Therapeutic Interventions: Evaluating a Behavioral/Cognitive
Approach
Discuss: What are the strengths and weaknesses of using a
behavioral/cognitive approach with the following client?
Client Profile:
Name: Aaron B. Gender:
Male Age: 17
Ethnicity: Syrian-American Religion:
Jewish
Relationship Status: Single
Description of Presenting Issue:
Aaron was referred for counseling by his physician. Aaron is
a star athlete on the high-school track team and attributes all his symptoms to
his efforts to be the best possible runner that he can. He eats little,
limiting his diet severely, and now weighs only 120 pounds, even though he is
5’10” tall. He believes that if he can lose another 10 pounds, he will be
able to run even faster. Aaron keeps lists of everything he eats, weighing each
food item and computing its fat content. In addition, he tracks his daily
training by keeping a record of how many minutes he runs and how many steps he
takes, counting his steps as he runs. Aaron also has many other lists that
guide his life, including a list of every possession he owns and every person
he talks to each day. If he forgets to include an item on one of his lists, he
becomes very anxious and only calms down when he has recopied the list with the
forgotten item at the top of the list. He tends to check his lists repeatedly,
making sure that words are in alphabetical and size order. Despite his youth,
he has few friends and activities other than his running, but is able to work
delivering pizzas.
Occupation History: Part-time pizza delivery
Education History: Currently attends high school; maintains
a B+ average
Medical History: Aaron acknowledges that he has developed
osteopenia (thinning of the bones) and also tells you that he has knee and shin
pain.
Family History: Aaron is an only child. His mother and
father divorced when Aaron was 10 due to his father’s infidelity. Aaron lives
primarily with his mother. She owns a successful interior design business and
travels frequently. Aaron describes his mother as hard-working, with high
standards and expectations. Aaron’s father works in the finance industry, was
remarried four years ago, and has two children (ages 1 and 3) with his second
wife.
Alcohol/Substance Use: Aaron does not smoke, drink alcohol,
or use illegal substances. He occasionally takes Vicodin (a painkiller)
prescribed by his physician for his knee and shin pain.
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