Adam K. Is A 38 Year-Old, Client, Of The Steven A. Cohen

of the therapy, the client meets the therapist to describe specific problems and to set goals they

James is a twenty-year-old male who was referred to me after an emergency room visit. James had experienced shaking, sweating, chest pain, and inability to breathe; he went to the emergency room because he was afraid he was having a heart attack (The Louis de la Parte Florida Mental Health Institute, 2002). After exchanging pleasantries, I began an intake interview with James. I found that he was forthcoming with his life history. He was raised in a lower middle class family and was the youngest of two children (The Louis de la Parte Florida Mental Health Institute, 2002). His most vivid childhood memories included violent domestic conflicts between his mother and father, which caused disruption in his daily living. James also admitted his father was a substance user and often came home intoxicated. Subsequently, his father abandoned his family and went to prison for assault and drug charges and James has no contact with him in

Throughout Mr. P’s life he has experienced lack of family support, victimization, rebelliousness, friends who use drugs or in gangs, lack of social and economic opportunities, and even more expanded list of risk factors that had led to adverse outcomes. His everyday life growing up consisted of reoccurring violence and abuse contributed to developmental disruptions which led to violation and wrong doing. Continued sessions with Mr. P. will focus on improving client’s social and interpersonal difficulties as client lack trust and intimacy and often finds it challenging to establish new relationships as well as utilizing resources to assist with improvement of health and wellbeing.

With solution-focused therapy, the client is the professional. We know that people overcome great adversity daily and often this occurs without any psychotherapy. Often the client just needs to be guided in the right direction. “We cannot change our past; we can change our goals. Better goals can break us out of stuck places and can lead us into a more fulfilling future” (Norcross, p. 408). The value of goal setting is something that has been discussed in every class I have taken since beginning the masters of arts in counseling (MAC) program. “This process of goal setting and action planning is not something we do to people, but rather with them. The assessment process, as well as the working agreements we strike with our clients, should reflect high degrees of

Jason has three goals he would like to achieve while he is in treatment. The first goal is to strengthen his long term sobriety skills. The objective scores for this goal are to list triggers (person, places, and things) that come before a relapse, also to complete a ten page autobiography and process that with his primary therapist. His second goal is to reduce the level of depression he has. The objective scores are to list five ways a higher power can help reduce depression, and make a gratitude list with at least ten items, and then process them with his primary therapist. The third goal Jason would like to achieve is to obtain a positive support network. The objective scores for this goal are to meet with a twelve step program individual and discuss support for recovery, also to obtain at least ten phone numbers of people that have long term sobriety. While in treatment Jason has a few modalities which are; individual sessions two times a week, family therapy two times a week, and process and didactic groups two times a

When working with an adolescent client who is presenting the signs of illicit drug use, it is always a good idea to explore the family dynamics. Adam being only 15 years old is still in the transitional stage where his actions are still closely linked to his family of origin. Teens are often dealing with the conflicts of wanting to be independent from their parents, yet realizing their parents are providing for many of their wants and needs. Adolescents like Adam often find peers who represent either everything they perceive that their parents are not, or embody the dramas and trauma that they were raised to consider normal.

Treatment is delivered by a primary therapist who conducts both individual and group sessions. His/her tasks entail coordinating the delivery of the program, scheduling and maintaining patient retention in the program. Whenever possible, the co-leader, chosen by the therapist, who has observed at least 6 months of recovery is involved. The co-leader serves as a peer supporter who can share his or her own recovery experiences. The therapist, therefore, maintains control of the group, facilitates the session within a positive environment and ensures the delivery of its educational element. Therapists specifically avoid allowing confrontational or extremely emotional environment. Thus, encouraging input from patients

William Thomas is a 34-year-old African American man that lives in Killeen, TX with his wife, Sandra and his son, Timothy (9 years old). William entered the Grace Christian Center on June 23, 2016. William suffers from PTSD as a result of his combat deployment to Afghanistan in 2014. William served in the United States Army for six years, He enlisted in 2010 and exited the military on an honorable discharge February 10, 2016. During William service, he achieved the rank of Sergeant and served in two combat deployments. William has no known drug allergies but said that he refuses to medication which is why he is here to see Grace Counselors instead of the VA. William loves to shoot guns, exercise and play the video game call of duty. William has been having anger outbreaks and cry spells since he left the service just four months ago. His wife, who escorted him to the church said that they are constantly fighting over stupid things and that he treats her like he’s her soldier. William keeps trying to explain himself but he says his wife doesn’t listen. He’s not treating her like a soldier he 's just trying to point out some things and he doesn’t feel respected therefore he feels the needs to raise his voice and through a tantrum.

