Sara expresses significant concern regarding finding a job, leaving her family and leaving her friends. While she enjoyed her studies in business she is not exactly sure how she can apply this to her daily life. She is also somewhat ambivalent about wanting to work in the business world, and wonders if she should try to find a position that she would find more emotionally and personally fulfilling. Sara is not involved in a romantic relationship at this time but does have a small but very close circle of friends, all of whom are moving to different places. Sara expresses sadness at the thought of leaving her friends, and concern that she will be able to keep up with them after college is over. She is also concerned that she will not be able to make friends in her new setting. Sara is an intelligent woman who appears to have done well in school and has potential to get a good job. It is interesting that she is able to express several emotions such as ambivalence and sadness and concern, but appears surprised when we go through some of the signs and symptoms of anxiety and she is able to identify most of the symptoms of anxiety more days than not.
The majority of the first session with Sara was spent in active listening on the part of this counselor. I tried to compare her behaviors, key experiences and behaviors. The history she gave was congruent with her stated goals. I used the end of the first session to use the technique of empathetic highlighting, restating to Sara what I believed she had told me and asking her to verify if my perception was correct. I used probing questions to move more into the areas of feelings, which Sara did not cover in depth, and eventually was able to uncover that Sara was experiencing a significant degree of anxiety surrounding the present and the future. At the end of the first session I asked Sara if she felt capable of working with me on forming some goals on which she could work to both identify her primary concerns and areas on which she wanted to work. Applying the Egan model to Sara, we were able to identify the following issues that she wanted to work on in therapy:
Goal #1 Sara states she wants to find a good and respectable job, by her own and by her parents' standards.
Goal #2 Sara wants to maintain an active social life, somewhat like she had while she was in college.
Goal # 3 Sara wants to see reduction in the degree of anxiety she is experiencing surrounding life changes.
I asked Sara if she could contemplate these goals in the week between our next session, and see if she could come up with any useful plans which we could implement to help her reach these goals. Sara felt that she could. We wrote the goals down on a piece of paper.
In our second session Sara seemed much more relaxed in her interactions with me. She had spent a lot of time thinking about the goals we had identified at her last session. She was particularly interested in addressing her symptoms of anxiety and was able to share with me that she felt that anxiety had been a problem with her for a long time, but that she had never actually been able to identify it. She had spent a significant amount of time reviewing her feelings over the last week and had seen how so many times her anxiety had shaped her mood or actions. She had been very diligent in thinking about her goals over the week, and we discussed her plans to meet each goal.
Goal #1 Sara decided that she would work on a resume over the next month. She was no longer sure that she wanted to work in the business world but felt that she would like to make application to some faith based and non-governmental charitable organizations where she might be able to use her business school skills in some way. She decided that she would search the newspapers and the internet and submit her resume for two positions in which she was genuinely interested per week. She would also avail herself of the career counseling services which were available though the college and work with a counselor there to help her find a job which met her skills and her interests.
Goal #2 Sara knows that as her friends move away, and eventually she moves when she finds a job of her liking, that she will need to be able to make more friends. She related that she was unsure about making friends outside of the school or work setting, since that had been her primary method of socialization in the past. Sara originally came in with the objective of engaging herself in social programs, in which she could find friends with similar interests to her own. On further questioning however she could not actually identify a social program or even give me any idea of how she would find one. She did talk about attending a church of her faith wherever she did find a job and felt that would be one likely way of meeting other people with similar interests. The anxiety associated with meeting new friends appeared to be somewhat of a blind spot for Sara. We discussed the need for structured plans to help her overcome this.
She would continue to work on this objective.
Goal #3 I was reasonably pleased when Sara stated that her third goal was to address the anxiety she had been feeling. It appeared that the anxiety was probably more significant to many of the issues that Sara was experiencing that she had previously known. She originally felt that she may work on her anxiety with some guided imagery tapes and relaxation techniques, but the more we talked about the problem, the more she began to see that her anxiety was likely not something that she could work on all by herself and would probably do best working with a professional counselor. She decided that she would begin seeing a professional counselor on a weekly basis to help her work through her anxiety issues, and perhaps find the source of the anxiety. In addition, she knew of a local woman's group which met at a local church and dealt with issues of self-esteem and other women's issues. She decided that she…