Session: __________ Student’s name: ___________________ Date: ______________
| The session participants included the client, C. B (name written in initials to disguise name and identifying information). The session takes place in the Open Sky Community Services offices in Worcester. The client demonstrates a positive impression in her body language and speech. She is optimistic about finding a solution to her mental issue (depression). Her tone, words, facial expressions, and demeanor are reflective of someone who suggests they understand they have a mental issue and need help in solving their problem. C.A is showing respect for the session and the therapist. While the client demonstrates a positive attitude in her words and body language, she also displays self-frustration in not being able to provide for her two children’s needs and in being independent without having to ask for help from friends and relatives. She shows a person tired, frustrated, and stressed with her situation. She presents the impression of self-bias with most of her talk and language with signs of boredom. The purpose of the meeting was to identify the presenting issue of the client, C. B., the positive and negative impacts of the issue, and attempt to help the client get a solution to her issue(s). The client is a 35-year single mother who has two sons of ages 7 and 5, respectively, and they depend on her as their sole breadwinner. |
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Student Learning Goals
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To apply knowledge, skills and theory learned in class in an actual psychotherapy session. To understand and experience how client-therapist professional relationships can help the client find solutions to their issues and solve them. |
Recording of Interview
| Student-client Interaction Dialogue | Self-Reflection/ Rationale for Intervention | Supervisor’s Observations |
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Clinician: Good morning, nice weather we have today, don’t you think? Client: Yes, it is; I especially love the sun and the overall fall feeling Clinician: beautiful colors to improve our moods and view of life Client: I absolutely agree Clinician: welcome to Open Sky Community Services, where your optimal health is our desire. I am a qualified healthcare professional with a degree in psychology and three years of experience working with mental health patients. Client: thank you Clinician: how are you feeling today Client: I am not okay. I have tried to solve my issues by myself, but I feel that they are getting worse by the day. My life is not going well, and I am on the verge of giving up. Clinician: (responding with a nod) please share with me what is happening in your life at the moment Client: COVID-19 has had a lot of negative impacts on my life. Before the pandemic, I was doing well at my job, and despite the responsibility to care for my two children by myself, I was managing well. Clinician: Mmhh Client: However, things started going south when I was laid off from work and had no meaningful income source. I worked in a restaurant which had to be closed due to issues of 3 social distancing. I have not managed to get any job since then. I have been surviving through family help, but I feel like everyone is now viewing my children and me as a burden. Clinician: Okay Client: I feel depressed; I have no hope for the future because work is not forthcoming. My children are looking up to me, but I have nothing to offer. I have reached my emotional limit. |
C.B has difficulty keeping up with her two children's bills and basic needs in her current situation of joblessness with no income source. Even though the presenting issue is depression, C.B.'s main issue does not have to depend on others for handouts or financial aid but earning her own money to cater to her needs and children. The limited resources she has are limiting both her physical and emotional wellbeing of her children and herself. The client is going through a phase and situation that many other people and possible future clients are undergoing due to the global COVID -19 pandemic that has hit the world's economy. While C.B's s case could be different, it is not unique as many people have lost jobs, livelihoods, and even for others their lives or loved ones. During the interview, the client reflects a positive demeanor and hopeful attitude with clear indications of her desire to come out of the current problems she is facing. While the client admits she is tired of asking for help from friends and family, she demonstrates that the real help she needs is to find a source of income that will not involve borrowing or depending on well-wishers. The client loves independence and being able to do her stuff in accomplishing her goals. She strongly values her children and thus made arrangements to come for the session. In the interview, the client recalls she had weathered the past financial and emotional challenges before the pandemic, especially when she was going through a divorce. As a therapist, I did well in applying listening skills and active communication by guiding the interview while allowing C.B. to be in charge of her issues and situation. As a therapist, I endeavor to help clients get clarity on what is happening in their lives and their problems and come with the best solution, a thing that comes out well during the session. Additionally, as a therapist, I did well in connecting the situation of C.B to other possible scenarios that many other people could be going through due to the COVId-19 pandemic. I figured out if I can help C.B with her case, it would build the foundational basis and information vital in assisting clients in similar situations due to the pandemic. As a therapist, I have improved in my interview skills as I actively listened to C.B with minimal interjections whenever necessary and only in the way of guiding the conversation to ensure we stayed on course in resolving the issue. By understanding transference and countertransference issues, I understood C.B's frustrations and self-blame and her feelings of being a burden to others. As a single