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Case Study of Jane and the Cognitive and Behavioral Approach

Faculty of Behavioural Sciences, University of Yorkville

PSYC 6113 Theories of Personality

Dr. Croce

December 20, 2020

Case Study of Jane and the Cognitive and Behavioral Approach

Personality is the unique set characteristics and qualities of a person that influence his or

her behaviour in different situations, which determines the state of who we are and shapes our

life experience and even influence our physical and mental health (Schultz & Schultz, 2017). It is

important for counsellors to include the analysis of clients’ personality while completing a

contextual assessment of clients. In this paper, I am going to analyze Jane’s personality using the

cognitive and behaviour approach and creating a case conceptualization.

The Case of Jane

Jane is a 33-year-old single white female. She was abused by her alcoholic father when

she was young. She had to sit in a closet once for hours because she cried when her pet goldfish

died. Her parents divorced when she was eight-year-old, neither parent wanted her, she went to

live with an aunt who remained aloof. Jane developed a self-harming behaviour as she began

cutting herself and she would often threat to commit suicide, but no one took those threats

seriously. She did poorly in school. Jane had difficulty maintaining friendships, but she enjoys

being around others and longs for companions. Friends describe her as unpredictable and intense.

She would get upset if she did not get her way. She had been married twice but both marriages

did not last long. She often feels empty inside. She drives her car dangerously and likes the thrill.

She is not capable to carry on any job for long period of time because she cannot get along with

others at work. She was caught stealing from one of her employers. She shops frequently,

especially when she is stressed or depressed. She has tried several drugs over the years but

mainly uses alcohol to numb her pain and lift her spirit.

Jane’s Personality under the Cognitive and Behavioral Approach

Cognitive behavioral approach is commonly used in the Cognitive and Behavioral

therapy (CBT) that focuses on what people think and how people behave are connected closely

and influencing on people’s overall well-being (Cognitive behavioral therapy, 2016). By

analyzing Jane’s case from the cognitive and behavioral perspective, many of Jane’s behaviour

issues are related to her emotions, thoughts, and beliefs.

Firstly, Jane developed the self-harming behaviour such as self-cutting and threating to

commit suicide. This could be the result of her belief that she would get the attention that she

always wants by hurting herself (Hendrick, 2016). Secondly, she has difficulties to maintain

relationships with friends, co-workers, and marriage partners; probably because she has low self-

esteem, feeling of worthlessness, anger, and view others with distrust. This could be the result of

her neglected childhood experience. Thirdly, her friends describe her as unpredictable and

intense and she gets upset easily if things did not get her way, thus, she likely has a high neurotic

personality. According to Widiger & Oltmanns (2017), people with high level of neuroticism

would associate with experience negative affects including anger, anxiety, irritability, emotional

instability, and depression. Fourthly, she often drives recklessly because she likes the thrill

feeling. She also uses drug and alcohol. These are possibly the only coping strategy that Jane

could think of to relief her anxiety and stress. Lastly, she has overspending issues as she shops

frequently, especially when she is stressed. It could be that the feeling of making purchases

helping to release some of her stress.

Case Conceptualization of Jane

By analyzing Jane’s personality, a case conceptualization is created using I CAN START

model, under the Cognitive and Behavioral perspective. The model is a holistic, strengths-based,

culturally sensitive treatment planning model that contains following nine components to create a
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case conceptualization of a client: (I) Individual Counsellor, (C) Contextual Assessment, (A)

Assessment and Diagnosis, (N) Necessary Level of Care, (S) Strength, (T) Treatment Approach,

(A) Aims and Objectives of Treatment, (R) Research-Based Interventions, and (T) Therapeutic

Support Services (Kress & Paylo, 2019).

I started the case conceptualization on the individual counsellor level. I analysed myself

in term of strengths, weaknesses, and cultural identify. I am a 40-year-old Chinese male

counsellor. I migrated to Canada when I was 20 years old and attended the university here. Due

to my background, I understand both Asian culture and western culture. I score high on openness

and agreeableness. I am a good listener and observer. However, I am a male counsellor and had a

good childhood, so I might lack of understanding on the parenting style of Jane’s parents. With

my knowledge and the understanding of Jane and myself, I realized that I need to be aware any

cultural and worldview differences between her and me, and my bias or stigma towards her. I

will eliminate those bias or stigma and focus on Jane’s worldview when building a therapeutic

relationship with her.

