ellen was referred to the clinic shortly after her fake miscarriage who was employed as an admin assist. with mr johnson whom she had an affair with for 2 years and mr johnson was unwilling to divorce his wife because of his children. what issues do you think are important to the development of ellens problems?

Good heavens! There's no way to know how her so-called problems developed with this brief description.

Is it possible Mr Johnson is near the same age as Ellen's father? Freud wrote on that.

Is it possible that Ellen is looking for advancement in her job?
Is it possible Ellen wants children?
Is it possible Ellen has an immature personality disorder? Or anti-social personality disorder (inability to follow work rules, manipulative, and controlling)?
Is it possible to let one's mind run amok when so little information is presented? Novelists (a few of them) make money working on these scenarios.
I agree with MsSue: It is ridiculous to try to draw conclusions on such a limited set of observations. Is this perhaps a creative writing course?

Based on the information provided, a few important issues that could be relevant to the development of Ellen's problems are:

1. Emotional turmoil: Ellen's affair with Mr. Johnson for two years suggests a deep emotional connection between them. Being in a relationship with someone who is unwilling to leave their spouse can cause significant emotional distress, leading to feelings of betrayal, rejection, and low self-esteem. This emotional turmoil could contribute to Ellen's overall well-being and mental health.

2. Unresolved guilt and secrecy: Engaging in an affair with a married man often involves a level of secrecy and guilt due to societal expectations and moral values. For Ellen, the burden of hiding the affair might have taken a toll on her emotional state as well. The secrecy and guilt could add to her feelings of dissatisfaction and contribute to her problems.

3. Lack of support: If Ellen's miscarriage was indeed faked, it indicates a certain level of desperation or a desire to manipulate circumstances. In such cases, having a lack of social support or a support system to lean on can exacerbate the problems. Without appropriate emotional support, Ellen may find it difficult to cope with her situation, causing her problems to persist or worsen.

4. Uncertain future and restricted choices: Mr. Johnson's unwillingness to divorce his wife because of his children may leave Ellen feeling trapped and uncertain about her future. This uncertainty can lead to increased stress and anxiety, contributing to her overall problems. The limited options available to her may make it challenging to find a solution that works best for her, further complicating her situation.

It's important to remember that these are speculative issues based on the given information. To understand the full scope of Ellen's problems and their development, it would be ideal to have a more comprehensive understanding of her journey, including her thoughts, emotions, and external factors that might impact her well-being.