How do you spot a scam?

I have just finished counselling with a client who was depressed. She is a young mum and initially she was in a very low mood. She hadn't experienced talk therapy before but her friends were pushing her to do something about how miserable she felt.
We talked about her life: the husband that loves her, her 7 month old daughter who she finds difficult to enjoy, her house, her friends and her relatives. About session three, I was wondering where the depression was coming from - her circumstances seemed good, she was healthy and she had several close relationships.

Then we started to talk about when the depression had started - just after her daughter's birth. She mentioned in a 'give away comment', her mother had come to see her then for the first time in 2 years. Well apparently her mum and dad had separated when she was 13 years, had gone off with their own lovers and in the intervening 10 years, my client had seen them separately, irregularly.
Then we started to unfold her memories of being left "in the family home" with her elder sisters (18 and 21 years), being expected to get herself up every day and out to school, feeding herself from whatever food was available in the kitchen, with her sisters at home only when they weren't at work or with boy-friends.

Apparently some days she bunked off school and sat on a wall near the shopping precinct, watching people pass, knowing that no one cared what she did or where she went.
So here was the root of her depression: my client had given up a lively job in a busy office when her baby was due, she was now stuck in her house with a new child and her husband was working long hours to support the three of them - for much of her day, no one cared what she did or where she went.
My client actually broke into tears as she uttered this phrase - no one cared what she did or where she went.

It has taken another six sessions to tease out all her pain and to counter the thoughts that were feeding it - what had she done to be discarded by her mum and dad, how was she going to cope with the world without her parents to love her, and how could she find someone to care about her?
It was easy for my client to project these thoughts into her new daughter's life: what would prevent her from abandoning her daughter on a shopping trip, why couldn't she feel any love for her daughter or her husband, and would anyone care if she went away?

Happily we have now worked through my client's difficult teenage years. She has recognised that her mum and dad were poor parents - so besotted with their own affairs that they hoped the other was doing the parenting and not realising that neither was. She knows she can make her own parenting different - she can choose to stay married to her husband, she can choose to love and cherish her child (or children, later) and in caring for her family, she can enjoy how much they care for her. A tipping point in my client's recovery was when she noticed how much joy her daughter has seeing her after an absence of a couple of minutes. Another important factor was becoming aware that her husband was always glad to see her, to hold her and to cherish her.

So now the depression is lifted. I don't say that it is gone forever because I cannot tell what the future will bring to my client. However, for now, she knows how to manage and chase away those low feelings: to see how her daughter and husband love her.

So now my client's first question to me 'Why am I feeling depressed?' is answered by "No one cared what you did or where you went" and we have found the antidote - 'They do now".