Counseling Across the Lifespan: Prevention and Treatment
Case Study Questions
CASE EXAMPLE
Joan, a 32-year-old African American woman, has just sought individual counseling from Dr. Practicality for the first time for depression and anxiety. Immediately after college, she entered a 2-year MBA program and received a degree in business. She has been in her current job as a high-ranking manager in a national corporation for 8 years, steadily advancing in rank and salary since she started. She reports that her career has always been important to her and that her parents always encouraged her to “make it” in business. She met and married her husband, Bill, in graduate school. Bill just recently became a partner in a start-up business. They decided to have children after she had been working for 3 years but before Bill ventured out into his own business. Now, 5 years later, they have two young children (ages 4 and 1½).
After the birth of her second child, Joan began to feel even more stressed than she had before. At first she attributed her anxiety and feelings of being out of control to the “maternity blues.” She assumed that after returning to work after her maternity leave, she would feel better. However, she has been back at work for a year and things continue to get worse. She feels guilty that her children are in day care from 8 a.m. to 6 p.m. Monday through Friday.
At work, she feels less productive. At home, she feels exhausted and can’t keep up with her long-held expectation that her home be spotless. Bill does not do much of the domestic work because he is busy with his start-up company. She does not have time to see friends, and they do not live near family. She is, however, active in her church and community service projects. They have also been struggling financially due to paying off graduate school bills, investing in Bill’s business, and buying the necessities for two quickly growing children.
Joan thinks there is “something wrong” with her and thinks she may need medication for depression. After assessing Joan’s situation, Dr. Practicality identifies several sources of external stress in Joan’s life. Joan, like many in her generation, did not plan ahead for home-career conflict. Because she is an able and capable woman, she assumed she could “do it all” with grace and ease. Joan and Dr. Practicality began by discussing Joan’s need to be “Superwoman” both at work and at home (and her subsequent guilt at not meeting her own standards).
They discussed Joan’s upbringing, cultural background, and the values she holds dear regarding work, community involvement, marriage, and motherhood. For example, Joan believed that her house was a reflection on her; the messier the house, the worse she felt about herself as a mother and wife. She was no longer sure how she could juggle her demanding career and her family responsibilities.
Together, Joan and Dr. Practicality outlined several strategies to help her ease the role strain she was experiencing. First, Dr. Practicality helped Joan change her self-imposed expectations about doing it “all” to perfection. This cognitive reappraisal helped Joan let herself off the hook for not having a perfectly clean home at every moment of the week. Next, Dr. Practicality helped Joan find ways to discuss with Bill his own role in the domestic chores. Bill and Joan then agreed that Bill would begin to do the grocery shopping and cooking as he enjoyed preparing meals and was home earlier than Joan. He also spontaneously suggested that he pick up the children from day care at 5 p.m. when he got home, which gave Joan even greater peace of mind.
Next, Dr. Practicality helped Joan make some financial decisions that allowed her to hire a cleaning service twice a month to take care of the larger cleaning jobs. Joan also began to look into ways to restructure her work day, investigating her employer’s policies on flextime and telecommuting. Dr. Practicality then began to address with Joan the ways in which she could better nurture herself. It turns out that Joan used to love photography and hiking. Although she was not even sure where her camera and hiking boots were at first, she sought them out and began taking a few hours on Saturday with her children to hike nature trails in the park and take pictures. Dr. Practicality also encouraged Joan to renew old friendships and build new ones, particularly with others who could help share in child care activities. She began to focus more on making stronger connections with other mothers in her church. As Joan began to feel better and more energized, she also found ways to create “personal time” for each member of the family (each person could choose their activity, such as reading, napping, playing quietly inside, or playing a sport). By working together, she and Bill were also able to designate time each week that was purely “couples time.”
Once Joan felt empowered again, able to make changes in her own life that could help her manage her various roles, she began to feel less anxious and was no longer depressed. Her multiple roles were not gone, but she felt in control of implementing ways to help her family manage the conflicting demands. Before leaving therapy, Dr. Practicality and Joan planned ahead for setbacks and identified all the coping resources Joan had at her disposal.
In summary, active coping strategies can help individuals relieve stress and strain (Richardson & Rothstein, 2008). In Joan’s example, she worked with her counselor to identify different strategies to help manage role strain. Because she felt empowered to help herself and because she had several resources to aid her (e.g., a partner, a good salary, a flexible job), she felt less anxious and depressed. One important point to note is that Joan was not forced to give up any of her roles. In fact, she ended up adding roles (photographer, active friend) that she found pleasurable and that gave meaning to her life. Along with specific strategies, it is the meaning one places on one’s multiple roles that eventually determines the level and type of stress one might experience.
In conclusion, men and women must typically navigate through a variety of often disparate roles on a daily basis. Those professionals in a counseling role are in an excellent position to help. With both prevention and management strategies, we can help reduce conflict and enhance individuals’ quality of life.
DISCUSSION QUESTIONS
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What do you imagine are the major issues with which you will be faced in counseling regarding work-family interface?
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What are some of the potential problems you might experience working with others in preventing and managing role strain?
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How would social identity factors, such as gender, racial/ethnic group, age, or sexual orientation, affect your work with different clients?
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How might your own experiences with work-family interface assist or hinder you in working with clients in this area?
- In what ways do you imagine you would be most likely to intervene to address issues of role strain?