Failed Counseling Case Study

Frankie Tilmon continues to be out of treatment compliance. Frankie has missed his last four appointments, 7/2/15, 7/9/15, 7/16/15, and 7/30/15. Frankie contacted this provider on 7/6 to apologize for missing his appointment on 7/2 and was reminded of his next appointment on 7/9, which he agreed to attend. On 7/15 Frankie contacted this provider to apologize for missing his treatment appointment on 7/9 and agreed to make his appointment the following day, which he failed to appear for. On 7/16 Frankie contacted this provider to again apologize for missing his appointment and wanted to confirm his next scheduled appointment day/time. I told Frankie that his appointment day and time has not changed; it was on Thursdays at 4pm. Frankie told

The patient arrived on for his counseling session. Reports stability on his current dose and denies the need for a dose increase or decrease when offered by the writer. The patient was made aware that he will be reassigned to counselor, Scott effectively immediately as his new assigned counselor will schedule his next session. The patient reports of no update with his medical pertaining to a referral to another PCP as he is currently still seeing the same medical provider.

Patient didn't call or show up for his scheduled individual counseling session today at 7 am; however, he received his dose of methadone at the Clinic around 9 :30 am. This writer called pt.’s phone number on file to reschedule a mandatory individual session. Counselor will be flag pt. in the system to see counselor before dosing tomorrow, 12/15/16 to discuss his recovery progress, what the program expects of him at this stage and how to get the most of out

SPC Yancey this is your June monthly counseling, you have been doing an excellent job taking over for SPC (p) Wehle, and you have taken ownership of each task. Good job working on responsibility as well as being there for the section. I appreciate your willingness to take charge of situations in my absence. You have a good leadership ability, the Soldiers like you and want to work for you. This is a part of your leadership that you need to nurture. While you do take ownership of tasks and missions there is a weakness in your follow through on a given a task. I suggest that you trust but validate every tasks you give the troops. This confirms follow through and appropriate completion. Do not be afraid to make them redo a task if mot completed

This writer and the Program Director met with the patient to share an explanation about dosing time arrangement. According to the Program Director, she provided the patient with an explanation as to why he will have to dose between 9am-11:30am due to patient #394 and her husband medical issues. If the patient returns back to work and needs to dose at an earlier time, the patient must provide proof his work schedule for the dosing time arrangement to be changed again. The patient requested for assistance from the clinic to preschedule his Logisticare transportation of which the Program Director and this writer agreed to assist him with. After the discussion with the Program Director, the patient was not pleased and began to get emotional as he feels victimized again. This writer explained to the patient, the patient reason for the dosing arrangement is due to the allegation and safety reason. However, the patient understood the purpose of the arrangement, but he was more concern about getting the earlier appointment rather than a later time. This reiterate about what the Program Director mentioned about if the need to change the dosing time, the patient needs to provide proof for such request. The patient provided this writer with a copy of his ER visit dated for 02/23/2017 of which the patient did in fact received one pill of Klonopin.

The patient arrived on time for her counseling session. Reports stability on her dose and denies the need for a dose increase when it was offered by the writer. When questioned about what caused her to relapse recently, the patient started to cry as she did in fact regret her recent relapse as she said, " I didn't need that shit.....it didn't do anything for me......I am just tired Charlene, now there is warrant for my arrest and I may be charged with a felony for larceny. I just stressed out because I need to come up with $500 to pay this lawyer to drop the charges to a misdemeanor. The entire cost for the lawyer to represent me is $2500 that I honestly don't have, Charlene." The patient was tearful throughout the session. The writer validated

Data: Client came to appointment on time with a decent attitude, and engaging during session. Today’s individual session was focused on addressing client’s treatment attendance issue. Client has not attending treatment group consistently, which will put her not in compliance with Kaiser Permanente suboxone program, as well as CD treatment at THS. Client has 7 absences from 03/01/17 – 05/25/17. Client reported no use of alcohol or other substances since started treatment. Client reported going to Kaiser Permanente weekly for counseling, UA, and obtain Suboxone prescription at Capitol Hill, Seattle. PC provided client with information for different OP groups but client stated, “I will make it work. Wednesday group works for me better.”

