Problem:
How will you document this session? Discuss three things you will write in your report explaining why they will be included. Include in your discuss any referrals or other action you think appropriate in this case. Need Assignment Help?
Isabella is a 15-year-old student completing her sophomore year of high school and presently taking a college preparatory curriculum. Her initial statement in the first counseling session is that she is "unhappy" and anxious at school, except when she is socializing with her friends. On further clarification, Isabella reveals that she is unhappy and worried because she doesn't think she is measuring up to her classmates and that she dislikes being with these "top" kids in her classes, who are very competitive. She reports feeling "on edge" at school, having difficulty focusing or concentrating, and trouble falling asleep due to staying awake at night and worrying about school the following day, particularly her "performance" in school. Her teachers have noticed her lapses in concentration and suggested she speak with you, the school counselor.
She reports particular concern in one math class, which she says is composed largely of "guys" who are much smarter than she is. She states that she thinks about the fact that "girls are so dumb in math" rather frequently during the class and she feels intimidated. She reports that as soon as she is in this class, she gets anxious and "withdraws." She states that she sometimes gets anxious just thinking about the class, and she says that when this happens she gets "butterflies" in her stomach, her palms get sweaty and cold, and her heart beats faster. When asked what she means by "withdrawing," she says she sits by herself, doesn't talk to her classmates, and doesn't volunteer answers or go to the board. Often, when called on, she says nothing. As a result, she reports, her grades are dropping. She also states that her math teacher has spoken to her several times about her behavior and has tried to help her do better.
However, Isabella's nervousness in the class has resulted in her cutting the class whenever she can find any reason to do so, and also faking illness or oversleeping to stay home from school whenever she can. As a result, she has almost used up her number of excused absences from school. She states that her fear of competitive academic situations has been there since she started high school a year ago, when her parents started to compare her with other students and put "pressure" on her to do well in school so she could go to college. When asked how they pressure her, she says they constantly talk to her about getting good grades and how success is tied to a college degree.
Isabella reports a strong network of girlfriends with whom she "hangs out a lot." She reports that during this year, since the classes are tougher and more competitive, school is more of a problem to her and she feels increasingly anxious. Isabella reports that all this has made her dissatisfied with school, and she has questioned whether she wants to stay in a college prep curriculum. She has toyed with the idea of going to culinary school instead of going to college. However, she says she is a very indecisive person and does not know what she should do. In addition, she is afraid to decide this because if she changed her curriculum, her parents' response would be very negative. Isabella states that she cannot recall ever having made a decision without her parents' assistance. She feels they often have made decisions for her. She says her parents have never encouraged her to make decisions on her own because they say she might not make the right decision without their help. Isabella is an only child. She indicates that she is constantly anxious about making a bad or wrong choice so that when she is confronted with decisions, she feels worried and lacks confidence in her choices.