parent whose family was doing well before the pandemic and having won custody of her children after divorce from her husband, it makes sense for her, especially as a female or woman feeling overwhelmed with the emotional, physical, and financial obligations her children. Her value system and work ethic, similar to one exhibited by most white people, primarily white Americans of independence, are evident as she explains how she feels she can no longer ask for financial help from friends and family. Otherwise, it could be if she subscribed to a culture and value system that sees no problem in always depending on handouts and help from others for survival. As a middle-class citizen who was doing well before the pandemic, it makes sense to feel a burden to others, mainly since she was initially used to working for her own money and catering for her children from her efforts. The family set-up of being a single parent affects her and could be further affected by memories of her marriage (both good and bad memories.) I believe that I have done reasonably well from my initial interactions with the client to develop a treatment plan and assess this plan's success. Prior knowledge of how to conduct myself when dealing with a client was crucial. It helped in successfully exploring the client's problem to identify her presenting and underlying issues. This was possible through the employment of various therapeutic skills such as active listening and exploration. It also ensured that the client freely shared their story and history to help identify the issue she presented. The choice of excerpt allowed me to address a case that was directly related to the COVID-19 pandemic. Dealing with such a case is crucial for any clinician because many individuals are affected by the COVID-19 pandemic. Many have lost their jobs, others their businesses and homes. The case presented the opportunity to identify the pandemic's effects first-hand and work alongside the client in identifying possible solutions to her problem. I believe that I managed to conceptualize the case as expected. I identified theories that fit best with losing her job and her depressive condition. The operant conditioning and cognitive theories helped identify how personal and environmental factors contributed to her problems. I managed to connect these theories to her problem appropriately and identified theory-specific strategies to address the issues presented by the client. I did well in making the identification of solutions, mainly the client's effort. Even when we researched potential employers or employment opportunities together, she did most of the work. She identified options that identified which areas were the best as they matched her experience or educational background. I think her cognitive processes contribute significantly to her self-image. I further ensured that even when she was at home, she had an activity to remind her of therapy and that when she came for the next session aware of what she wanted to achieve. I found operant conditioning and Beck's cognitive theory as appropriate for the case. These two ensured that I not only focused on the client's physical and environmental well-being but also her mental health. I have managed to extend my knowledge on clients with psychological issues arising from the COVID-19 pandemic through the experience. I believe these would be crucial in helping patients with similar issues in the future. However, I needed to use more theories in understanding C.B's case and not just two as I did. I believe more theories would have helped her understand her situation better and help guide her in determining her depression faster. I will enhance my skills, as I have seen significant progress in the way I handle clients today than before. |
The therapists did well in listening, engaging, and prompting the client to understand her situation. The therapist did well to create a great rapport from the start and prompt the client to explain her situation and seamless transition from the known to unknown. More guided questions would be by following through with what the client talks about the most, such as if C.B explained that she was in her current predicament due to the COVID-19 pandemic, the therapist could ask the client on their thoughts about how other single parents (especially single mothers) are dealing with the pandemic effects. |
Impressions
| Overall, it was a good experience and a great impression of how I interacted with the client. I feel I have made much progress in interacting with clients as I maintained focus, engaged the client, listened actively, and helped her identify her issues. The client is not progressing well in dealing with self-blame, frustration, and feeling like she is a burden to friends and family. The client is doing well to understand her problem or issue and what she wants to be changed. My role as a therapist or clinician is to help the client determine the real issues and underlying causes and help them develop the capacity to overcome these issues for the client to develop, recover, improve, and maintain the skills and resources for their successful daily living and working. |
Plan :
I intend to help C.B understand her issue more deeply in future sessions so that she can come out of it as soon as possible and handle similar issues in the future. I intend to help her come to terms with the reality that she is not the only one laid off due to the COVID-19 pandemic. I will help her understand that many people lost their jobs, livelihoods, loved ones, and many companies h=shut down. I will also help her know that some people got jobs during the same COVID-19 pandemic period, promotions and companies were started. By digging extensively into her issue, she can look at both sides and see how the people making it within this period are doing. From there, she will be able to decide on a customized solution to her situation. I also intend to follow up on the progress of C.B in future sessions with details of how her children are doing, how she is dealing with self-blame, and if she still feels she is a burden to friends and family by asking for their support.