RT had a scheduled medication management appointment with Mary Pestrak at 4:30pm on 6/15/16, but RT called NP Mary and rescheduled. RT stated that she wouldn't be able to come to TSI for her appointment. However, writer met with RT and inquired about RT's well-being and RT stated " I am doing good". RT informed writer that on 6/14/16, she went to her PCP and did blood work and is scheduled to go back to her PCP on 6/21/16 to get the completed physical form hat was provided to RT by writer. RT's medication management appointment is rescheduled for 6/22/16, RT ensured writer that she will be there. Writer informed RT that she is awaiting to hear from Marguerite to get more information on a GED program. RT was appreciative of writer's assistance.

Counseling supervision, the ethical and legal issues, and the multiple relationships that result is a dynamic topic that presents numerous complex issues. The important functions of the supervisory relationship are to teach counseling through a hands-on process, assess, inform, implement, and evaluate the application of theories, ethical and competent practices to prepare the supervisee for their future profession in the counseling field. However, while supervisors play multiple roles in the supervision process, there are situations and times when the boundaries between therapy and supervision are not always clear. During the supervisory relationship it is vital and of the upmost importance that the supervisor model’s ethical behavior and implements the ethical standards of the counseling profession.

This writer agreed to meet with the patient as she missed group and her scheduled individual session with this writer. The patient apologized to this writer for her absence and then reports about transportation issue. This writer discussed with the patient about her MVA this month on the 18th and the status of obtaining a police report. The patient reports, " I can get the police report by the next appointment. I just have to go to my insurance company that isn't too far from where I live to get a copy of it."

I enjoyed reading your post. You provided relevant and important members that you would include in your group. I agree that teachers are essential for the school counselor to collaborate with as they are with the students most of the day (American School Counselor Association, 2012). I like how you would collaborate with the school or district psychologist in order to create the school counseling program. Is this something that your school or district psychologists do in your school district? I think that would be a great resource. An important addition to group would be the students. Students are the ones that are receiving the services that the school counseling program is providing. They have direct information about themselves

As a counseling student, it is very important to formulate a counseling theory tailored to ones’ own personality and beliefs. A counselor may choose a single theory to model when practicing therapy or pick and choose components and techniques from various theories, otherwise known as eclecticism. No theory is considered right or wrong. Understanding the different therapeutic approaches are important to effective counseling, however, counselors must also understand their own personal value, view of human nature, human behavior, counseling techniques and the purpose and goals of counseling. Understanding these components along with the different theoretical approaches will provide the counselor with a 9 knowledge of their own counseling, orientation and is essential to not only the productivity of counseling but the growth of the counselor as well.

Another tactic is to promote social support and encourage counseling. Social support and counseling can be advantageous to older persons and family members’ who are the caregivers. Having other people to talk to can help in releasing tensions and providing a way to cope with issues that may aid in abuse. Many times, families in similar circumstances can come together to share solutions and provide informal respite for each other. In addition, when there is a larger social circle, abuse is less likely to go

Cooper, J. B. (2010). Counseling microskills. In B. T. Erford (Ed.), Orientation to the counseling profession: Advocacy, ethics, and essential professional foundations (pp. 148–162). Upper Saddle River, NJ: Pearson Education.

Solution-Focused Brief Therapy (SFBT) counselors and Reality Therapy (RT) counselors both strive towards creating a relationship with their clients. In regards to SFBT, Winbolt states (2014), “The relationship between therapist and client is critical; collaboration and a ‘robust’ working relationship are more important than theory and expertise.” In order for a SFBT counselor to have success with their client, they must first establish a relationship. Without the foundation of a working relationship between the counselor and client, the goal of SFBT will be unreachable, even with the highest degree of training. Similarly, RT counselors must also begin their therapy with a client by forming a working relationship. According to Glasser (1965), “The therapist has a difficult task, for he must quickly build a firm emotional relationship with a patient who has failed to establish such relationships in the past” (p. 21). Although building a relationship with a client may be a difficult task for a RT counselor, it is very important for them to do so in order for them to have success with their client. It is evident that the relationship between a SFBT counselor and a RT counselor with their clients is a key component of these two therapies.