Caitlyn came in because her parents forced her to. She is a 16 year hold high school Junior. Her parents had sensed that things were “off” with Caitlyn for a while but weren’t sure what it was or what to say. Caitlyn’s grades were good, she was active with her friends, and while she was moody at times, nothing seemed worse than what they assumed the “average teenager” was like.
Most of their conflict was around mealtimes or about food. Caitlyn would get up early before school to jog a few miles. But she wouldn’t eat anything more than a glass of juice for breakfast. When her parents pushed her to have some yogurt or a bagel, she quoted calorie stats to them and converted those calorie counts to how much additional exercise she would have to do to burn those calories.
Caitlyn would do all she could to be busy during the evening mealtime. When her parent pushed her to eat with them or meet them at a restaurant, she would get defensive and call them controlling. Her parents didn’t like the arguing and Caitlyn seemed fit, so they didn’t push it.
Then, one afternoon at school, Caitlyn passed out during gym class. She was taken to the school nurse. During the assessment, the nurse also became concerned about Caitlyn’s eating habits and lack of weight. This conversation embarrassed Caitlyn, she felt overwhelmed (in part because of her low blood sugar) and started crying. She was vulnerable with the nurse and started to discuss the possibility of changing her eating habits, but as soon as the conversation turned to numbers (a goal for the number of calories to consume each day) Caitlyn got cold and argumentative again.
The nurse relayed her concerns to Caitlyn’s parents and said they should have Caitlyn talk to someone. Her parents know you and ask if you would meet with Caitlyn (in whatever capacity you typically having helping conversations – friend, mentor, pastor, or vocational counselor). They share the resistance Caitlyn has given them and the school nurse. Caitlyn’s parents have done some investigating of her room and found laxatives and think she is vomiting after some meals. They sound scared.
You start to think about how you can avoid receiving the same resistance from Caitlyn that she has given to her parents and the nurse. Most of the people you talk with initiate conversations with you because they want to change. This feels like Caitlyn will be an “involuntary counselee.” You’re not sure if or how to approach the conversation with her differently.
When your first meeting with Caitlyn occurs, she greets you with, “I know my parents want you to make me eat more. That’s why they brought me here… for you to ‘fix’ me.” You’re caught off guard. You wanted to build some rapport before jumping right in. But Caitlyn sabotaged that approach. This conversation already feels like a chess match and you’re on the “other team” from the person you want to help. What do you say next?
Case Study Discussion
This case study was written to set up the presentation for the free webinar Levels of Motivation – A Case Study. The webinar will be Thursday September 24th at 1pm EST. My goal in this twice-monthly series of free webinars is to teach one primary counseling concept or skill each month and then provide a case study that allows participants to become more proficient at utilizing that skill or concept.
These are great events for:
- Pastors, chaplains, and ministry leaders looking to enhance their pastoral care skills
- Counselors wanting CEU credits to help them learn more about the intersection of their faith and practice
- Leaders in church-based counseling ministries looking to grow in their case wisdom
- Undergraduate students looking to discern a calling to vocational ministry or a career as a professional counselor
- Friends and small group leaders committed to walking faithfully alongside their peers in tough times
Note: If you want to participate in many or most of the webinars in this series, when you RSVP click “auto subscribe to all future webinars,” so you don’t have to keep up with registering for each event.