Muna is a 22-year-old, fourth-year student at a large midwestern urban university. She is the oldest of four children. Muna’s parents immigrated to the United States from Saudi Arabia when she was 7 years old. In session, she presents herself as an alert, intelligent, and confident young woman. She appears well groomed, wearing blue jeans, a solid-black blouse, and a beige hijab that covers her hair and neck. When asked in the initial counseling session what she would like to work on, Muna nervously revealed that she was having a difficult time deciding whether or not she should tell her traditional Muslim parents that she is a lesbian. Muna went on to say that she realized she was “different” when she was about 12 years old. She shared that, around middle school, when boys and girls were socialized to interact and play with children of their same gender, she wished that she would have been able to socialize with the boys in her school because she was not very interested in the things in which the other girls her age were interested. She remembered a desire to play some of the sporting games with her male peers, rather than engage in some of the activities of her female friends. She also recalled having a crush on one of her female friends at age 16. At the time, she dismissed the crush as just “feeling close to a best friend.” Muna went on to share, “Once I left home to attend college, I met other women who felt the way I do. I realized that I was not the only one like this.” Muna explained that being a lesbian is not allowed in Islam and that the Quran forbids sexual relationships outside of heterosexual marriage. Muna expressed a great deal of fear about potential negative repercussions from her family and her Islamic community if she were to disclose her sexual orientation, but she also feels like she is being true to herself for the first time in her life.

• What are the presenting problems that you want to focus on as you work with Muna?

• What will be the most challenging aspect working with this client?

• Describe the types of interventions and clinical approaches you believe will be most beneficial for Muna. (Be specific.)

• How will you negotiate Muna’s clinical goals and personal values while also taking into consideration the values of her faith, family, and community?

• How will you address her gender, sexual orientation, ethnic, and spiritual identities in your counseling sessions?

• How will your gender, sexual orientation, ethnic, and spiritual identities influence your work with Muna?

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