Initial Interview with Sheila Sheila begins the session by stating that she doesn’t know why her doctor feels this interview isHuman Computer Interaction necessary. “I’ve been having medical problems for the past year that have not been alleviated by medication. I have so much pain that, at times, I can’t care for my four young children. My husband is so alarmed that he hired a full-time housekeeper so that the children would be supervised when I’m unable to get out of bed.” Sheila appears distressed about her experience and says she just wants to feel better soon. “I’ve always been a very active person. I was on the swim team in high school and the track team in college. When I got married, my husband and I got road bikes and joined a biking club. We would bike 40 or 50 miles on the weekends. I’m not used to being disabled like I am these days. These aren’t just ordinary aches and pains like I had when I worked out. These problems have caused me to be unable to do anything. Sometimes I can’t even go to the grocery store I feel so bad. And, you know, I’ve got four children that I have to take care of. I can’t just stop.” “When did these physical problems begin?” you ask. “It was about 12 months ago, right after the birth of my fourth child,” Sheila says with a sigh. “A few weeks after Carrie was born, I began having severe headaches. The doctor said they were tension headaches, not migraines, but they’re so painful I have to lie down somewhere quiet and wait for the pain to go away.” “And you’ve continued to have these headaches for a year?” you ask.

“Well, the headaches haven’t been as bad with the medicine I’ve been taking, but I have had several other problems besides the headaches,” Sheila states. “In the last year, I’ve had severe pain in my lower back that I thought might be a ruptured disk, but nothing showed up on the X-rays. Then, I had some serious stomach problems, and the doctor said that even though it wasn’t showing up on the X-rays, it might be an ulcer, so I started taking ulcer medication. I’ve also had shooting pains down both my legs that come and go. I never know whether I’ll be okay or not. It’s just been miserable.” You wonder why the physician with whom you spoke didn’t mention all these problems. “And have you been seeing the same doctor for all these problems?” you ask Sheila. “Oh, no,” Sheila says. “I’ve been to several different doctors. I went to a chiropractor for the pain in my back and legs, and I saw a gastroenterologist for the problems I’ve had with my stomach. The chiropractor has been doing adjustments and said I was out of alignment. And I was having so much trouble with my stomach that I thought I’d better see a specialist.” “What kind of trouble have you been having with your stomach?” you ask. “Well, it started with just severe pain, but it got worse and I began to feel very nauseated and couldn’t eat certain foods or I’d get very bloated.” Sheila rubbed her forehead and looked very disconcerted. “I just don’t know what’s wrong. I feel like I’ve just been constantly sick for a year.” “It sounds as if you’ve been through a lot in the last year. Let me see if I understand everything you’ve told me so far. You’ve had severe headaches and back pain. Sometimes, you have shooting pain that goes down your legs. You’ve also had pain in your stomach that includes a bloated feeling and nausea. Is that correct, so far?” you ask. “Yes, but the bloating and nausea sometimes happen without the severe pain in my abdominal area. It doesn’t happen all at the same time, but it can. Do you see what I mean?” Sheila asks. “I’ve also been so sick to my stomach through all my pregnancies. For 6 of the 9 months, I couldn’t even go into a room that smelled like certain foods or I’d throw up. I haven’t had one easy pregnancy. I thought I’d die having this fourth baby. I told my husband this was the last baby I was going to have. He has always wanted a big family, and I told him four children are enough.”

 

“Yes, I understand what you’re saying. Have there been any other physical problems you’ve experienced in the past year?” you ask. “Not in the past year,” Sheila states, “but about 6 years ago, after Mikey, the oldest, was born, I was having problems getting my menstrual period regulated, and the doctor said I had endometriosis. I had a D&C, and it seemed to take care of the problem,” Sheila states. “Okay, have there been any other physical problems you’ve experienced?” you ask. “Well, the only other problem I’ve had that I haven’t even talked to my doctor about is this numbness in my hands. I get this tingling sensation in my hands like the feeling when you’ve been sitting on your leg and it goes to sleep. It seems to happen for no reason at all. My hands just go numb. It’s very uncomfortable and makes it difficult to pick anything up or hold anything.” Sheila looks very anxious and taps her foot constantly while describing these symptoms. She looks around your office and asks you how long it took you to get a counseling degree. You explain to her that you went to graduate school after obtaining an undergraduate degree and that it takes 2 or 3 years of additional education depending on the program. Sheila leans back in her chair and looks wistfully out the window. “I always wanted to go to graduate school. I have a degree in biology and was premed in college. I thought I would become a doctor. Of course, those plans changed dramatically when I got married. My husband just wanted me to stay home and have children. He’s old-fashioned and comes from a very traditional family. The woman stays home and cares for the children while the man goes to work. So, I spend all my time running after kids and changing diapers while my husband spends 2 or 3 nights a week out of town on business trips staying in nice, luxurious hotels and going out for expensive dinners. Not that I’m really complaining. He makes a very good living, and we have a nice lifestyle.”

“But it sounds like taking care of four children can be pretty stressful and draining at times,” you respond. Sheila nods her head and sits up in her chair. “I just never get a minute for myself. My day starts at

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