Maria is paralyzed from the waist down following an accident three years ago in a swimming pool. She is hoping to complete her degree in accounting, but she is complaining of depression and an inability to focus on school. When you see her, she looks anxious and tired. Her affect is flat, and she tells you nothing interests her. At the local college, she has had trouble finding appropriate parking and misses many days of class when the weather is bad because of the parking situation. One of the professors she must work with rather closely has made remarks about the difficulty of "other people getting around that wheelchair." She believes her boyfriend, who was there the night the accident happened, has remained with her simply out of pity. When they fight about other things, she throws this up to him, although he vehemently denies it and tells Maria this is a hurtful accusation.
micro level- I would talk to Maria about how she has had to make a lot of different changes in her life. Yes, some not so good, but we need to look at the positives of the situation. Her boyfriend is still with her now and surely he must care a great deal about her. School is very important and would make her feel good about herself if she finished it. In the micro level, I would be wanting to make her feel better about herself.
meso level- In this one, maybe I would find out more about her and her family life; where she grew up, went to school, friends, siblings, etc. See if any of this has anything to do with her unhappiness lately or if it is all about the disability she feels. Just to know what her life was like before the accident. Maybe a good idea for her would to seek some social group that would interest her where she could go talk to other people, any type of help group.
macro level- This is where we need to look at the bigger picture, if she is having issues with the constructor or the parking lot, i would advice her to email her teacher, just to explain that it offended her when he made that statement and talk to anyone in the office about how she is missing classes because of no close parking lots and maybe they can work something out for her.
