Utilization of Acceptance and Commitment Therapy (ACT) With Charlotte Underrepresented on Campus: ACT Case Study on Campus

Case Description

Charlotte is brought to the university counseling center (UCC) by a peer who saw her crying on campus. She meets with the counselor and is hesitant to talk at first as this is her first counseling session. Charlotte opens up to the counselor about growing up with both her parents in a financially stable home until age 13 when her father passed away from heart problems. She details that her family downsized to an apartment when her dad passed away. Charlotte reports coping with her father’s passing. She discussed her mom becoming the sole financial provider working two jobs to support Charlotte and her three younger sisters financially.

Charlotte discusses the stress of being a premedical student in college. She tells the counselor that she wants to become a physician while struggling with her capability of succeeding in premedical studies. Charlotte expresses interest in becoming a physician to support her family financially. She continually compares herself to her roommate, who excels in premed classes at her university. Charlotte often states, “I am not good enough,” and “I do not want to be a disappointment to my family.” She experiences anxiety about visiting the tutoring center on campus, hoping her peers will not find out that she does not understand the course material. She reports having racing thoughts, trouble sleeping nightly for the past month, and stomach aches two to three times per week. She mentions thoughts about not being alive and not caring if she is on earth anymore. I clarified with Charlotte about whether her thoughts are more related to thoughts about death or thoughts about committing suicide. Charlotte discussed with me that she would never kill herself and has no plans to commit suicide, but occasionally thinks about death when she experiences significant academic and financial stress. She expressed that she does not want to commit suicide due to her strong faith and spirituality.

Charlotte is hesitant to attend a follow-up session due to discomfort discussing her concerns and family details with a counselor. She feels a sense of embarrassment that she is attending counseling and fears her family and friends’ judgment of her. She believes that attending counseling sessions once-a-week is time-consuming with her busy schedule. Charlotte wonders if the counseling sessions will help her feel better. She decides to attend another counseling session due to experiencing overwhelming feelings of stress daily and her desire to not drain her family or friends with her issues.