad will happen, but you
do not know what it is. Are you afraid of the unknown? Or, is there some
specific bad thing that you think will happen…say, if you go to his
family?
B. Why don’t you go forward with that? What if
you make a schedule and decide? What do you think will be the best
possible schedule for visiting one or both of the families?
C. Sounds like you are feeling anxiety, a
nervousness, a tension, a stress, like you are really almost paralyzed
with indecision at this time.

Response to
Choice A
Mrs. Carlson:
Well, I do not really know his family that well. I have seen them a few times
of course. But I do not know them like I know my own family.
Coach
Comments:
Cognitive.
Response to Choice
B
Mrs. Carlson:
Hmmm, a schedule. I am not sure I could do that. I am not sure, you know, what
it is that I need to put together. Can you help me with that?
Coach
Comments:
Solution Focused.
Response to
Choice C
Mrs. Carlson:
Yes and that is it! And when I get to feeling stuck, then I get to feeling
depressed—then I cannot sleep. I tell you it is a real problem!
Coach
Comments:
Client Centered.
Social Worker
Statement 4

A. So, this holiday decision is really getting
you down. At this point, do you feel you cannot function?
B. Well, I think you were saying you wanted a
schedule. Would it be something like, we go to my parent’s house for two
days and then we go to my husband’s parents house for two days?
C. So, does the fear have to do with what you
are thinking about meeting strangers, people who really don’t know you?
Or, maybe people who are important to you, people like your husband’s
family?

Response to
Choice A
Mrs. Carlson:
Yes, I really need some direction. I do not know which way to go. Can you tell
me what I should do?
Coach
Comments:
Client Centered.
Response to
Choice B
Mrs. Carlson:
Oh yeah, that might work. I think that maybe—I will have to ask my husband,
though. And, I am not sure that he is going to come in here with me. So, I have
to go and see what he is going to have to say about this.
Coach
Comments:
Solution Focused.
Response to
Choice C
Mrs. Carlson:
Ah, hmm, that might be. Because I do not like to go out on the street and say
hello to people—other strangers. I do not like to get too close to them, you
know. I do not know them!
Coach
Comments:
Cognitive.
Social Worker
Statement 5

A. OK, so would you like to go talk to your
husband and say, “I would really like to go for two days to my family
and then two days to your family. Would that be OK with you?”
B. Are you really concerned about how people
are going to judge you? What they are going to think of you?
C. So, you are feeling powerless and stuck. You
are reaching out and hoping that somehow I will have the answer to tell
you what to do. And you think that will make you feel better.

Response to
Choice A
Mrs. Carlson:
Yeah, I think I would like to tell him that, but I do not think he is going to
like that. Because he is going to want 3 or 4 days with his parents and just
one with mine. So, I am not sure what his priorities are right now. You know,
we have just been married two years. And, I am not quite sure, you know, what
he is thinking about and whether he will go to my parents for as long as he
goes to his parents.
Coach
Comments:
Solution Focused.
Response to
Choice B
Mrs. Carlson:
Yeah—Yes, I think that is for sure. Yeah, because you know they do not always
say what they are thinking and they may end up treating me badly because I do
not know what they are thinking.
Coach
Comments:
Cognitive.
Response to
Choice C
Mrs. Carlson:
Yes, that will solve everything!
Coach
Comments:
You have reached the end of the Client Centered simulation. If you wish, you
can now try a different approach and see where it leads.
Social Worker
Statement 6
(This scenario
is only engaged if they selected options A or B from the above scenario.)

A. So, maybe you have an idea that it is very
important for everybody to like you and it would be really terrible if
somebody did not like you.
B. But, really, you would like it to be fair
where you go to both sets of parents equally?

Response to
Choice A
Mrs. Carlson:
Well, I guess maybe I do.
Coach
Comments:
Cognitive.
Response to
Choice B
Mrs. Carlson:
Yeah, I would like for it to be fair. And, you know—I need to feel less anxious
about it too. Because when I feel like it is not fair then I get anxious, and
then I can get depressed about not seeing my family as much.
Coach
Comments:
Solution Focused.
Social Worker
Statement 7

A. Do you think it would be a good idea to tell
your husband what you want? Since he loves you and there is a good chance
he might agree to it, after all, it is fair and equal and would make you
happy. Do you think he might agree to it?
B. Suppose his mother did not like you, what
happens then? You will only see her once a year. And besides maybe she
really will like you—you do not know. But, even if she did not like you,
is that the end of the world? You are not married to his mother; you are
married to him.

Response to
Choice A
Mrs. Carlson:
Well, I think I could try that and see what he has to say and hope he will
agree and go to my family too, like he’s going to his family.
Coach
Comments:
Solution Focused.
Response to
Choice B
Mrs. Carlson:
Well, that seems like a good thought to hold onto.
Coach
Comments:
Cognitive.
Social Worker
Statement 8

A. What if you think that you are
just going there to be with him and to help him enjoy his family to kind
of see what is going on? And, do not be concerned with what they think of
you. Just be more concerned with being with your husband and sharing a
good time with him.
B. How about you give it a try and we
will talk about it next time. It sounds to me like you’ve developed a
plan.

Response to
Choice A
Mrs. Carlson:
Yeah, that sounds like a good thing. I could probably do that.
Coach
Comments:
You have reached the end of this simulation. If you wish, you can now try a
different theoretical approach and see where it leads.
Response to
Choice B
Mrs. Carlson:
Exactly!
Coach
Comments:
You have reached the end of this simulation. If you wish, you can now try a
different theoretical approach and see where it leads.