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Maria's presenting issues include poor relationships with her immediate family, her inlaws, and her children; depression; sleep deprivation; loneliness; stressors related to separation and divorce; inability to develop a trusting relationship with the opposite sex; and issues related to cultural identity and values. A feminist counselor will describe to Maria the goals of feminist counseling and the counselor's personal philosophy concerning client empowerment and the need for an egalitarian client-counselor relationship. The counselor will help Maria see that her affiliations and actions may not be congruent with the cultural values of her Hispanic roots.

During counseling, Maria will be allowed to articulate, in her own words, her feelings of aloneness and the frustration she experiences when she is unable to receive support from her family or to develop other loving relationships. Expressing these feelings will allow Maria the opportunity to hear her own words and self-evaluate her position in an environment in which her feelings and opinions are validated. Additionally, Maria will be able to more readily recognize the negative impact of self-deprecation and powerlessness.

Maria exhibits symptoms of poor self-esteem and a sense of powerlessness in trying to regain the support of her family members and proving to herself and others her value as a good mother and a good teacher. The counselor will guide Maria through some empowerment exercises based on the reality therapy approach so that she can understand the difference between what is in her personal control and what is not. The counselor will ask Maria such questions as, "What in yourself or your environment can you control or change?" After some probing by the counselor, Maria might say she has control over how she sees herself and her sleep environment.

To improve self-esteem, Maria can make a list of her positive attributes and positive things that other people have said about her. The counselor will encourage her to concentrate on these positive attributes by making verbal affirmations.

A cognitive approach can be used to help Maria make some personal changes. Maria might be instructed to name one thing that she would like to change about herself. The counselor and Maria consider the change together to ensure that what Maria wants to change is in her control and that the result would be evident in a relatively short time. This will show Maria that she can effect change and that some things can be changed immediately. Small, immediate changes will encourage Maria and keep her from doubting herself.

To improve sleep, the counselor can remind Maria of the benefit of sleep in developing holistic wellness. Suggestions might include (a) referring Maria to a medical doctor to determine her physical fitness; (b) reserving the bed for sleep only, not for watching television, working, or worrying; (c) entering the bedroom only to go to bed; (d) developing bedtime rituals; (e) abstaining from napping; and (6) envisioning sleep as a pleasant, sought-after state of being. Dream analysis is also an appropriate technique to help Maria understand what her dreams mean and how they affect her interactions with people in her family and work environment. Paradoxical intention may be used to help Maria to redirect her thoughts and see sleep as the better alternative. For instance, Maria can get out of bed when she cannot sleep or when she has bad dreams. She can perform tasks that are necessary but unpleasant to do. An example would be for Maria to get up and clean all of the kitchen cupboards. This task may be so unpleasant that sleep becomes a much more appealing option.

Group support can help Maria deal with many of her issues, including loneliness, alienation, and family issues. Maria has problems in her important relationships. A homogeneous group composed of Hispanic women would be ideal to help Maria reconnect with her cultural peers and gain support from their shared experiences.

Maria feels incapable of reestablishing family relationships and developing new intimate relationships. It seems to be easier for her to totally withdraw than to try to change her behavior or the behavior of others. Feminist family counseling with Maria and her family can help them deal with family support, child-rearing practices, and extended family role issues. This will help Maria deal with her guilt concerning the responsibilities of motherhood while having the extended family play a larger role in helping with child care while Maria is working. When Maria improves her inner strength and is more confident in herself, her attitude about approaching an intimate relationship can change. The counselor may have Maria explore her readiness to become involved in an intimate relationship and visualize what that relationship looks like culturally and personally. The purpose of this exercise is to see if Maria's personal values and her cultural values are congruent.

It may be helpful for Maria to reconnect with her church and other advocacy networks for Hispanic women. Contact with advocacy groups can help Maria establish feelings of belonging. This reconnection with her cultural group also will help to improve her relationship with her family and provide a way for Maria to teach her children about her heritage. This may help Maria reconcile her departure from her family and the community. The counselor may suggest to Maria that she get involved with community groups that advocate for Hispanic women and other oppressed groups so that she can make a greater impact on society at-large while improving her self-worth. For instance, if Maria got involved with an advocacy group that works to combat domestic violence against Hispanic women, her story may be an inspiration to other women and at the same time help Maria to feel that she is making a valuable contribution to her community.

The most important thing to consider about feminist counseling with Maria is the need for an egalitarian counseling relationship. Maria must feel that she has some important contributions to make to the counseling sessions. The counselor considers Maria's culturally reinforced behavior and helps her to reconnect with her cultural group. Maria's self- worth will improve when she understands that her behavior is not a symptom of pathology but in fact may be a part of the solution to some of her problems. Reconnections with family, church, and her community will nourish Maria's need for belonging, improve her self-worth, and provide her with a much needed support system.

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