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Positive feedback:

Tierra Williams I like the way you viewed the whole case. I also diagnosed her with PTSD and depression

Constructive Feedback:

The one thing that caught my eye among your entire case was when you stated you would build a relationship with Sara. Im old school so I'm going to refer to the book, but I read therapist build emotional barriers, and me personally a relationship builds an emotional bond in some way shape or form. and that could interfere with the job that needs to be done for this family.

other than that awesome job!!

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Main Issue:

Children Services has removed Sara's fearful 15 yr. old son from the home and is required bi-weekly family and individual counseling before he can be placed back into her care.

Diagnosis:

Sara suffers Posttraumatic Stress Disorder,  Major Depressive Disorder, and Antisocial Personality Disorder. Sara suffers PTSD because she was physically and emotionally abused by her mother and felt unloved, she was sexually assaulted at the age of 14, family history of alcohol and drug abuse,and has had several miscarriages and still born. She is in denial and states "The past doesn't affect her anymore". Saras past is affecting how she is raising her children. She suffers Major Depressive Disorder because she developed a relationship with her mother but is still reminded of all the hurt indicating she is still bothered by her past, she never had a relationship with her dad, she has several children with several different fathers. Her not having a relationship with her dad may have an impact on her relationship with men. Sara seeing her mom with multiple men may think that is okay. I have diagnosed Sara with Antisocial Personality Disorder because her son is scared to come home. Someone in the household is hurting her son and she has no remorse for it. She wants to complete the counseling and get her son back ASAP. Sara not having a relationship with her mother or father and living with various people throughout her life may have caused a numb feeling towards others feelings and physical well being.

Therapeutic Relationship:

As a therapist in any case I would approach the reform movement. I would want my patients to walk into my office and feel comfortable and relaxed and feel a sense of trust. In this particular case I would analyze Sara using unconscious conflicts because I want he to speak freely yet I want to conclude whether she is suffering psychological issues as well. I would the proceed with Cognitive- Behavioral Therapy because I want her to think and talk about the issues inside the household that she is having with her son and eventually admit her wrongs, and establish behavior issues that need to change to create a better relationship among Sara, her son, and the rest of her children. As an analyst among the family session in this case I would use free association so Sara and her son can address issues amongst each other freely and come to an agreement on things that need improvement as well as behavior issues. I would like to suggest things I feel may need worked on, an outside opinion is sometimes needed. I would the proceed another Cognitive-Behavioral Therapy session so as time gradually proceeds I can observe personal behaviors and the between the two.

Question:

I feel its always best to make a stranger comfortable by telling them a little about myself, in a therapist predicament I would tell something about myself that relates to the reason why they are here. My question for Sara would be " Why is it that your 15 yr. old son is scared to come home?"   I would ask her this question because is obvious the reason she's here but to see what her response is, watch her body language as she responding and see if she can admit to her the wrong on her behalf that's being done in the house.

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response to Tierra Williams

Postivie Feedback:

I agree with the fact that Sara has a lot of regrets from the way she was raised and doesn't trust her mother, I think you brought focus to a lot of good points.

Constructive Feedback: I like the questions you would ask her but I wouldn't jump into a bunch of questions right away with someone who doesn't feel very open at first.

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Main Issue:

Sara has to go through mandatory counseling in order to get her 15  year old son back who ran away from home saying he was scared to go back. Sara had an unstable childhood, she never had a place to call home and was constantly living with different people. It is important for children to have parents in there life or some parent figure for them, Sara did not know her dad and her mom wasn't very loving towards her telling her "You're only a problem". Sara also dealt with the fact that her mom didn't believe her when she said her boyfriend almost raped her, her mom was very emotionally abusive to her. Due to never having a parent figure and not getting the love a child needs she is still hurt from the past but says " it does not affect her and she is over it", although she doesn't speak to her mom.

Diagnosis:

Sara has PTSD, anxiety disorder and dissociative identity disorder. Sara is raising seven children on her own, she has dealt with several miscarriages and had one still born child on top of everything she has went through, she is stressed out and is dealing with not feeling good enough for her children and feels as if she is a failure to them. I think she has learned how to be a mother on her own and is trying to be better for her children than what her mother was to her. Sara has a hard time trying to be a good mom when she has so much hatred toward her mother, she hasn't quite forgave her and is still hurt from the past.  Sara has dissociative identity disorder because I think she tries to move on from the past and be someone she is not. When something reminds her of the past I think she shuts down and acts the way her mother would, that's why she feels lost with herself and hurt because she says she is okay from the past but it gets worse everyday and very upset when something bad happens, like her son running away.

