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Client: Mariana Alvarez
Age: 29
Gender: Female
Culture: Mexican-American, first-generation college graduate.
Location: Austin, Texas
Scenario: Moved to a new place (a tech company) recently; is experiencing anxiety, isolation, and conflict of identity due to the relocation.
I. Case Presentation
The interviewee is a 29-year-old Mexican-American female, Mariana Alvarez, who moved to Austin, Texas, to get a promotion as a software project coordinator just recently after leaving San Antonio. She is the first in her family to have college education and she is proud of her accomplishments, but the rotation to fast-paced corporate setting has evoked anxieties, loneliness and self-doubts. Growing up in a traditional family, where collectivism and interdependence are highly regarded, Mariana is the first ever to live on her own and is having difficulties with adapting to the norms of a competitive workplace that requires an individual approach to performance.
During the last two months, she has suffered problems with sleep, irritability, and constant concern about the workplace errors. She complains of physical tension, fast mind and not going out with colleagues. The change was observed by Mariana, who was still living in San Antonio, by her mother via weekly phone calls and advised her to talk to someone. Despite her initial reluctance to consider therapy as something that was applicable to people with serious issues Mariana started to realize the impact of her anxiety on her performance and relationships. She has chosen to consult a clinical psychologist hoping to have knowledge of coping strategies and be able to have a perspective of her stress. She has not only a desire to quit being anxious but also to re-establish her purpose and their cultural identity.
II. Seeking Help
When Mariana started seeking mental-health assistance, she thought of the needed professional who she should address thoughtfully. Her recall of a psychology elective she completed in college was that clinical psychologists are experts in assessment and evidence-based treatment, all of which involve long doctoral training in human behavior, research, and ethics (Hagerty, & Williams, 2022). Since Mariana had problems related not only to emotional distress but also to the issue of self-identity, then she desired a provider that would take her through a comprehensive and in-depth psychological assessment and not just a short-term counseling session. She dismissed pastoral counseling and life coaching because she felt her symptoms needed a clinician that was trained to distinguish between stress, anxiety and possible adjustment disorders.
Mariana visited the internet one late night and typed in the search bilingual clinical psychologist, Austin TX. Cultural competence was important to her, which is why she wanted a person who would understand the peculiarities of being bicultural and first-generation. Lu et al. (2024) state that minority clients tend to find therapists who understand the role of sociocultural aspects in the expression of emotions and the development of help-seeking behaviors. Mariana looked through some profiles on the Psychology Today directory and narrowed on those who spoke of multicultural counseling, anxiety treatment, and understanding of the young professionals in the high-stress occupations.
The profile that impressed me was that of a licensed clinical psychologist, Dr. Samuel Ortiz, PhD, who specializes in anxiety and stress management in Latinx adults. Culturally responsive therapy, bilingual service (English and Spanish) and acculturative stress research were highlighted in his biography. He received his PhD in Clinical psychology at the University of Texas at Austin, had completed an APA approved internship program at a community mental-health center and had undergone postdoctoral training in behavioral assessment. The fact that he explained how therapy works in a very open way, and the warm photo of an office that looks like a home, is something that Mariana appreciates. She was nervous and hopeful and sent an email to Dr. Ortiz to make an initial appointment. She was filled with optimistic apprehension with the confirmation message, as maybe, professional help would restore her equilibrium.
III. The Interview
Arrived the day of the appointment. Mariana pulled up in front of a refurbished bungalow that had been turned into an office of the therapy close to downtown Austin. The atmosphere was pleasant with gentle lighting inside and a faint smell of coffee. Dr. Ortiz looked at her gaily: Welcome, Mariana. It’s good to meet you. Comfort yourself, pray, please, make yourself comfortable. The friendly method he adopted made her immediately relax.
The initial session was a clinical intake interview, semi-structured session that would be used to get a background, build rapport, and provide an understanding of the presenting issues (Stefana,, 2025). Dr. Ortiz started by asking open questions, such as, what brings you in today? and in this case, Mariana explained herself and discussed her experiences based on her own words. He echoed her words and expressions, made paraphrases and summaries as she talked about work stress and homesickness, and intermittently: He said, that is why it sounds like you were under pressure to deliver at work and also miss the warmth you experienced back at home. The empathy-based methods (Stefana, 2025) conveyed empathy and made Mariana feel listened to.
After half an hour, Dr. Ortiz began to ask questions based on her sleep, appetite, and focus, which are similar to structured assessment protocols (Hagerty, & Williams, 2022). He ventured into family history, cultural identity and coping mechanisms. After Mariana said that she does not talk about feelings with her parents because of cultural standards regarding privacy, Dr. Ortiz was sensitive and said, It is more than most of clients with similar backgrounds say they have to balance their respect to their family values and their voice. This proved to be ethical practice elements such as cultural humility and competence (Lu et al., 2024).
Behaviorally, Dr. Ortiz noted that Mariana looked straight in the eyes, however, fidgeted her hands when talking of work duties. She would speed up her voice on stressful issues and slow down at the mentioning of the family. These nonverbal communications helped him to argue his view on anxiety and not depression. All along, he kept a steady cadence, and at times, he would inquire about how he was feeling at the moment to slow down the speed and establish trust.