Next, I performed a contextual assessment of Jane. Based on my knowledge about Jane,

she was abused by her father and then abandoned by her parents after her parents’ divorce.

Children who have experienced early neglect are vulnerable to cognitive and behavioral deficits

and in need of intervention (Spratt et al., 2013). Children without adequate care, after they

became adults, they are less able to access employment and are more at risk of behavioural,

physical, and mental health problems, including depression, high risk behaviours, alcohol and

drug misuse, and violence. These challenges have been linked to anti-social and criminal

behaviour in adulthood (Csáky, 2014). These would have contributed to her issues such as poor

academic performance, unable to hold any jobs for long, anger, drug and alcohol abuse, reckless
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driving and stealing. Besides physical abuse, she was also been neglected emotionally in her

childhood first by her parents and then later her aunt. Emotional Neglect is a parent’s failure to

act, to notice, attend to, or respond appropriately to a child’s feelings (About Emotional Neglect,

2011). Her parents forced her to sit in a closet for hours because she cried when her pet goldfish

died, and her aunt’s ignorance toward her, are typical acts of emotional neglect. Because her

emotions were not validated as a child, she may have difficulty knowing and trusting her own

emotions as an adult. She may have difficulty understanding her own feelings, as well as others’.

These may explain why she is unpredictable, intense and have trouble to maintain relationships.

Because an important part of her (their emotional self) has been denied, she finds herself feeling

empty and has difficulty trusting or relying upon others in her adulthood (About Emotional

Neglect, 2011). Furthermore, her childhood neglecting experience would also result to her low

self-esteem, feeling of worthlessness, anger, and view others with distrust, known as inferiority

complex (Schultz & Schultz, 2017) that again adds to her mental issue. Overall, all her childhood

experience, personality, emotions, thoughts, and behaviors contributed to her current mental

illness.

For Assessment and Diagnosis, as a counsellor in Canada, I am not allowed to provide

diagnosis. I will have to refer Jane to the proper individual or organization who can diagnose her.

After her diagnosis, I can continue to work with her on counselling therapies.

For Necessary Level of Care, I can take Jane as one of my outpatients and setup an

individual weekly session to see her. I can also help her seeking social support, getting some skill

trainings to land on a job.

It is important to identify client’s strengths which can be used to help overcome the

mental disorders. Jane’s strengths are she loves to be around others that means she is an extrovert
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and sociable person; she is willing to overcome her mental health issues and seeking for changes

because she realizes those issues are hurting her life experiences. These strengths can be used as

the motivation and assets for her to change her thoughts and ultimately her maladaptive

behaviors to overcome her mental health issues.

We can use the Cognitive and Behavioral Therapy (CBT) as the treatment approach to

help her develop the necessary skills to cope and overcome her mental disorders. Hofmann et al.

(2012) indicated in their research article that CBT has been found to be efficacious in many

mental illnesses. Jane’s behaviour issues could all be treated using the Cognitive and Behavioral

theory. Using CBT treatment, the counsellor will work Jane on those inaccurate beliefs and

maladaptive thinking to help her to correct those thinking (Hofmann et al., 2012).

Regarding Aims and Objectives of Treatment, I can help Jane to set some short-term

goals and some long-term goals. The example of a short-term goal would be to stop the self-

harming behaviour such as self-cutting. This will involve work with her to develop a skill to

recognize her negative thought that would normally cause the cutting behavior, and then replace

the self-cutting behavior with non-harming activities. For long-term goal, that would be to

improve her self-esteem, self-worth, and her ability to recognize and control her emotion. This

will help her to build and maintain a healthy relationship with her friends and partners in the

future and be able to hold a job properly.

For Research-Based Interventions, I can help her to increase her awareness of her

thinking patterns and develop emotion regulation skills by practicing some relaxation and coping

techniques.
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Lastly, I can also connect Jane to therapeutic support services, such as find a support

group in Jane’s local community. This will also help Jane to expend her social circle and

improving her social skills.

Conclusion

Our personality does not only influence our behavior and shape our life experiences, but

also contributes to our mental health status and ultimately impacts our overall health. From the

case study of Jane, we understand the importance of analyzing clients’ personality when creating

the case conceptualization. This will help counsellors to gain a deeper understanding of clients.

Approaches such as CBT and I CAN START case conceptualization model can be used to guide

counsellors on creating appropriate therapeutic treatment plans that lead to positive outcomes.
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