If necessary, she will be offered help via rehabilitation centers to deal with the alcohol and drug issues. It is important to help her understand that the alcohol and drugs are merely symptomatic of the deeper-lying issues that are related to the abuse, and that they can only be addressed once the root problem is eradicated. V. Case Process

Initially, the client was somewhat hostile and completely unwilling to talk. The counselor did not attempt to push her into saying anything. The counselor did not make any attempt to start an unrelated conversation, but asked the previously determined questions one at a time. At first, with no response from the client, long periods of time passed without any conversation. Gradually the client began to open up and share her thoughts. She revealed very deep-seated feelings of guilt and fear related to the abuse. In addition, her sense of shame that she did not reveal the abuse, and the guilt for wanting to kill her father instead of herself drove her to the suicide attempt. She also felt guilty with regard to her other siblings and family members, feeling that she let them down by not implicating her father, and on the other hand feeling guilty about her negative emotions relating to her father.

The counselor worked on the client's feelings of self-respect and -esteem via a number of exercises and questions. The client was also required to do home exercises such as journal writing in order to develop a stronger sense of self-worth through the honest evaluation of her feelings. The positive progress in this regard can be used as a springboard for later counseling regarding the drug and alcohol issues. Rehabilitation will probably be necessary due to the longstanding nature of the client's habits.

A positive prognosis is given, as the client is now more aware of the reason for her feelings...

She has indicated her willingness to abandon this behavior, but also understands that this will be a lengthy and painful process, of which the current counseling is only the beginning.
VI. Results

The results can be viewed as very positive, although only time will tell whether they were completely successful. The client is in counseling for her drug and substance abuse, and is to enter a rehabilitation clinic in the near future. She is currently living with her family, from which the father is absent. Family members are to be included in later counseling sessions.

The family views the results as positive, as the client has made no further attempts on her own life. Drug and alcohol abuse is still a problem. Other professionals however also view this outcome as positive, because the client is aware of her problem, and has declared herself willing to enter a rehabilitation facility. The community can view the result as positive, because the client has finally been able to honestly relate to her feelings regarding the abuse. As such, the client can empower not only herself, but also other members of the community to be honest about abuse issues and to seek help, and finally healing.

VII. Personal Reflection

What worked well with the client was to be continuously gentle with questioning, but also encouraging answers via silence rather than further questions or clarifications. The discomfort caused by silence was experienced as more intense than the discomfort of the questions themselves. What would not work well is confronting the client directly with the core issue from the beginning. A better approach is to begin with gentle, leading questions that address the issue very subtly. This approach will also be used with similar clients in the future.