When the session was just ending, which is defined as the end phase, by Stefana, (2025), Dr. Ortiz recapped what they had talked about, affirmed Mariana as being a brave person who came to seek help, and proceeded with the next step: the psychological testing of Mariana to know more about her anxiety patterns and strengths. He promised her that her participation will be voluntary and confidential. Mariana walked out of the office both relieved that somebody listened to her and anxious to know what testing would entail. As she drove home she thought to herself that she was starting to feel a little bit of control coming back to her, something that she had not felt in months.
IV. Psychological Testing
At the second visit, Dr. Ortiz started by giving an explanation of the role of psychological testing. He explained that tests are the means to give a more complete picture of cognitive, emotional and behavioral functioning and use it to inform individual treatment (Hagerty, & Williams, 2022). He stressed on the results being understood as part of the situation and that no particular score can be used to define a person. The testing would enable them to know how the thoughts, stress responses, and coping styles of Mariana interact.
Mariana is an analytical person and she had a number of questions. What makes you know whether these tests are reliable, she said. Dr. Ortiz stated that standardized psychological instruments are created after a research work that guarantees reliability (similar results) and validity (measuring what they are meant to measure). Why so long, personals, she said, in a nervous laugh. He responded that larger item pools are able to measure a variety of traits and reduce bias leading to higher accuracy. Dr. In the case by Ortiz, she mentioned her dilemma about confidentiality and used Section 9 of the APA Ethics Code as a reference to make sure that she received informed consent, administered tests in the language and culture that fits the person, and that the data were stored securely (American Psychological Association, 2017). His openness made her believe that this was an ethical and cooperative process.
Dr. Ortiz has chosen three tests that apply to the case of Marijuana:
1. Beck Anxiety Inventory (BAI): 21 item self-report tool which measures the severity of typical anxiety symptoms. This would aid in measuring her distress and tracking it during the course of time.
2. Minnesota Multiphasic Personality Inventory-2-RF (MMPI-2-RF): a detailed personality test that determines the emotional, behavioral, and interpersonal patterns. It might be able to explain the presence of her anxiety to go along with depressive or adjustment-related characteristics.
3. Coping Inventory of Stressful Situations (CISS): assessing problem-focused, emotion-focused, and avoidance coping styles- helpful to use to formulate interventions that would maximise strengths of Mariana.
In the course of testing, Mariana became surprised to find the process rather involving. She liked the formulated questions, yet she at times felt embarrassed by her answers (What if I will have overreacted?). Dr. Ortiz justified these feelings by saying that most clients feel unconfident but that being honest guarantees significant outcomes. He gave her the occasional pauses to eliminate fatigue and praised her effort- mere signs of ethical awareness and care towards the welfare of the client.
By the end of the testing Mariana was mentally exhausted but inquisitive. She understood that answering the questions had led to introspection of her habits and beliefs. Dr. Ortiz informed her that she would get the results discussed during their next session and he would plan on how to deal with stress better. Mariana felt freer when she walked out, maybe because she had finally taken some tangible steps to knowing herself.
V. Conclusion
Mariana was driving home after the test session and her thoughts were on how much she had gone since her first anxious search on the internet. She was now aware that she was not weak because she had sought help but rather self-aware. The interview and psychological test that she had gone through had provided her with a better understanding of her resources and issues. She also expected Dr. Ortiz to incorporate these findings into a therapy that is based on management of anxiety, assertive communication, and exploration of cultural identity.
Mariana would like to be treated by learning mindfulness to help her calm her racing thoughts and cognitive strategies to help dispute perfectionism. She is also hoping that the therapy will enable her to resolve the conflict between family values of collectivism and the individualism culture at work. All in all, Mariana is optimistic. She is no longer afraid of the path she has to follow, and she considers psychological services now as a helpful collaboration based on science, compassion, and the respect of her cultural narrative.
This case exemplifies the interaction of the essential components of clinical psychology, training, assessment, interviewing, multicultural competence, and ethics to establish productive client experiences. With the help of caring listening, culturally sensitive evaluation, and the ethical principle of testing, clinical psychologists like Dr. Ortiz can help people like Mariana to move towards self-understanding and development.
References
American Psychological Association. (2017).
Ethical principles of psychologists and code of conduct (Section 9: Assessment).
Hagerty, S. L., & Williams, L. M. (2022). Moral injury, traumatic stress, and threats to core human needs in health-care workers: The COVID-19 pandemic as a dehumanizing experience.
Clinical Psychological Science,
10(6), 1060-1082.
Lu, L., Chen, C., & Flores, R. (2024). Cultural competence in psychological practice: A contemporary review.
Journal of Counseling and Development, 102(2), 115–127.
Stefana, A., Damiani, S., Granziol, U., Provenzani, U., Solmi, M., Youngstrom, E. A., & Fusar-Poli, P. (2025). Psychological, psychiatric, and behavioral sciences measurement scales: best practice guidelines for their development and validation.
Frontiers in psychology,
15, 1494261.
