APT5035 - Case study Jane is a 30-yr-old woman, living with Bill, her partner of 2 years. She moved to Victoria several years ago, her family all continue to live interstate where Jane grew up. Jane works as a sales consultant for a property developer. Initial call to make appointment was made by Jane’s mother, who was visiting Jane and about to return home, she said Jane was ‘too distressed to talk’. You have seen Jane for two sessions and have the following information: Presenting issues: • Feeling upset, overwhelmed, in tears a lot recently • Angry often, “takes it out on Bill” Goals: At this early stage, Jane isn’t sure, but talks about wanting to ‘deal with’ her parents better and to not feel so angry and overwhelmed. History • Reasonably happy home life with parents and older sister, Becky, until mother became very sick when Jane was 12 and father left shortly after. • At that time, father started ‘strange’ relationship with married female family friend, which continues to this day. He is very close to her (now adult) kids. • Mother’s illness continued throughout Jane’s adolescence, with several hospitalisations. Jane’s memory is of minimal support from others and being left to do much on her own (as Becky had left home), including care of mother. She believes her mother should have sought more help from others. • Mother had a younger female friend Hannah move into house when Jane was 18, who is still there and has very close relationship with mother. Jane is not clear about nature of their relationship. Current situation - Relationships Father: Jane has regular if superficial contact, and feels guilty if she doesn’t speak to him as ‘he’s still my father’. Jane spoke about her anger that he chooses ‘his other family’ over his own kids, that it feels like he’s just ticking a box when he rings her. When asked what else he could be doing that would show Jane he actually cared, she says ‘He’d be coming down to visit’. She then acknowledged she doesn’t really want him to come - ‘ I wouldn’t want him to stay with us’ - but denied he might sense that and that might be why he doesn’t offer. Mother: Ambivalent relationship – Jane gets very angry with her, even over quite small things. Describes phone conversations where Jane will become increasingly angry, not letting it show but withdrawing from the conversation, even holding phone away from her. Jane reports that both she and Becky have long complained about mother always putting Hannah first over them – even when mother was in hospital, Hannah was given more info about mother’s illness than they were. Jane finds it hard to identify what her mother would need to say or do in order for Jane to feel less angry at her - ‘even if we were to ask Mum to not live with Hannah, I don’t think she’d do it’. Bill: Jane feels concerned that she needs to be with him all the time - says it’s not about not trusting him with other women, more that she doesn’t feel comfortable if he’s not with her – she has a sense that she can’t be sure he’ll still be there if they’ve been apart for a few hours - and if this relationship doesn’t work out, “I would have wasted our last few days or hours not being with him”. She can also get very angry with him - two examples she provides: 1. Both fell asleep on couch watching TV, she later woke to find he’d gone to bed without waking her. She woke him up extremely angry that he had ‘left her there’. 2. After they agreed they’d stay home on New Years Eve, Bill rang her, saying they were now going to go a work colleague’s party. Jane was angry he’d changed the plan, Bill said ‘my friends are my family’. This was very upsetting because Jane knew he wasn’t close to his work colleagues, but also she says ‘I should be his family’. • What are the major issues faced by Jane? • What else do you need to know about Jane’s life? • How would you work with the client, comparing TWO of the three therapeutic approaches covered in lectures (Cognitive-behavioural Therapy, Acceptance and Commitment Therapy, and Solution-focused Brief Therapy)? For each of your two chosen approaches, discuss: o What issues might be prioritised, how you would establish this? o What techniques/strategies might you use? (describe specific examples of techniques as applied to the case study information) o What would tell you if your approach / strategies were being effective? Where necessary, you can extrapolate information not already provided, but indicate when you do that. Ensure you are considering a range of possible responses from Jane, not just one, when exploring which directions you might take.