103 The Professional Counselor | Volume 13, Issue 2 Although many diagnoses overlapped in both scenarios, there were differences regarding the frequency of endorsement. The most common diagnoses for the male client included adjustment disorder (n = 9) and attention-deficit/hyperactivity disorder (ADHD; n = 7). Conversely, the female client was most frequently diagnosed with a dependent personality disorder or style (n = 8). The female client was never diagnosed with ADHD and was only determined to have “attention problems.” Dating Relationship Considerations Participants drew attention to relational concerns in the client’s life within this category. The identified themes included unhealthy relationships, support, and dating violence. The unhealthy relationship theme was evident in both client cases. Several participants (n = 15; seven in the male client case and eight in the female client case) noted comments like “unhealthy relationship” while providing examples of unhealthy behaviors, such as the partner’s communication style and controlling behaviors. Several responses highlighted the theme of support. Participants appeared to skirt around labeling relationship violence and resorted to more general comments, such as “the client needs relationship support” or “better communication in the relationship is needed.” Additionally, one counseling student noted the lack of support in the relationship and questioned the need for such a serious relationship at this “young age,” demonstrating judgment and bias (further discussed in Category 6). This theme also captured counseling students’ recommendations for enhanced relational support (e.g., date nights). The final theme within this category, dating violence, was evident in six responses that labeled the relationship as “violent” or mentioned “dating abuse” as a concern. In responses that noted abuse, three mentioned “emotional abuse,” and two identified “sexual abuse” in the female case. The word “sexual pressure” was also used by two counseling students that completed the female case, but it was not explicitly noted as abuse or violence. In the female case, two participants mentioned “rape” four times, whereas “rape” was never mentioned in the male case. In the male case, the only comment that slightly implied relationship violence noted: “needs to discuss relationship boundaries with his partner, so she doesn’t pressure him to advance sexually.” Treatment Approaches Treatment approaches were categorized and counted based on theoretical orientations. Most participants responded with similar treatment considerations for both presented cases. The five grouped themes included cognitive behavioral therapy (n = 15), solution-focused therapy (n = 11), family therapy (n = 9), couples counseling (n = 3), and other (n = 7). The other theme resulted from various suggestions that were not specific approaches for individual therapy but could support the client. These suggestions included tutoring, group therapy, and peer support. Several counseling students made referral recommendations instead of offering treatments or approaches that the counselor could directly utilize with these clients. For example, a suggestion included psychiatric evaluation or referral for the female survivor (n = 10). This suggestion was not recommended as often for the male survivor (n = 2). Additionally, one respondent suggested that the female survivor should “get a referral for a gynecologist.” In contrast, no responses indicated a medical referral for the male client. Practice Considerations Participants answered questions regarding any apprehension or reservations they might experience while treating the proposed clients, categorized as practice considerations. The themes that emerged were ethical and legal concerns, family concerns, and school concerns. Almost a quarter of participants (n = 11) indicated clinical concerns related to ethical or legal implications or limits of confidentiality because of the clients’ ages. Some counseling students mentioned “involving parents” or “disclosing
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