COUNSELING PSYCHOLOGY COMPREHENSIVE EXAMINATION.Julie Lewis is a 72 year old African American woman. Three months ago, Julie underwent back surgery to treat chronic back pain and numbness in her left leg.
CASE VIGNETTE: Utilize this scenario as the basis for your responses to the prompts (listed following the vignette).
Julie Lewis is a 72 year old African American woman. Three months ago, Julie underwent back surgery to treat chronic back pain and numbness in her left leg. Julie decided to seek your counseling services because she is not “bouncing back” from the surgery the way she had expected. Julie describes having little energy and sleeping a lot since the surgery. She also frequently gets very upset when driving. She describes feeling nervous and very angry by how inconsiderate and dangerous other drivers behave, to the extent that she often finds herself yelling and screaming at other cars when she is driving. On two occasions, she has become so upset that she has turned around and gone home rather than complete her trip.
Julie is semi-retired and works 2 night shifts per week at a hospital as a psychiatric nurse. Since the surgery, Julie finds working a 12 hour shift to be especially exhausting. She often spends the day after she works a night shift in her nightgown all day rather than getting dressed and leaving the house. She lives alone in a condo near the hospital where she works. Julie admits that she feels sad and lonely much of the time. She realizes that the amount of time she spends wishing that other people would do things the right way is not healthy, but she also cannot seem to stop. She reports being on antidepressant medication off and on for most of her life. She had taken Wellbutrin for a number of years, but she reports it stopped working about two years ago. She has recently begun taking Celexa.
Julie has been divorced twice, and has been single for approximately that past 15 years. She has three grown children, two sons and a daughter. She describes having good relationships with her children, but she also feels that her children have their own lives and she does not want to be a bother to them. Julie describes both of her marriages as disasters. Julie was married to her first husband for almost 20 years, and he is the father of her children. Her first husband had little consideration for Julie’s feelings, and he had multiple affairs while they were married. Julie describes her second husband as a loser who depended on Julie financially and emotionally. While Julie had always known that he was a drinker, he developed a problem with alcohol a few years into their marriage. Julie tried to put up with the substance abuse as long as she could, but, after 17 years of marriage, Julie divorced her second husband. She has not spoken to her second husband in years, and she has no idea where he is now.
Julie describes the family she grew up in as very strict, and any affection in the family was given to her younger sister, who according to Julie could do no wrong in their parents’ eyes. Julie, on the other hand, felt like she could not do anything right for her parents, no matter how hard she tried. Julie’s family was very active in their conservative church while she was growing up, but Julie now describes herself as an atheist. She does not have positive views about organized religion, and she believes religion as a way to repress and control people.
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