Case 2 Maria

Maria was a 39-year-old Mexican American woman who was referred for individual counseling by her couple's therapist. Maria was born and raised in Mexico, until the age of 16, when she and her family moved to the United States. Maria's primary complaint was her inability to understand herself and her husband of 12 years. She described feelings of depression, anxiety, hopelessness, and frustration. Maria endured emotional and physical abuse by her husband for many years, but continued to feel an obligation to stay with him, and care for him and their children.

At intake, Maria was administered the MMPI-2 in English because she presented using the English language. Her profile appeared to be valid, and suggested that Maria likely had a serious thought disorder with paranoid features, possibly Paranoid Schizophrenia. After several therapy sessions, the therapist's clinical impressions did not substantiate the client's profile and the MMPI-2 was readministered in Spanish. In both the Spanish and English versions, Maria reported a significant amount of distress, yet it appeared that she expressed her concerns more openly in Spanish, due to a lower K scale on the Spanish version.

The Spanish version also yielded decreased scores on eight clinical scales. Between the two versions, four of the scale scores differed by at least one standard deviation. The greatest difference was evident in the Pa scale, on which there was a decrease of two standard deviations. In addition, the Depression (D) and Pd scales decreased by approximately 15 and 13 points, respectively, in the Spanish version. Despite such drastic decreases in several of the clinical scales, Maria's profile remained elevated on six clinical scales.

In addition to decreases on clinical scales, four Content scales dropped to the subclinical level in the Spanish version. These differences were evidenced on the LSE, Work Interference (WRK), FAM, and Negative Treatment Indicators (TRT) scales. This suggests that Maria's MMPI-2 performance in English reflected greater problems. This provides further evidence for identifying the client's "comfort zone" with respect to language for self-disclosure.

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