Therapeutic Relationship:

I would build a relationship with Sara based on trust, I would try to be someone she can sit and talk to while feeling comfortable and being able to express how she truly feels without being judged. I would not jump into a lot of questions, I would she how open she is to talking first and try to get her to tell me a little bit about her childhood. I would first focus on her and her upbringing as a child and then talk about how she is doing now as a mom and dealing with the struggles she has faced.  I would try and get Sara to realize that to be able to be okay and move on she has to try and forgive her mom for a feeling of relief lifted of her shoulder and should try focusing more on her children. I would tell her maybe her mom has changed for would be willing to get help with her and go through classes together or try and get together once a week and do a family dinner, maybe just the thought of her mom trying and wanting to help her will make her realize she maybe wasn't a great mom but could change and be a good grandparent and help her along the way.

Intro Question:

I would start by telling her my name and a little bit about myself, warming her up to be and feeling a little comfortable. I would tell her that I understand getting your son back is important and I will help with that but I also would like to help you for the long run. I would ask her questions about her childhood, how she feels about her mom and what her biggest regret is in life. Maybe talking to sara about more than just what she thinks you are trying to get out of her will allow her to open up more within a few days.

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Response to Israel Harris

Positive Feedback: I agree with Sara being depressed and carrying a lot of emotional baggage. She's also not being honest and she has a lot of repressed feeling even though she states the past doesn't affect her anymore. Due to the lack of love in her childhood she may not know how to show a lot of love or the right kind for that matter.

Constructive Feedback- I wouldn't recommend drugs right away she needs to find a way to deal with this on her own first.

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Main issue- Sara is ordered to go to mandatory counseling in
order to gain back custody of her 15 year old son who ran away from home.
According to Sara “The past doesn’t affect her anymore” refers to her childhood
upbringing however she also stated her mother physically and emotionally abused
her. Her son is afraid to go home which indicates he may also be getting
physically abused. She may not notice/realize how much the past is affecting
her parenting. She may not also notice how much her mother and she are alike. Due
to the lack of love from her mother and almost getting raped by her mother’s
boyfriend she has a lot of resentment built up towards her.  She still doesn’t trust her mother but “the
past doesn’t affect her anymore”.

Diagnoses- Sara has PSTD and depression she’s constantly
reminded of her past. She’s raising 6 children. Her mother plays a huge role in
her unhappiness and so does the absence of her father. She has a lot of regrets
from the way she was raised and she doesn’t trust her mother because of the
past. Sara's son stated that he was afraid to go home which indicates he may be getting abused a
home by either her or maybe even a boyfriend which indicates how much of an impact her childhood had on her life.

Therapeutic Relationship- I would develop a relationship with Sara by
making her feel comfortable and also making her feel like we have a lot in common
as far as upbringing. I would then ask
her. Do you think your mom played a huge role in the reason why you were
unhappy growing up? I would then try to get
her to notice any traits that her mother and she has in common.  I’d tell her I’m here to listen and help her
get her son back. I would then also ask her would she like a non biased opinion
and advice today or would she like me to just listen. I’d ask her that every
session until she’s open for opinions and conversation so that I could develop
a more personal relationship so that I can get honest answers and honest
conversations.

Intro Question- My intro would be hello Sara my name is
Tierra. I understand the main purpose of you and I meeting today is because you’re
a determined mother who wants to get and will get her son back correct? Then I
would ask her to tell me a little bit about herself. Following that I would ask
her to tell me a little bit about her upbringing and her childhood and if there
was anything she could change about it what would it be?

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Response to Morgan McCrobie,

Positive Feedback: I agree that Sara is suffering from Chronic Post- Traumatic Stress disorder due to her physical and emotional abuse and feeling her mother did not love her.

Constructive Feedback: I like the relationship trust you would try to gain with Sara, and the goals you would set to help Sara get through her past, and the ability to get her son back.

I think you did good overall.

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Response to Joseph Pallotta,

Positive Feedback: I agree, the physical and emotionally abuse from her mother led to Sara developing Post-Traumatic Stress Disorder and on top of the abuse, her mothers boyfriend tried to rape her.

