The Case of Janet
(substance abuse and a sense of helplessness)

Janet is your client in a community mental health center.  She is in your office for individual therapy because of a requirement of her parole. 
 

Some background information:

Janet reports that she has always had difficulties handling her family and her personal life.  She says that she had a relatively stable marriage until she found out her “old man was running around with other girls”.  Although she filed for a divorce from him, she never appeared in court, so she is uncertain about her marital status.  She reports that after the separation he “disappeared” until quite recently when he “reappeared out of nowhere” and took their son (now 15) to live with him.  She also has two girls, ages 8 and 10, who still live with her.  The client says that once her husband had left she was forced to resort to stealing to support the family and her drug habit.

In general, as you explore her past experiences, it becomes obvious that Janet finds it easier to avoid facing certain life difficulties and self-responsibilities and to settle for immediate relief or pleasure when at all possible.  Janet also is a chronic worrier; she sometimes becomes so concerned with things that might happen to her or her children in the future that she becomes incapacitated.  She believes her unhappiness is externally caused and that she has little ability to control her sorrows; Janet is convinced that her lot in life is to be the victim of emotional pain, unduly inflicted by others, and the world in general.

Janet has been addicted to cocaine for four years.  During this period she has had behavioral problems with her two daughters, as well as the son.  Eventually, she moved in with her current boyfriend, and the behavioral problems with the children escalated.  She reports that she is on parole for a theft charge and is afraid that she will have to go back to prison for parole violation because of her drug use.

Janet lets her parole officer know that she has seen you and that she wants to get some help to “get her life together”.  A few days after your initial contact with Janet, her parole officer calls and says that her urine test is “dirty” showing traces of several drugs.  The parole officer asks about your treatment plan and is interested in what theoretical approach you use as a counselor.  Your preferred approaches are cognitive-behavioral therapy and reality theory.