According to Andrew’s medical records from U.S Department of Veterans Hospital, he was diagnosed with traumatic war neurosis, which is currently known as Post-Traumatic Stress Disorder (PTSD). During his evaluation, his symptoms were nightmares, irritability, increased startle responsiveness, and a tendency to angry outbursts. Considering the limited knowledge and education of PTSD, he was not prescribed any psychotic medication for treatment. Along with PTSD, Andrew had abused alcohol on a daily basis. He had a pattern of consuming four to six drinks every evening and engaged in alcohol binges most weekends. However, Andrew has been sober for almost two years. In addition, his medical records also indicated

Psychiatric studies that were part of this study include Beck Depression Inventory, Hamilton Anxiety Rating Scale, and SCL-90-R questionnaires. The Beck Depression Inventory questionnaire measures the severity of depression and screens patients who require intervention. BDI scores minimal depression from 0-13, mild depression from 14-19, moderate depression from 20-28, with severe depression scoring lying within the 29-63 range (Beck AT. Depression: Causes and Treatment. Philadelphia: University of Pennsylvania Press, 2006). HARS provides an overall measure of global anxiety that is psychiatric and somatic symptomatically. Scoring ranges from 0-56 with a score over 14 indicating high levels of anxiety (Bagby RM, Ryder AG, Schuller DR, Marshall MB. "The Hamilton Depression Rating Scale: has the gold standard become a lead weight?" Am J Psychiatry 2004; 161(12):2163-77). SCL-90-R questionnaire presented

The BAI [1993 Edition] was authored by Aaron T. Beck and Robert A. Steer, and is intended to measure the severity of anxiety in adults and adolescents from the age range of 17 through 80 years (Dowd, 1998). Clients respond to 21 statements assessed on a measure from 0 (Not at all) to 3 (Severely, I could barely stand it.). Each statement is an indicator of a personal, physical, or panic- related issues associated with anxiety. The client indicates how much he/she has been troubled by each issue throughout the past week including today, by marking an X to the agreeing measure of his/her anxiety symptom (Waller, 1998). The raw score is determined by adding the score for each item, which in turn determines anxiety level (Dowd, 1998). Anxiety level range from: 0-9 minimal, 10-16 mild, 17-29 moderate, and 30-63 severe (Leyfer, Ruberg, & Woodruff-Borden, 2006).

Solution-Focused Therapy is different than most typical types of therapies. It is a simple all-purpose approach (George, Iveson, & Ratner, 2015), with a wide range of applicability; it is a form of brief therapy that emphasizes cognition and behavior. As such, the therapy required to assist in solution-generating change could take as little as one session. Appointments are made one at a time, assuming one more is all that is necessary. Planning out a treatment plan with this in mind, the format is more geared towards three to five visits, at around forty-five minutes each, beginning to end, and indeed, typically, three sessions is all that is necessary. Some therapists feel that if progress is not made by the third visit, it is a poor fit for the client’s situation, and would require an alternate form of therapy (George, Iveson, & Ratner, 2015). When progress does occur, the length between session visits increase.

Given the restrictions imposed by health insurance requirements, short-term therapies are now the treatments of choice for many therapists and patients. Short-term therapies may be best described as “time-limited psychotherapy.” However, research has found increasing evidence of the effectiveness of such time-limited approaches as interpersonal psychotherapy (IPT), cognitive behavioral therapy (CBT), and solution-focused therapy (SFT).

Goals aid the clinician in monitoring the client’s progress, in addition to determining if the client’s strategies and intervention approaches should be adjusted. The involvement of the client and the family can lead to increased participation with treatment. Therefore, goals that are measurable, visualizable, and benchmarks help to make sure that the clinician, the client’s family are all aware of what the client is doing in therapy and how they can help the client reach his or her goals the clinicians the ability to regularly follow up with the client and the family (Haftel, 2014, p.1).

Clarification and agreement around the client’s goals represents a starting point for collaborative exploration of multiple ways in which these goals can be attained. Goal setting offers a platform for both therapist and client to resolve any differences through collaborative dialogue which reflects their mutual intentions and understandings (Clark, 1996) Goals can be defined as immediate, those which help to achieve longer term goals, goals to be worked on in therapy and long term or life goals (Hanley, Sefi & Ersahin, 2016) A client may formulate life goals including non-specific, contradictory, avoidant, unattainable or no life goals, which can then be broken down into therapeutic goals and the therapist will have her own goals as well