Construtive Feedback: I like how you want to reach her goal, but I feel you need to create a bond or trust in your relationship with Sara. If she can not trust you then why would she let you into her life? You want her to know that you will not leave her like her mother did.

I think you did a really good job overall.

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Main Idea: Client Sara, has lost custody of her 15 year old son, and is trying to get him back from CPS, but is required to get counseling before she is able to get him back.

Diagnosis: To me, I think Sara has Deep depression, PSTD, and Anxiety. Due to the Sara traumatized past having to deal with Physical, Emotional, and Sexual abuse Sara deals with a lot of both depression and Anxiety. Being, that Sara didn't feel loved by her mother, dealing with one of the men her mother was with trying to rape her, having a unstable childhood, the abuse, never knowing her father, domestic violence, and the fact that she has 6 kids with 2 having the same father, and the other 4 with different. Can play a big role of her having PSTD, Anxiety, and depression.

Therapeutic Relationship: My first focus would be, to try and establish a relationship with Sara so that she would trust me and open up to me, which we would then be able to first focus on trying to cope with her traumatic past, And then her relationship with her children, and her future goals as to becoming a better mother. I would also try to get her and her mother in a few secession to try and help them with better establishing a relationship.

Intro Question: I know it can be very stressful to have your son taking away, could you give me a background as to what happen?

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Main Idea: Trying to get her son back from Children Services. She faced many hardship do to how her mother treated her in her youth.

Diagnosis: Due to her series of traumatic events, such as her mothers physical and emotional abuse, feeling as her mother did not love her led to  Sara having Chronic Post-Traumatic Stress Disorder. On top of the abuse she was almost raped by one of her mothers boyfriends. She also had numerous men in and out of her life. She could not hold a relationship which is why she has six children with four different men. She might be avoiding marriage which PTSD can cause and she also avoids her mother until she joins a support group in her church which has changed her life.

Therapeutic Relationship: I would try and get Sara to trust me. I would ask her a serious of question about her youth. I want Sara to know I am here to help her and will not leave her like her mother. I would tell her I want to help her get custody of her son again and help her live a long happy life. In order to do that I would bring her mother into the room therefore they could talk about their relationship and hopefully be able to fix it. I would try to get her mother and her to tell their honest thoughts and opionions and hopefully be able to fix them.

Intro Question:  What brings you here and if you do not mind, I am going to ask you some questions, and take notes about what you say, so I can keep it fresh in my memory?

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Response to Israel Harris

Positive - I am a big fan of your genuine approach to therapy, keeping the relationship between therapist and patient one that is both positive and healthy, and not based on apathetically labeling her struggles. If the patient leaves feeling like they are just a paycheck, something is wrong.

Negative- I try not to be too much of a critic, but here I go. The only thing I could really try and nit-pick at is that maybe the focus should not be so intensely on just getting the son back. Yes, that should definitely be one, if not the main goal, but I feel like focusing on her relationship with her other children, as well as her relationship with her mother could be beneficial to her as well.

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Main Issue: The patient, Sara, is attempting to regain custody of her fifteen year old son, but must receive mandatory counseling before Children's services is willing to release her son to her. The reason for removing her son from her custody has not been disclosed, however, it is apparent that Sara has experienced a significant amount of emotional trauma during her childhood. She grew up in an unstable family, and never truly had a long term place of residency. She has never met her father, and her mother reportedly abused her both emotionally and physically. She has also disclosed that she has been a victim of rape at the hands of one of her mother's boyfriends. The goal of therapy is to determine what pain she is still holding on to, and to help Sara to work toward becoming a more stable human being, as well as a mother who can care for her children.

Diagnosis: Given the extensive amount of trauma she has experienced, I would say that Sara suffers from multiple different psychological disorders. Her abusive mother, as well as the sexual abuse she sustained at the hands of her mothers boyfriend might indicate that she suffers from PTSD, causing her to relive these episodes, and preventing her from truly moving on, even if she is willing to forgive her mother. Secondly, her mothers instability, her frequent change of residency, and the fact that her children have five different fathers indicates that she might be experiencing athagoraphobia, fearing abandonment and preventing her from establishing intimate, committed relationships with other people in order to protect herself. Third, the fact that she was treated so poorly may have resulted in severe depression, creating feelings of worthlessness and hopelessness.

