Case vignette

A strength-based approach to patient mental health care.

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A strength-based approach to patient mental health care.

A therapist helps a patient identify their protective factors and resources, instead of focusing solely on their problems.

Therapist

Nice to see you again James, is there anything you’d like to address today?

James

Well, I'm on another school suspension. I don’t get why they keep singling me out.

Therapist

I’m sorry to hear that. I know we've discussed in previous sessions how you feel the suspension policies at your school are not fair. Can you tell me a little about what happened?

James

I was fighting with Brandon again. He won’t leave me alone and the school doesn’t believe me when I tell them he’s the one starting it.

Therapist

That sounds very frustrating. Is there anyone at your school you’ve spoken to about this?

James

Not really, but there are a few teachers that get it.

Therapist

You mentioned how you built a good relationship with the PE teacher. Is this a person who can support you?

James

Yeah, I could try talking to him about this problem specifically.

Therapist

That sounds like a great plan. Are there any other people who could support you or ways you could feel heard about this?

James

My family is mad at me about the suspensions too, but journaling has been helping some. Do you think I should send the school a letter about the suspensions?

Therapist

That seems like a great way of expressing yourself. I know you put a lot of time into your writing, and writing is a great way to process emotions. Would you like to work on the letter together?

James

Yeah that sounds really good. I can bring my journal next time for you to look at.

Therapist

James

Things to consider.

01

While you may remind patients of various strengths and resources they have, the best approach is to give them space to identify their protective factors independently while offering collaboration as needed. 

02

Consider the ways US schools enforce systemic racism. If it comes up in session, you can ask if the patient feels race is a factor in disciplinary actions at school. Be sure to learn more about inequitable suspension policies and empower your patient to advocate for themselves, or find an adult or community program that can help them do so. 

Question to think about:

What are some of your own strengths when facing difficult circumstances? In what ways have power and privilege, or disadvantage, helped shape these strengths?

Ask for pronouns
Ask how the patient is doing
Ask for consent before touching
All of the above