and her partner are Roman Catholics and he has insisted that birth control is not appropriate. However, her repeated requests that they marry have also been ignored; her partner has no real interest in changing their status as an unmarried couple, and Ms. Jones fears that he has been and continues to be unfaithful to her. Ms. Jones' last delivery was via Cesarean Section surgery; the literature suggests that this approach to childbirth may be especially traumatic for women (Ryding, Wiren, Johansson, Ceder, and Dahlstrom, 2004).
In addition to her concerns regarding her failure to lose weight gained during and after the last pregnancy, Ms. Jones expressed a strong sense of being unattractive as a consequence of the scarring associated with this surgery. Overall, Ms. Jones was aware of her depression and concerned with her status; she was disappointed in what she perceived as the failure of the prescribed medication to resolve the problem and hoped that counseling would be mor
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