Counselling Assignment Essay Example

team and will only converse about other people's actions. Whenever probed regarding his own sentiments or actions, he evades divulging any thoughts, opinions or emotions.

The mother is deeply troubled as she fears her son may attempt suicide again upon leaving the lockdown unit. She also had a confrontational meeting with the mental health team who allegedly blamed her for her son's problems and behaviour due to her parentage. The client both rejects and agrees with this notion. The client believes it would be fatal for her son to return home without addressing the root cause of his suicide attempt.

From my perspective, the presenting problem is not the son’s conduct, but rather the way his mother reacts to it. The mother feels culpable for her son’s suicide attempt and subsequent misbehavior toward caregivers at the London Hospital. Moreover, she is blaming herself for her daughters’ negative reaction to the son’s actions. These feelings of self-blame are reinforced by her daughters who assert that her lack of emotional availability and failure to recognize warning signs due to work contributed to the son’s suicide attempt. Ultimately, the presenting problem pertains to intergenerational interactions following the son’s suicide attempt and offspring behaviors.

The client has identified the following mutually agreed-upon counseling goals and strategies: getting community care for her son upon his return home to alleviate her stress over his lack of resources and support; living without constant guilt related to her son’s situation. The client’s “Stage of Change Behaviour” has been identified as precontemplation based on objective and subjective information, as she is currently resistant to changing her behavior.

Furthermore, the client lacks the ability to comprehend the

concept that individuals are accountable for their own conduct and responses to others' actions in their surroundings, as noted by C. Marino in 2001. The client indicated that her situation would improve if her son ceased causing her distress. When asked about her reaction to her son’s behavior and actions, she simply suggested that he could resolve the issue by cooperating with the people in London.

During the interview, the client displayed visible signs of being upset, such as wringing her hands and making jokes when discussing sensitive topics. She emphasized that her distress was not her responsibility, but rather her son's. If performed, the following skills could aid in the counseling process: the ability to assist in storytelling and the use of "therapeutic building blocks" (Young, 2001, p. 30) to describe the components of a helpful therapeutic relationship.

The foundation of change therapy lies in the capacity to guide clients in sharing their story. Below, I have itemized my helping skills in therapy and given an illustration for each one. The invitational skills serve as the primary way for the helper to invite clients into a therapeutic alliance as stated: "the basic means by which the helper invites the client into a therapeutic relationship" (Young, 2001, p.).

During the interviews, I was able to establish a therapeutic relationship by utilizing various nonverbal skills such as eye contact, body position, voice tone, attentive silence, gestures, facial expressions, physical distance and touching when appropriate. An instance of my attending skills was demonstrated when I allowed a moment of silence following the client's last statement during the initial interview. As a result of the silence, the client was able to

rethink her difficulties and express them in a new light.

During a client session, the client paused and asked, "Am I obsessing too much about whether he talks to his nurses?" This moment of silence allowed the client to reflect on her statement. Afterwards, she took it a step further by reframing her thoughts in relation to her own behavior. More in-depth discussions and illustrations of helpful skills can be found under the specific headings below.

According to J. Cotterell (personal communication, 1986), the use of empathy - not sympathy - is crucial to establish a therapeutic relationship with the client. It is important for the client to feel that the therapist understands how challenging their situation is. The trust that develops from this empathic approach creates a foundation for the helper's other activities (Young, 2001, p. 35). An example of empathy in action during a therapeutic relationship is demonstrated when I stated to my client during our initial interview on Feb 21, 2007, "I understand that it must be very challenging for you to manage your son's behavior."

During our conversation, I acknowledged the client's challenging perspective and expressed my comprehension without restating her exact words. In response, the client leaned forward and proceeded to delve into the intricacies of her struggles with her son. To gain a comprehensive understanding, I employed various assessment techniques like probing statements and open-ended and closed questions. When the client mentioned feeling angry, I utilized probing questions to clarify the nature of her anger.

During the interview, various types of questioning techniques were used to gather information effectively. Open questions were utilized to obtain background information, such as inquiring about what

or who was causing anger and how they were causing it. Examples of open questions include asking about the individual's daily routine before and after a suicide attempt. Closed questions were implemented to clarify previously discussed topics, such as confirming details about the individual's son being transported by ambulance to the hospital. The use of diverse questioning methods ensured that the interview time was maximally beneficial for obtaining information.

Advanced practice in counseling involves the use of advanced reflecting skills, with the initial step being the implementation of a statement to encourage clients to reflect. During my counseling session, I utilized statements to sum up the client's statements and ensure that I correctly interpreted their content. For example, I stated, “I understand that your daughters feel that you are the cause of your son’s situation.” Subsequently, a reflection of feeling or meaning phrase was incorporated. Incorporating restatements or reflection of feeling statements is instrumental in bringing awareness to the significance of clients' stories in light of their backgrounds (Young, 2001, p.).

