I think one challenge that I could encounter as the therapist in treating Rebecca would be her accepting the fact that she needs help. Rebecca may believe things are okay and be in denial that she has issues that require treatment. Another challenge that could arise is committing to therapy. Although Rebecca is committed to school and show interest in classes she might not feel there is a need to come to therapy as scheduled. Therapy may not be as important to Rebecca as other things in her life.
Trust would present a problem with the therapeutic relationship. Rebecca being suspicious of others can cause distrust with the therapist. If there is no trust then Rebecca may not be open with her feelings. Social skills may also be a challenge. Rebecca is not good with communicating to others or appropriately responding. If the anger and hostility is not eventually controlled it will challenge the development of a healthy therapeutic relationship. The third challenge would be the delusions that tend to lead to obsession. The therapeutic relationship would be in jeopardy if the delusions or obsessions occur toward the therapist.
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