Therapeutic Relationship: In order to establish a feeling of comfort and stability during therapy, I would divide the focus between her troubled youth, the relationship she has with her children and her faith, focusing on the positive she has in her life, using that as a platform to heal and to develop an understanding of how she can best succeed in building a better life for both her, and her children. It is crucial to build a relationship with the client based on understanding, and that will require trust on her part, as well as patience and empathy on mine.

Intro Question: It is very easy for a therapist to believe they know what is best for the client, but what is truly important is knowing what the client wants out of therapy, and what they are willing to do to achieve there goals. After the initial introductions, I would start by asking, "What is it that you want to achieve through our sessions together, Sara?" Based on her answer, we could go from there. Her answer may indicate how serious she is about utilizing therapy, as well as what her ultimate goal is.

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RESPONSE TO Stefan Sabo

Positive- I agree with your PTSD diagnosis. I also like how you referred to her childhood as interesting. When you meet with a client you really have to be careful on how you refer to things.

Constructive- I see why you would want to develop the therapeutic relationship by letting the client know that you are not perfect as well (panic attacks). However, you only really have an hour so you don't want to make a situation all about you or spend to much time discussing your problems. I am not sure if that would constructive way to go about things.

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Nicole Miller

Positive: I also think that PTSD is a major issue for Sara, judging by her... interesting childhood. She has been through some crap and I feel that she's hiding it. I never even considered bipolar disorder until you said something about it. It makes sense.

Constructive: Er, I don't have much to say here. While I feel your intro question is good, personally I'd try to ease into it a little bit. I'd introduce myself first, tell her a little about myself, and then ask your question. But that's just me. Really good job, though.

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Main issue- Sara has lost custody of her 15 year old son to CPS. She has a lot of emotional baggage she carries around everyday stemming from her childhood experiences living with her mother. Sara has repressed all of these feelings claiming that they no longer affect her anymore. These feelings are still affecting her very much based on the fact her son has been taken and she has been ordered to counseling if she would like him back. Sara has a very untrusting relationship and repressed hatred for her mother due to her poor job of raising her, as well as the lack of affection her mother gave her as a child.

Diagnosis-  I believe that Sara is suffering from depression. Based on the information provided it is hard to say whether she is manic depressive or bi-polar. The fact that she has so many children by different dad's (except for two of her sons) indicates that she practices risky sexual behavior which can be a sign of bi-polar. I believe her talking to a psychiatrist and an psychologist would be the best thing for her.  I recommend this because she can talk freely with someone about her repressed feelings, and also learn some positive coping mechanisms. I also feel she needs some medication as well so that is why I recommended the psychologist as well.

Theraputic relationship- I would try to form a therapeutic relationship with Sara by expressing my willingness to advocate on her behalf to regain custody of her son if she is willing to help me help her. I would use my skills of empathy and genuineness to build a good repore with her.

Intro Question- My intro question would be: Please tell me what brings you here today? I would follow that question up by using the strengths perspective. For example: I can tell you love your son very much and coming here today really shows how motivated you are to get him back. This motivation is going to be very helpful in getting your son back.

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Main Issue: Sara's 15-year-old son was taken by CPS, and she is required to get counseling if she wants to get him back. It would have been nice to know the reason for the kid being taken away, though... Something about childhood issues coming back to bite her in the butt? Though, it seems things are alright when she gets in with a support group at her church.

Diagnosis: To me, it seems like she has a case of PTSD, mostly stemming from a somewhat troubled childhood. One major event that could have led to this was the fact that she was almost raped at the age of 14, and she ran away because of this. There could also be some traces of depression in here, as well. As a child, she was physically and emotionally abused by her mom, so she never felt loved. Not to mention her kid being taken by CPS. I'm pretty sure that for most people this would bring on a little bit of depression.

Therapeutic Relationship: I think that Sara would do well with some counseling for the proposed PTSD. Granted, I have a severe panic disorder, but I think that if I were to tell her about some of the issues I've had since I was a little kid, she'd open up a little more. As her life went on, she seemed to develop a somewhat stable relationship with her mom, aside from the occasional reminders of the past. I'm unsure as to whether or not it would be a good idea to bring Sara's mother in so that they could both talk. Her mother strikes me as the type to bring up the past in order to justify her actions, OR she would try to blame these things on her daughter.

Intro Question: Do you think you could tell me a little bit about why you're here? (So she has the opportunity to explain herself first, after I introduce myself.)

