Theresa Case Study

Client: Theresa is a 12 yr Korean American adoptee who recently started 7th grade at a middle school in a small midwestern town. The racial makeup of the city is estimated:

• 96% White
• 0.12% African American
• 1% Native American
• 0.31% Asian
• 0.97% from other races
• 0.62% from two or more races

Presenting Concerns: Theresa presents with symptoms related to anxiety and parent-reported themes of perfectionism, particularly related to performance in her math class. Theresa experiences significant amounts of pressure to excel, which result in her avoiding challenging tasks and feeling intense distress when her quiz and test scores aren’t 100%. Theresa says she feels physically ill (e.g., headaches, pain in her stomach) before tests in math class and often declines social activities in order to study. The stress also has a negative impact on her sleep.

Recently, with the start of the new school year, Theresa also reported feeling a sense of secrecy about her middle name, which is Korean. She witnessed an international student being teased about their name and fears that the same thing will happen to her if anyone learns about her name or attention is drawn to it somehow.

Background: Theresa was born in Korea and relinquished for adoption at age two. Her white adoptive parents seem loving and supportive and are actively involved in a local church community. While their relationship seems close, Theresa reports feelings of disconnection and loneliness, wishing she could feel a deeper sense of belonging. At times, she reports a sense of confusion about her place in the community, wondering about her place among peers, neighbors, and even within her own family.

Her parents are concerned about her mental health.

Discussion Questions:

1. What variables do you see influencing Theresa’s mental health? How does her lived experience as a Korean American adoptee intersect with her tendency toward perfectionism?
2. What additional questions would you ask Theresa and her family to formulate next steps together? Think about experiences with race, identity, adoptive family dynamics/beliefs, etc.
3. How might you begin to understand more about her parents’ perspective about identity, and what kinds of support networks might be accessible in their community? What assessments or tools might you use to gauge their view of cultural identity having an impact on Theresa’s experiences?
4. Are there any specific kinds of therapies/supports that could be helpful for Theresa?
5. How would you broach Theresa’s interaction with the stereotype about math? How do you see it having an influence on her sense of self?
6. What supports could you offer that incorporate Gospel/spiritual values into your work and walk together?