Layla Cognitive Behavioral Therapy (CBT) Case Questions
Read over the below case write up regarding a client named Layla. Then, respond the prompts that follow:
Imagine you have been assigned (as a therapist) to see a client named Layla.
Layla is a 20 year old college junior who says she is seeking counseling because she is having trouble choosing a major. Over the course of her undergraduate career, Layla has changed her career goals five times. She started with pre-med, then to computer science, to engineering, pre-law and finally business. Layla has done very well in most her classes, yet has not found her interest in any of these.
Layla is the oldest of 3 children. Her parents are both undocumented immigrants from Ethiopia. Layla’s parents met in college, where they were active in student protests against oppressive practices by the Ethiopian government. The government was targeting and punishing protesters. Despite this, her parents continued to march for justice. One day, on her way home from classes, her mother was kidnapped, and tortured for her activism. Her captors, who were state agents, threatened her do the same to her family if she continued to protest. So, her family put their money together and bought her a plane ticket to the United States. Layla’s father came with her. They planned to seek asylum, however, their case was denied and they were ordered to return to Ethiopia. Because they feared for their lives, they were unable to return to Ethiopia. Thus, they remained, undocumented, in the U.S.
Layla and her siblings were born soon after. Layla’s parents worked long and unpredictable hours, taking any job they were able to get. Due to their undocumented status, they had few good choices. Layla and her siblings always had food on the table, and were told to focus on their education. Layla was responsible for babysitting her siblings, making sure they did their homework, cooking for them, and makings sure their homework was done. Layla grew up hearing her parents’ stories about the injustices they fought as college students, the torture her mother experienced, how they became undocumented Americans, and seeing their work conditions. She was often terrified they would be hurt. Layla was often alone with her siblings while her parents worked the nightshift. She stayed awake watching the door all night until a parent came home. She often had nightmares that intruders attacked her and her siblings and spent the day thinking about how she could protect them. She also had nightmares about her parents not returning home.
Layla has also been working since she was a child, saving money for herself and her siblings to go to college, and sometimes for sweet treats or school supplies her parents were unable to provide. She walked dogs since she was 7 years old, started babysitting the neighbor’s children since she was 10. She has also worked her way through school. Throughout college, Layla continues to live at home, work as many hours as she can, and take care of her siblings while her parents work to help her with tuition. Although she is older, and the nightmares are less frequent, they have not gone away. When she is most scared, she looks at her bank account and thinks about how safe she would feel if she could save some money. Maybe her parents could leave their risky jobs. Maybe they could be home more.
The only thing Layla has ever cared about outside her family is her activism in movements supporting undocumented rights and racial justice. While she does not get to be with her mom very much, protests help her feel closer to her mom. Layla used to dream of pursuing civil rights law. However, her parents do not support this dream. Given their experiences, they are terrified of Layla being harmed as a result of justice work. With news headlines of protesters in support of Black Lives Matter being targeted by police or counter-protesters, the deployment of the National Guard to “keep the peace,” and the government’s violent rhetoric against protesters, Layla’s mother’s trauma symptoms from her own torture have become intense. Layla does not want to see her mother this way, and does not want to add to her mother’s stress. She has decided to pursue a “safer,” more stable career path that will allow her to provide financial support for her parents and siblings, while also remaining physically safer and calling less attention to her family. However, she is unsure of which specific career to pursue. She is unhappy with the majors she has tried so far, and is thinking about switching majors again. She does not want to be in therapy, but her academic advisor insisted that she see you. Layla feels uncomfortable talking about herself. In her relationships with others, she tends to be the one people turn to for help. When she does begin to talk about herself, she feels selfish and guilty for burdening others. When you, as her therapist, as about her personal life, she repeatedly switches back to her major choice. She would like you, as her therapist, to recommend a different major.
Apply Albert Ellis’s ABC model to understand Layla’s career indecision.
How might you treat Layla from Ellis’s perspective, using REBT (page 37-40 of G, NW, & F Chapter 12 CBT PDF.
How might cognitive restructuring be helpful for Layla? How might cognitive restructuring be limiting (e.g., what else might Layla needs)?
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