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Posted: July 17th, 2022
Discussion Question
CNL-605 Topic 6 Case Study: Rebecca
Rebecca is a 15-year-old Caucasian patient brought to your office for counseling by her mother. The intake documentation identifies ongoing struggles with anxiety and depression. Your initial impression is that Rebecca is a shy teenager, very much into the Goth culture. Her hair is dyed pitch black, she wears thick black mascara and eyeliner; in spite of the hot Arizona weather, she wears a long-sleeved black shirt, black
jeans, and high black camo boots. Her fingernail polish is also black: all contrasting her very white skin tone. Her mother does most of the talking; Rebecca avoids eye contact and presents disengaged.
Rebecca’s mom reports that the reason they sought your services today was because “she cut again.” Her mom grabs her arm; reluctantly Rebecca pulls her sleeves up to reveal several fresh superficial scars but also multiple older scars, which span from her wrists to her elbow joints.
The nonsuicidal self-injurious behaviors began approximately 2 years ago, a difficult time for Rebecca when they moved across the country for the fourth time since she started school. Rebecca explains that her dad is in the military and they move a lot. She reports that she was bullied a lot by her new peers in seventh grade and that, at that time, a girl at school taught her about cutting. In addition to being bullied, peer pressure among the teenage girls became difficult to cope with. Some of the boys in her class were interested in her but the more dominant,
established girls brought about some serious competition. They constantly found ways to prank her or to comment on her looks or weight. The same girlfriend taught her to count calories, exercise a lot, how to use laxatives, and how to purge after a large meal. She worries a lot about her weight, grades, and her looks, and about not being liked or loved by anyone. At times, she tried cannabis and
drinking alcohol to alleviate her stress—but this is rare, as her parents monitor
her closely. Cutting is easier to hide…and cheaper. She insists that she has never considered taking her own life, explaining that when she cuts, the pain “outside” alleviates her pain “inside.”
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