Julio is a 22 yr. old, Mexican male student who comes to the college counseling center for issues of anxiety. From the first moment you speak to him, you notice he has pale skin that flushes when you greet him and light-colored eyes that are different from your expectation of a Chicano male. When you shake his hand, his grip is soft and gentle compared to what you would also expect. As such, you immediately take note of your potential biases and assumptions of masculinity among Chicanos and offer him to sit down.
When you begin your initial intake assessment you learn he has recently immigrated to the US within the past three months. You ask him to describe his hometown where he is from and you learn he comes from a rural mountain town and has enjoyed the close bonds of relatives and friends in the area his whole life until now. He stops there. He appears shy to you and needs prompting to speak further, but when asked questions he actively replies. He has a lot of insight and shares with you he feels like he has “anxiety.” He asks you if he pronounced it correctly, which he did, and you become aware of how good his English is. You then ask if that is a concern of his, to speak English in front of others, and he responds it is so.
You return to the topic of friends and family. He seems to be homesick. You reflect that to him, and he agrees that it is indeed how he feels. You then ask him what brought him to the US. Julio states that in his hometown there were not good options for college nearby. He had an aunt, uncle and cousins who moved to FL and offered him a place to stay. They encouraged him to come for college. He said he was interested in pursuing psychology and he felt that a degree from the US would hold more value than from Mexico. You validate his pursuit of psychology by acknowledging that he has good insight and it will be useful in his study and practice.
You also acknowledge your gender, race, class, national and ethnic differences than him, and ask Julio how he feels about working with someone so different from him. Julio responds that he doesn’t mind and offers no further input on the topic, so you respond by asking what Julio thinks it is most important for you to know about him, his homeland, and his culture. With that Julio begins to describe his family, religious values and spiritual practices, and as well as cultural customs that seem to all clash in the US from Julio’s perspective. This exploration further details Julio’s presenting problems and symptoms of anxiety.
Julio describes he has trouble falling asleep, restlessness throughout the night, and fatigue the next day. Julio also says he is not ordinarily shy at home but is in the US. He finds himself thinking a lot about what others think of his accent, his dress and mannerisms, how they perceive his “skin flushing,” and excess sweating. He is also self-conscious about the fact that most Chicanos and people of Hispanic descent in the US look very different from him and that there is little sense of community among the people he has met. He goes out of his way to avoid talking to strangers, classmates, and professors, but he said he was willing to forgo that for counseling services. His “anxiety” and discomfort are so distressing for him that he is considering returning home after his first semester.
Other than his cousins and aunt and uncle, Julio has not made any friends and stays to himself. He doesn’t feel comfortable going out with his cousins and their friends, and other than coming to campus for classes, he stays at home with his aunt and uncle and goes out once a week for a Spanish Holy Mass on Saturdays with his aunt.
Instructions: Review the case study provided on Julio. Then respond to the following prompts/questions in a cohesive written case report.
Describe the client’s presenting problem(s) through a theoretical framework of gender. Identify any gendered patterns of development described in your text you feel are relevant to this case.
Identify the intersectional aspects of identity that need to be explored to better understand your client and evaluate how these intersections may play a role in the presenting problem(s).
With the information provided, give a brief assessment of the client’s strengths?
What assessments do you think are appropriate for Julio?
With the information provided, identify a working hypothesis for a diagnosis and the gendered implications for recovery.
Identify three goals for treatment you think are most significant for this client’s presenting problem(s) and present an objective for each item to achieve these goals.
What referral resources would you suggest—professional, community-based, school, or otherwise—in response to the case?
Identify two countertransference issues that could arise working with this client and how you would work to resolve them.
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