When an outsider's perspective is used to reframe issues, clients can see them in a different light. Feedback then allows caregivers to understand the client's problems. Like Plato's shadows reflected on a cave wall, other viewpoints help redefine our own. During my interview, I provided an example of a reflection of feeling statement: "When your daughters say these things to you, it makes you feel guilty and as though you are a bad mother. Is that correct?" The outcome of the client's feelings manifests as reflection of meaning, which is the second half of this statement.

The accusation implies being a "bad mother."

To understand the actual problem, the caregiver can use clarification statements that help pinpoint the client's actual issues. This approach helps set specific tasks and goals. For instance, an excellent example of a clarification statement is, "I understand that you are mad," which helps clarify the actual problem.

During a client's second interview, summarizing statements such as focusing and signal summaries were utilized to enhance reflective skills, according to Young (2001, p. 130). The focusing summary technique was implemented to steer the conversation at the beginning of the interview. An example of this type of summary was used during the session, with the statement: “Last time you were here, we talked about your son’s behaviour and how that was impacting your life." Meanwhile, signal summaries aided clients in understanding their caregiver's comprehension of the session's content.

During our sessions, we use an example of summarizing previous discussions before addressing a new topic. For instance, we might say, "Before talking about your daughters, let's review what we've covered about your son. You attempted to discuss his problems with him, but he refused. As a result, he accused you of being a bad parent despite your efforts to provide for him. In addition, we utilized a thematic summary approach."

According to Young (2001, p. 132), a theme refers to a repeated pattern of feelings, content, or meaning observed in clients. During a session with the client, I utilized a thematic summary to reveal my observation by saying that the topic of working outside the home repeatedly emerges in our conversations, suggesting that the children were unhappy about their mother's absence. Additionally, while acknowledging the client's nonverbal behaviors, I noticed

that she laughed and leaned forward while discussing difficult and uncomfortable issues like her husband's suicide attempt. The client remained tearful and laughing simultaneously throughout the conversation.

This paragraph suggests that the client is struggling to align her thoughts and actions. To help the client identify potential changes, a motivational intervention is necessary (Rollnick, Mason, ; Butler, 1999, p. 190). This type of intervention allows the client to articulate why change might be beneficial to them. During a conversation about the benefits and drawbacks of reframing her reactions to her son's behavior, the client concluded that releasing the guilt associated with her son's actions would not cause harm.

During the session, we talked about how adult children are accountable for their actions and how change in their perception can only come from within. Although the client acknowledged this, we discussed how she can modify her response to other people's behavior if she grants herself authorization to do so. Throughout the session, the client recognized her own feasible choices, available resources, and supportive systems. However, it was a bit challenging to prompt her to converse about these options, resources, and supports from a personal perspective.

During the first visit, I inquired about the available supports in the community, at work, and within the family. The client was unable to articulate any supports. Nevertheless, during the second visit, the client spoke about the help they had previously received from a Native traditional healer. This was acknowledged as a viable resource for future assistance. Furthermore, I aided the client in granting herself permission to accept aid from her adult daughters. The client expressed concern that she was "terrible" for depending on

them.

We previously talked about how it's important for the daughters to assist the client in order for them to comprehend her challenges with her son. My expertise lies in aiding clients in committing to their own plans and methods for achieving their goals. It's crucial for the client to consider me as a reliable and capable professional (Young, 2001). Maintaining a professional communication with the client is key in developing this respect. According to Young (2001), when clients perceive their counselor as an expert, they are more likely to experience positive results and accept and commit to their goals.

According to Y. Applewaite (personal communication, 2004), it is important for a client to not only have a knowledgeable support person but also to set their own goals and methods of achievement in order for the goals to be personally meaningful. The client's own plans and strategies will result in a higher level of commitment to achieving their goals. Rollick et al (1999) also suggest that personal control is necessary for motivation to change. The client has established her own goals and in future interactions, there will be discussion on how she can attain them. The client has faith in the goals as they were defined using summarizing statements.

In my opinion, my abilities and limitations as a therapist stem from my conviction that individuals deserve to express themselves and receive attention. This guiding principle influences my choices in ethics, particularly in terms of non-paternalism, non-maleficence, and beneficence towards clients as outlined by Yeo and Morehouse (1998). These ethical considerations help me to value and appreciate the distinctiveness of every person I assist. However, I struggle with

the tendency to provide unsolicited advice when listening to others.

My desire is always to improve people's lives and help fix their problems. However, I struggle to remain attentive when I disagree with a client's choices or when they are too hard on themselves. In these situations, I have the urge to comfort them and say something positive. Although I am aware that this behaviour is not appropriate in a professional relationship. In the second session, I introduced cognitive behavioural therapy as a method of guiding the client towards shifting the blame away from themselves. I was not interested in analyzing the client's beliefs or using any other analytical therapy.

Young (2001) has noted that analysis can take too much time without necessarily resulting in behavioural change. In this case, the client's son was due to return home in two weeks, making fast and effective therapy necessary. Through my specific communication and counseling methods, I utilized partial self-disclosure about my own teenager and his struggles to help lower the mother's defensive state towards me. The mother also shared that caregivers in London had previously "blamed" her for the client's suicide attempt and subsequent silence towards them.

