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Kara and Meg, a middle-aged lesbian couple, present with intimacy issues. Kara is Native American descent. Meg is Caucasian. Kara recently found out that Meg has been seeing another woman for the past 6 months. Meg defends her behavior by blaming Kara for being distant and unavailable. Kara begins to cry as she discloses a recent memory of being sexually abused by her father, a cold and unavailable man. She describes Meg as being much like her father, "cold and selfish" which results in flashbacks and recoiling from Meg's touch. She wishes that Meg could be more sensitive and compassionate.
1. Describe methods for identifying, evaluating, and exploring the problems and goals for Kara and Meg.
2. Would you use a mental status exam (MSE) with a Kara? How about Meg?
3. What specific MSE factors would you integrate into your interview with this couple?
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