Failed Counseling Case Study

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.

Steve Counselor red flagged pt. and requested that he meet for brief TX intervention to discuss his current counseling non-compliance status and explaining the risk of discharge from the program if he fails to do an individual session by 1/22/17. AMS receptionist told this writer that pt. is asking why he needs to meet with this writer. This writer told him to inform him that if he fails to complete one hour individual session by 1/22/17 he will be subject for a TX discharge. Pt. refused to meet with this writer and he failed to schedule an individual session on the above date.

In the coaching discussion it was not said that my conduct was not meeting expectations, but not allow myself to be in situations where it appears I’m being insubordinate.

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

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."

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

Robbie J. is a 19 year old African American male and at this time he is currently a freshman at Henderson County University. The client has been referred to this office by his school residential advisor and family doctor. The reason behind this is that the client has not been attending his college classes and has been caught drinking on campus by campus security three times in the past two months. His parents have been advised by the school that if the client doesn’t attend counseling sessions he will be asked to leave and not return back for the following academic school year. The client must attend five sessions and also join an A.A. group.

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

Primary Counselor met with Pt. for his one hour monthly individual session. Pt. showed up late to this session. Counselor greeted him and asked him how he has been since last session. Pt. reported to be busy at work and he requested to reschedule this therapy session for tomorrow, 1/31/17.

The patient was placed on hold due to his AWOL status. The patient provide an explanation stating he was not feeling well. This writer discussed with the patient about the importance of daily dosing and th erisk factor of missing a dose will put him at risk for a relapse, at which the patient agreed. The patient then reports he relapsed yesterday and used heroin, 10 bags by IV due to missing his dose. The patient signed a AWOL notice. Furthermore, the patient may consider going inpatient to further help with this relapse so that he can get clean. The patient is aware to notify this writer as soon as possible about his consideration of going inpatient. The patient has a court hearing on 03/07/2016 to address his DUI case.

Pt. has been in the AMS of DE program for 5 months and 7 days. Pt. has submitted three negative UDS results and he is compliant with the AMS of DE monthly mandatory counseling session. Pt. stated that he pays his TX fees every Saturday, works on his TX plan and takes medication as instructed by AMS Doctor. Pt. attends faithfully to the Clinic for dosing without skipping or missing days. Pt. reported that he maintains a supportive relationship with his brother and younger daughter. Pt. reported that he has not experienced any recent triggers and no relapse in the past 60 days. Pt. stated that he is committed to storing his prescribed take home medications in a secured lock box and placed on the top shelf of his closet. Pt. is a disabled veteran

Introduction This essay is an evaluation of two counselling models applied to a situation where a client has experienced loss and how a counsellor can create a therapeutic relationship with the client using each counselling model. It will also contain other skills a counsellor could use to obtain/maintain a good therapeutic

References 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.