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Korinne Bisel:

Positive Feedback: I agree with the diagnosis regarding Sara having abandonment issues and how she is holding on to things from her childhood due to her relationship with her mother.

Constructive Feedback: When it comes to the therapeutic relationship, I think it would be beneficial to show some short of sympathy. With abandonment issues, showing some compassion and concern may develop a positive environment for Sara to open up during in the session.

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Lori Wilson-Thomas:

Positive Feedback: I agree with you that Sara is most likely suffering from post traumatic stress disorder. I also agree that she may be experiencing anxiety and depression from being separated from her son. I feel that it is a good strategy to remind her that she is not alone in what the is experiencing.

Constructive Feedback: I feel that you could have elaborated on why you think she is suffering from each disorder you described. I think you were accurate but you could have provided a bit more information. I also think your introductory question is a little too complicated for an initial question. If I were asked that question right away, I definitely would not have an answer!

Overall, good job analyzing the situation.

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Main Issue: Sara must receive counseling in order to get her son back from Children Services. She appears to have some unresolved childhood issues that still need to be addressed. These unresolved issues are having an impact on her relationship with her mother and how she is raising her children.

Diagnosis: Anxiety and depression because she is frequently reminded of the hurt from her childhood due to her relationship with her mother. She has repressed the feelings of abandonment she developed as a result of her homelessness as a child, moving from home to home with various relatives. She also experienced a lack of love and affection from her mother during childhood, which leads her to strive to provide that for her children. As a result of these childhood issues, her son being removed from her adds to her current stress level and depression. This situation of losing her son has caused her to now have to consciously deal with all of these feelings.

Therapeutic relationship: I would establish a trust between Sara and me by sharing with her a time when my children were taken from me by their father during a custody battle and expressing to her my understanding of how it felt at the time and how I was able to overcome the situation. I would also encourage her by letting her know she is making the right decision to come to counseling, not only to get her son back but to also deal with all of the hurt and pain she endured during her childhood.

Intro question: Tell me a little bit about why your son is with Children Services

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Main Issue: The main issue that brought Sara to counseling is the fact that her son was removed from her household. According to her history she has experienced a significant amount of emotional struggle throughout her life. She claims how much love she has for her son, which may be true, but it seems that she has not been able to create a stable household for her six children. She has a church support group that is helping her heal from the past, but is still harboring pain in her relationship with her mother.

Diagnosis: I feel that Sara is suffering from Post Traumatic Stress Disorder and potentially Bipolar Depression. Although she claims that her church group has helped her heal, there is still inconsistency in her behavior. If she had truly worked through the pain from her childhood, then she would not be in an unstable state that resulted in the removal of her son. Also, she is still harboring anger with her mother, even though they have developed a relationship. The fact that she is frequently reminded of the pain shows that she has not surfaced and dealt with all of the negative emotions, which is a sign of PTSD. She does seem hopeful still, which I feel is indicative that she will be able to sort through latent emotions.

I also feel that Bipolar Depression could be a potential issue for Sara. I think more observation would need to be done to understand her patterns and mannerisms. Bipolar Depression could stem from the fact that while she is unable to maintain a stable household, she still speaks passionately about her son and at times wishes to give him more than she is offering. This could be a sign of the manic 'high' mixed with the lowness that is experienced with Bipolar Depression.

Therapeutic Relationship: Sara would benefit from weekly psychotherapy sessions. I feel that Interpersonal Therapy would help Sara progress. With this type of treatment, Sara would be able to identify her emotions, express her emotions, and sort through the pain she has experienced throughout her life. I feel that if Sara were more able to understand what is causing her actions, then she will be able to maintain stability in order to create a stable home for her son.

Introductory Question: You must love your son a lot. How does his absence make you feel?

I would ask this question to understand Sara's immediate response to the situation. I feel like opening her up by asking her about her son would smooth the process of diving into her own emotional turmoil. This would also help to understand what issues she and her son may be dealing with, so that those can be addressed as therapy progresses.

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Something Positive: I think Sara has great intentions and is a much better mother then what role model she had. Sara does need to do some soul searching to help her become an even better mother. Sara needs to get to the root of the problem so she can be a better mother to not just the son that was removed but to all the children.

Constructive Feedback: Korinne I think your right on with your diagnosis, Sara needs to truly heal from her childhood trauma in order to feel better and that can only help the entire family out. Your intro question is great!

