Mimi, is a 19-year-old, first-generation Hispanic-American college

Mimi, is a 19-year-old, first-generation Hispanic-American college student in her second year at the university, arrives at the university counseling center, accompanied by her roommate, Dana. Mimi is reluctant to complete the initial paperwork and complies only after being informed that it will help the therapist better understand her needs. She identifies as a single female and declines to report her sexual orientation. On her intake form, her top three concerns are listed as academic concerns, depression issues, and family concerns. Mimi is accompanied to the appointment with her roommate Dana. Mimi has requested Dana attend the appointment with her to make her feel more comfortable. As the nurse practitioner, you enter the room to introduce yourself and begin your visit. While staring at the floor with her legs crossed and both hands covering her face, Mimi shares that she stopped attending class 6 weeks ago because she is “not sure of the point of going to school anymore.” Her appearance is disheveled. She learned last month she has not been admitted to the College of Business and therefore needs to choose another major, which has increased her anxiety. Since she stopped attending class, Mimi feels increasingly sad and has difficulty concentrating, finding herself preoccupied with thoughts of “what went wrong” and trying to imagine what her future might look like. She states that the only reason she came to the university was to “major in business, get a high-paying job in consulting, and take care of my parents.” She reports having a twin brother, who also attends the university and is doing well as a computer science major. Mimi responds to questions without elaboration. Dana interjects that Mimi’s parents have tended to “play favorites,” and Mimi often feels like the “other child.” She states that Mimi has been having difficulty sleeping at night and feels tired most of the time. Dana goes on to indicate that she became concerned after Mimi failed to leave her room for 3 days in a row, and she says Mimi looks like she has lost 10 pounds over the course of 2 months. Dana says “I know that she has enough pain pills to kill herself if she wanted to. She says I’m being ridiculous 1. What concerns do you have about Dana’s presence during your initial session with Mimi . 2. Describe how you would approach this with Mimi and Dana. 3. What strategies can you use to promote a therapeutic alliance with Mimi and why you would choose those strategies.

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