Questions for Supervision
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The aspects of the interview that I would like feedback for include: communication (body language, style, intonation and clarity, question formulation) and competence (in the therapy process, integrating evidence-based practices in my work). The questions I have for my field instructor are: What do you think I could have done better during the session? In your opinion, do I need more skills, knowledge, and experience in connecting theory with practice? Do you any specific advice or tips on my interview/therapy technique? |
Reflection on Policy
Public policies affect my client, C.B, especially in employment, as it's the public policy that allowed for her to be laid off in the first place when the pandemic struck. The public policy determines whether the economy stays afloat or crushes, affecting employment and business opportunities. As a result of C.B losing her job, she has now ended up depressed. If public policy prohibited employers from laying off workers during the pandemic, things would be otherwise for my client. Public policy also affects how I work with my client as whatever solution I guide into identifying must be within the law and public policy's confines. The policy affects how I work with C.B such that we now have help her deal with issues of inequities and injustices in public policy and prepare for national recession policies that may go against her financial well-being.
Organizational Context Analysis
Describe how the organizational context (agency funding sources, organizational policies, mission, or external public policies) of your agency impacts or determines your role, including its use of evidence-informed practices.
The organizational context of Open Sky Community services, the agency I work for, affects and determines my role. The mission involves the incorporation of best practices in empowering tour clients and the community. As a therapist, I am inclined to use evidence-based best practices that help individuals get better and keep the community healthy. The agency advocates for collaborations with families and individuals for successful therapy. We, therefore, have to factor in others' input in every work we do as employees of the agency. The goal of helping people live beyond their real or perceived limitations makes our services and delivery focused on the now and future projection. Often we seek to help the client deal with the current issues of the moment and prepare for dealing with and avoiding adverse issues in the future so they can live fulfilling lives. The funding sources also affect my role as a clinician/therapist as it determines the remuneration, working hours or durations and operations of the organization. Additionally, these funding sources often have interests in the firm's operations, which affects the direction the organization takes in working towards its vision and mission. For example, Open Sky Community services are supported by ADDP and MHCA, which leads to my work, including helping the less privileged such as the physically challenged persons and the homeless people, live fulfilling lives. The Open sky's organizational policies affect the structure and shape of suggestions that I can implement in my work, engagement with clients, and ways of addressing grievances both from colleagues and clients. Public policies limit the activities I can do or not do when delivering services to my clients.
Using one of the clients described in a process recording, identify how the organizational context affects this client and your treatment intervention plan.
For example, because Open Sky Community Services' mission is to help people live fulfilling lives, my work with C.B is not limited to seeing her get a source of income and come out of depression only. The job will now include setting up measures or helping her build capacity to deal with possible future setbacks that have similar effects to COVID-19. The job will involve helping her develop the right mindset, attitude, resilience, and resources of dealing with getting laid off in the future and asking for help from friends and family to live a fulfilling life even after overcoming her current predicaments. The funding sources mean that I can recommend C.B to seek help from the partner organizations for her situation if she will be comfortable with it as some of the funding organizations exist to help such individuals as C.B and the organization recommends us suggesting it to clients when necessary. I the light of helping her resolve her current issue of unemployment and depression, I have to consider the organization's mission that requires me not only to help the client resolve their current issues but also prepare for future eventualities for them to live fulfilling lives.
How do these internal and external factors serve and not serve marginalized groups and/or persons from marginalized groups (e.g., people who lack power and privilege based on race, class background, sexual orientation, disability, status, age?
The internal and external factors help in prioritizing work as some of them require priority to particular groups. For instance, since ADDP funds the agency, clients who are physically challenged are not only helped with their current issues but also referred to the firm for further aid in their well-being. The orphans, widows, people of color, elderly, and women are highly considered because of the agency's mission and the interests of the funding organizations.
Our conversations about these issues a part of supervision? Please describe
Conversations about these issues are part of supervision. For instance, when addressing the tools and resources that will help us deliver the necessary services to clients, supervisors will always mention the funding confines, allowing the acquisition of the resources or tools or the need to find alternatives. Additionally, in addressing how the services are delivered, supervisors are always guided to countercheck the delivery methods to continually match or support the agency's mission, vision, and capacity to provide these services continuously.