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Main Issue: Sara had a troubled childhood and is fearful that history may repeat itself because, children services has taken custody of her son. It is causing her anxiety and some depression. Sara is also trying to over compensate for what she was lacking in her own childhood.

Diagnosis: Sara is suffering from post traumatic stress disorder. A bit of seperation anxiety and depression due to the current situation.

Therapeutic Relationship: I would let Sara know that there are lots of people that went through similar things that she went through as a child and that it isn't the end of the world, that there is a solution. I would let her open up at her own pace so that she felt comfortable with me.

Intro Question: What do you want to gain from this other then getting your son back, and how has all of this made you feel?

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Start with something positive: I feel that you care a lot for your son and willing to do whatever it takes to show him he's loved and thought of. I think loving yourself and finding better ways to cope with your child hood would be positive for you.

Provide constructive Feedback: Look deep into yourself and ask yourself if you have really forgiven not just your mother but yourself. Do you blame yourself or fear that your going to become your mother. How do you think your son felt to be taken from you the same feeling you had when you were a child. I think building trust in relationships would be good for you and to release her emotions she may have held on to and not expressed for one reason or another.

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Main Issue: Sara is struggling with the separation of one of her son who has been taken from her. The main issue stands out to me is why is she in this situation where her son is taken from her care. She needs to find what it is in herself that she doesn't like and change it. She should make a more stronger initiative on parenting and making the up bringing of her children a healthy and safe one that way authorities have no reason to take her son from the home.

Diagnoses: Anxiety because she seems to have abandonment issues since she was little. She said her mom used to drop her off at relatives houses and not come back for days. She bounced around a lot. Depression because she holds on to her childhood and relationship with her mother that was turmoil and she said that she has forgiven her mother for the things she has done to her in the past but has she? She hasn't forgotten. she said that she makes an effort to have a relationship with her mom but she still has repress feelings towards her in her parenting she does things in spite of how her mom did things. She makes sure to over exert her caring and compassionate feelings that she never got as a child from her mom. She's over compensating for what she never had.

Therapeutic Relationship: I would start by developing a common ground and try and build a bond based on trust and show empathy not sympathy to her current situation. Try and provide positive feedback and really listen to what she's saying and read between the lines.

Intro Question: What emotions did you feel when your son was taken from you? Does it bring up any other feelings from your past?

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I was thinking' ...the other day, "God, I love my child' so much."

"I just' don't love him because he's my child', it's – it goes beyond that... I just' want him to have what I didn’t' have. I didn’t' have all that love, you know what I'm saying'?

But I want him to have it, all that he needs and all that he wants.
“My mother was a hateful and violent person. I never knew my father”.  My mother used to just drop me off at my grandmothers or aunts, and I wouldn’t see her for days. When I was with my mother she screamed at me about everything.  She said "You are so stupid" all the time to me.
I know God was with me because my grandmother and aunt loved me. I liked staying with them.
I make sure my son knows that I love him.  I give him a hug and say “I love you” to him almost every day.

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Each requirement will be graded 7-10 pts. The criteria for quality will be based on 2 factors:

1) My expectation of quality work

AS WELL AS

2) The average quality of the class

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EXAMPLE OF FEEDBACK (part 2):  In response to Dr. Milleman (Of course, you would need to provide a fuller response/feedback if you want an "A")

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EXAMPLE OF FEEDBACK (part 2):  In response to Dr. Milleman (Of course, you would need to provide a fuller response/feedback if you want an "A")

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START WITH SOMETHING POSITIVE:

I think developing trust by showing empathy is a great way to develop a relationship.

PROVIDE CONSTRUCTIVE FEEDBACK:

I think that she also needs to process the hurt from her childhood and trust will help that. I would try to associate the hurt and how it affects her parent-child relationship by saying, "How do you think your relationship with your mother affects your relationship with your son?"

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EXAMPLE OF POST (part 1):  Dr. Milleman (Of course, you would need to provide fuller descriptions for each area if you want an "A")

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EXAMPLE OF POST (part 1):  Dr. Milleman (Of course, you would need to provide fuller descriptions for each area if you want an "A")

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Main issues: Children services has custody of her son and Sara wants to get her son back.

Diagnosis: Anxiety Disorder because she wants to get her son back and is unsure if children services will grant that if she goes through counseling

Therapeutic relationship: I would develop trust by being genuine and showing empathy for her situation

Intro question: "It must be stressful to be separated from your son."