The client's knowledge of someone else facing similar difficulties was crucial to establish trust quickly, as they knew there would be no blame assigned. While self-disclosure is not universally recommended, evidence has shown that it encourages clients to express their feelings and share more about themselves. Clients have reported that self-disclosure from helpers is valuable. Our conversation centered around the challenges of juggling work and raising a family.

During the therapeutic communication, the client openly expressed her anger and fears despite being

aware of its therapeutic nature. The therapist's display of empathy and non-judgmental attitude towards the client helped build her trust and confidence. In fact, the client even shared that she "hated him for all he's putting me through" - something she had never revealed to anyone before, which seemed to have left her feeling embarrassed.

The client had asked for confidentiality and was reminded of the rules and responsibilities regarding confidentiality in therapy. In the second interview, the client felt more at ease and was able to communicate better with the counselor. She revealed that she had thought about her negative reaction towards her children's blaming her, something she had not mentioned in the previous session.

In future sessions, the use of Cognitive Behavioural Therapy to bring about change in the client's life would be justified. According to Rollnick et all (1999), clients who are more receptive to change require a skill intervention. Uphold ; Graham (2003) state that CBT provides patients with tools to manage their inwardly experienced feelings by modifying their outward behaviour. The next counselling intervention for the client will be focused on her behaviour and how to alter it by reframing the underlying cognition behind it. If the methods employed do not yield favourable results, what modifications will you make next time? What is your reasoning? There were no adverse outcomes observed.

In the unlikely event that a negative impact on the client is perceived, I would adjust my counseling methods in the specific area where the issue arose. For example, if the client does not react well to self-disclosure, I would promptly revert to discussing their situation. Employing self-disclosure can

be precarious, particularly when counselors are unaware of its potential (Watkins, 1990). Evaluating if my primary objectives were met is crucial, along with identifying any reasons for failure. As of now, the objectives have not been achieved. Nonetheless, the client has made minimal progress in acknowledging their ability to modify their behavior.

The client is considering a shift towards a "skills based intervention" in line with her strengths and goals, as stated in Rollnick et al's (1999) recommendations. However, there is some resistance to change, fueled in part by the client's deeply held belief that motherhood is the root of children's behavior and reflects on her ability as a mother. This belief has been reinforced by the client's adult daughters, who attribute the behavior of the client's adult son to her "selfish" actions related to full-time employment rather than being at home "being a mother like you should be".

The text describes the challenges faced by the caregiver when working with a client who was distrustful of healthcare providers due to past experiences with the London Mental Health Unit. The client was hesitant to discuss their difficulties, but the caregiver was able to create a safe and comfortable environment by discussing client-caregiver confidentiality and showing empathy through nonverbal techniques such as indirect eye contact and body positioning. The caregiver also used partial self-disclosure to establish trust and encourage the client to confide in them.

As I reflect on my performance in this counseling assignment, I see both strengths and weaknesses stemming from the fact that I have a troubled teenager. On one hand, this gives me firsthand knowledge of the dearth of resources available to teenagers

in our area and the frustration felt by single mothers dealing with difficult teens. This allows me to offer genuine empathy and care to the mother. On the other hand, it also makes it tempting to impose my own child's solutions onto the client's situation.

While my goals and my son's situation differ from the client's goals and situation, I recognize that the therapeutic relationship should solely focus on the client's needs and objectives. Nonetheless, I am conscious of the risk of becoming too immersed in the client's issues and strive to follow Frieda Fromm-Reichmann's analogy of therapists being akin to skin divers: delving deep into a client's problems but also resurfacing as needed. This is an aspect I aim to further enhance moving forward (as outlined in Young, 2001, p. 52).

The Canadian Pharmacists Association has published the Compendium of Pharmaceuticals and Specialties, which serves as the Canadian drug reference for Health Professionals. This book was authored in Toronto, ON. Additionally, Knox S. is referred to in this reference.

In 1997, Hess, S., Peterson, D., and Hill, C. authored a publication.

The Journal of Counseling Psychology published a study conducted by Rollnick, Mason, and Butler in 1999. The study involved a qualitative analysis of client perceptions regarding the effects of therapist self-disclosure in long term therapy. The article can be found in volume 44, pages 274-283.

"Health behaviour change: A guide for practitioners" authored by Uphold, C. R. and Graham, M. and published by Churchill Livingstone Inc. located in Toronto, Ontario.

The book "Clinical Guidelines in Family Practice" (4th edition, pages 633-639) by V. was published by Barmarrae Books, Inc. in Gainsville, FL in

2003.

In Counseling Psychologist (1990), Watkins Jr. reviews research on the impact of counselor self-disclosure, spanning from pages 477 to 500.

The book "Concepts and Cases in Nursing Ethics" (2nd edition) was authored by Yeo, M. and Moorhouse, A. and published by Broadview Press in Toronto, ON in the year 1998. The information is presented within denoting a paragraph.

Young, M. (2001). Building Blocks and Techniques for Learning the Art of Helping (2nd ed.). Toronto, ON: Merrill Prentice Hall Inc.