I don't know what's wrong. W: Well, fear can make one uneasy and act differently from what one is used to. Do you think that there was something around you, a situation a symbol a person that made you feel even more fearful?

I wanted to know what kind of situations made her fearful or uneasy

I had an idea that perhaps what made her fearful was the possibility of loneliness for life.

C: I really have no idea & #8230; there just seems to be a lot more for me to do than the people around me and it's just that I can't seem to bring myself up to where there are. I don't know if I ever will, you know.

W: What is it that the people around you are surpassing in?

Tuning in Please let it not be below par academics! That's the only positive she has in her life right now!

C: Well, at work, It seems like I'm stuck, you know. I've been doing the same chores for the last 6 months, haven't gotten any additional responsibilities. Whereas this guy who got hired 3 months ago has already been working on a ton of more responsibilities than me.

W: Sometimes it isn't the number of responsibilities you are given but the nature that decides what your worth is. What are you asked to take of most frequently?

Reaching for client's feedback and self-analysis of a disturbing situation

I have to get her to look at the positives here

C: You know I work at diner! Sometimes I feel like I only got the job because of my cousin & #8230; yea I normally get to work the register but mostly the karaoke program. Karaoke is a major part of the diner, it's what its famous for!

W: It seems to me like the chores you're asked to do make or break the diner!

What do you think about your responsibilities?

Tuning in Come on! Determine you self-worth here!

C: Well yeah, I guess! I mean yeah, they are important! No one juts trysts anyone with money or their marketing like that & #8230; I feel so paranoid about making a mistake and messing everything and losing what I have as a responsibility that sometimes I wish I didn't have such a huge part to play!

Don't cry! Please don't cry!

W: I know that fear of losing something as consistent as that can be fearful! But I know you and your level of dedication to everything you do! Sometimes it annoys me honestly (hint at humor)! Whatever you put your name against, you always make sure you never giver less than your hundred percent! I think that is why the nature of the responsibilities entrusted on you is so huge!

Empathy

I wish she would see how significant her input is

C: You really think so?

W: Of course I do! I'm honestly surprised that you don't.

Practicing encouragement

Breathe in, breath out

C: (Long Pause) Thanks!

W: Thank me when you get the chore to do the diner's specials announcements (wink)

Reassurance

Come on! Smile!

C: (Smiling) actually the manager asked me to take over that from next month, as Jenna's leaving & #8230; (Pauses while I smile at her) & #8230; yeah I know what you mean now when you talk about the nature of responsibilities! It's probably why the nature of fear is so huge as well!

W: Take the good with the bad right!

Analyzing situation's pros and cons

She's finally come around!

C: Yeah! That's the best I can get or hope to get & #8230; certainly better than what I've had to deal with from a year ago! (sheepish smile)

Overall sense about your work as indicated by this process recording:

Overall, I thought I did a good job in providing the client with the necessary encouragement she needed and reassuring her about the positives of the situations she was in. I was able to offer supportive counseling and allow her to form a positive conclusion on her own.

Specific questions for supervision:

What could I have done to be more effective in my delivery of service availability?

Ideas about next actions or interventions or follow-up that might be indicated:

How are you handling the added responsibility of specials announcement?

The most important stages are the fourth and fifth ones because this is where the actual behavioral change occurs. The fourth stage of action requires the individual to apply all strategies introduced...

Here one of the most successful methods used is the recognition of daily accomplishments made by the individual, both tangible and intangible. Another important method that has proven useful in this stage has been the implementation of different strategies for attaining different behavioral changes in the individual. This method of using alternative strategies allows individuals to develop diversification and adaptation skills when dealing with a difficult transition of change and not giving into prior temptations. Another important aspect in this stage is the consistency of support from her peers as her family is no longer around.
The fifth stage or method for implementing behavioral change in one's depressive inclinations is the maintenance of the mental health over a significant period of time till the relapses can be controlled consistently and consciously. Here the most important method implemented is the continuity of awareness of the problems that can surface if the individual diverts from the behavioral change plan. Another important method used in his stage is the constant reversion to the lifestyle that the individual had prior to the application of the behavioral change process so as to keep them weary of the consequences of a relapse (Greene et al., 1999).

Summary, Critique of Practice and Results:

Summary

The method applied was very efficient in allowing the individual to not only address the problem when she was ready but also to help her understand the extent to which she can adapt and change maintaining a consistent level of growth and awareness about her mental health and depressive inclinations. The individual analyzed for this study was able to lucidly understand the problem and even though the change process seemed daunting, the individual mostly was able to stay mentally tough and surrounded herself a strong social structure of peers and foster care structure. She took additional steps to join health groups, even though she was initially reluctant to do so, but she did make an effort in order to remain updated on all depressive and health issues/patterns.

Critique of practice:

Sarah was a patient recommended to me from a colleague, primarily because of my experience and history with treating kids in the foster care structure. I took on the case as I realized that this could be an opportunity to document part of implementation in modern behavioral theories. Plus, she reminded me of a patient I had dealt with previously without having much success. I felt like I could perhaps make amends through helping Sarah. Upon meeting Sarah, in our first session, she seemed like a reclusive and secretive person. She wasn't much of a talker and the friendlier I tried to be, the more skeptical she became about the reason behind my desire to help her. The idea that I had to employ the Stages of Change formula was not going to work unless I could get Sarah to open up and talk about her situation with me. So I decided to play by her rules and not make the first authoritative move. After a couple of sessions, she started talking about random things in my life, like the paintings on my wall or the books I owned, she even talk about my fashion sense, but every time I tried to get more out of her, she would shut me out. I realized through her attitude and peer profiles that she liked to size someone up before deciding to trust them so I allowed her to dictate therapy session initially.

That seemed to be the winning strategy but it was the third session with Sarah that I felt like I was being more of a hindrance than anything else. The reason why I had taken Sarah's case was because she reminded me of another client who I had wanted to help but had been unsuccessful with. I felt like I needed to make things better for Sarah in order to feel good about my own practice with such clients. The third session however started off on the wrong foot, primarily because I was being very defensive. Sarah's defenses had always been very high around me and it had required a low of patience on my part in the prior two sessions in order to deal with her complexities. However, I was running low on tolerance levels even before this particular session had begun. I did not react well to the usual carefree and disregarding demeanor of Sarah and I became angry myself.

The anger on my part should not have been revealed! It is my job to cover up what I…