Skill Demonstration Paper

Silence is okay and at times I should allow it to happen on its own, but I need to work harder to stop myself from filling “the void” in sessions. I should practice what I have preached as a counselor in session and be congruent. One of my new goals is to work towards being okay with silence in my sessions. Slowing down and talking less is more important for the process because in the case of counseling less is definitely more. Silence is a useful skill to have, but I am now realizing how uncomfortable I am with it. I realized when working on my presentation that I feel as though I am not helping if I am not moving the conversation along, but that this is something about me I need to work on. It makes me feel inadequate in the moment as a trainee, but silence is very useful and can help the client to grow too. When looking back at our ced 727 class I remember learning that silence is our friend. Silence helps everyone to reflect and/or compose their thoughts. Being okay with this process is a very important aspect of being a good counselor and something I am going to continue to work on throughout my own

Although these clients will still be abusing illegal substances, Sheon (2004) indicated that any reduction of harm is a step in the right direction, and the amount of success is measured by the client’s quality of life and well-being (as cited in Brown et al., 2005). “Harm reduction is about being respectful in somebody else’s world” (Georgina Perry, Service manager and co-author, England as cited in Cusick et al., 2010). By not respecting somebody else’s choices, the clients feel they must lie about their unhealthy lifestyles, which prevents the clients from getting assistance because they were trying to protect themselves from the real situation (Georgina Perry, Service manager and co-author, England as cited in Cusick et al., 2010). A way to reduce the harm from illegal substance abuse is clean needle exchange, and teaching clients how to properly inject themselves (Brown et al., 2005). The needle exchange is a program where clients exchange their used needles for clean ones, which helps reduce the spread of diseases such as HIV/AIDS (Brown et al., 2005). With continuation of these programs the harm from abusing illegal substances is reduced and the spread of life threatening diseases, such as HIV,

Skill number six is where the resource family understands how to help the child develop a strength based understanding of his or her life story and to make new meaning of their trauma history and current experiences. The goal is to guide the resource family with strategies on how to talk about the child’s past, build meaning to his or her life narrative, and process new information that the child discloses. Some tasks associated with this goal include:

The client has high motivation for treatment within MRFH. The client was diagnosed with Alcohol Use Disorder: Severe and Cocaine Use Disorder (crack): Moderate. The client sought treatment at MRFH when he realized he had lost control of using alcohol and crack cocaine. The client stated he attended the MRFH program in the 1980 's but does not remember the exact date of attendance. The client stated he was diagnosed with Mild Depression by a primary care physician when he was 56-years-old. The client reports he has no history of suicidal or homicidal attempts, and currently denies having any suicidal ideations or homicidal ideations. The client stated one to two times per week he experiences muscle tension and worrying about things that he often realizes have no significance. The client stated prior to the age of 18-years-old, "I would knock over my neighbors mailboxes and destroy their gardens, because they would make my parents aware of my wrong doings and that was way of getting them back." The client stated, there was one time that I started a fire and blamed it on my brother. I would break things as well and blame someone else. The client stated if there was an event taking place that he wanted to participate in, he would rush and complete what he was doing so he could become involved in other events taking place around him. The client stated, "I started using drugs and alcohol without thinking about what the consequences. The client appeared to be oriented to the

Throughout the session the client was able to give me a timeline of his substance use. He kept looking down on the table. The client showed strength by recollecting his substance use history and his behavioral problems.

D.D. is a 50-year-old, African American male presenting with a number of anxiety and depressive symptoms. The client reports that he came to counseling for “extra support and someone to talk to.” D.D. has been struggling with mental health issues since he was young. Since the age of 15 he has been hospitalized on and off for “hearing voices.” In the early 1980’s he was diagnosed with schizophrenia and prescribed Risperdal to treat the symptoms. Since then, D.D. has been in a variety of mental health settings, including hospitals, day programs, and outpatient treatment. The client has an extensive alcohol and drug use history that he believes impacted his Schizophrenia. In the early 1980’s the client would use alcohol every day “to avoid the voices,” drinking “anything he could get his hands on.” He was also heavily involved with drugs at that time and regularly used marijuana, PCP, cocaine, and heroine. In 2000, the client was sentenced to eight years in jail for four bank robberies. While in jail, D.D. received mental health treatment and alcohol and drug treatment, which was greatly beneficial. When the client was released from jail in 2008, he was drug and alcohol free and was taken off of Risperdal.

Based on this disclosure and admission, I was able to begin my work. I reinforced what the treatment center began to implement, the 12 Steps of Alcoholics Anonymous. We created a structured schedule of meetings and the 12-step work began. Weekly he came to therapy and we “sparred” back and forth of his lack of interest and motivation on the program. It became clear to me that I was not making any headway on this type of counseling and my client could be in danger of relapse. I suggested over and over the vital importance of this activity. It was frustrating, because although he recently achieved two years of abstinence, I feared he was only “Dry.” Without the daily maintenance of a, “spiritual program.”

In my client scenario, Anthony has come to drug and alcohol counseling as a result of a probation requirement. Anthony, a 31-year-old African American male, was arrested and charged with possession of cocaine with the intent to deliver. During his incarceration, he admitted to daily use of cocaine, as well as heavy drinking. As a result, Anthony participated in drug rehabilitation programs while incarcerated. Furthermore, upon his release, his probation officer ordered him to complete drug and alcohol counseling as a stipulation of probation. While Anthony doesn’t have an issue admitting to his daily drug use, he does not agree with the probation requirement of counseling or that his alcohol and drug use were a serious issue. Anthony sees his situation differently that other addicts or alcoholics, and even expresses uneasiness about his marginalized status and the lack of understanding surrounding the conditions that led up to his arrest. He has stated that he doesn’t have anything in common with most addicts and that he isn’t a “fiend.”

Juan Medina is a 23 year old Hispanic male who was mandated by the court to receive drug treatment and counseling to avoid serving a jail sentence for drug possession of heroin. Mr. Medina resides with his girlfriend and son in a poor community. Mr. Medina has no high school education because he dropped out of high school in the 10th grade, due to poor academic performance, and suffers from a learning disability. Medina’s addictive behavior history shows that he is a participant in a local gang who distributes and sells drugs in his neighborhood. Mr. Medina’s financial status is unstable and considered to be within the low income level. Juan began drinking at age 12, and then began smoking marijuana at age 13. He continues to use both on a

The client for this paper is a twenty-seven-year-old single mother to a six-year-old son. The client was raised in a hardworking middle class family in which her father built a successful business. Her parents divorced when she was ten years old, and she reports she never heard them argue before they announced to the family they were separating. The client describes the divorce as “ugly.” She started smoking marijuana with her friends at the age of fourteen which led to her opioid intravenous addiction by the age of eighteen. The client’s drug of choice is hydrocodone. She admits she has never tried to abstain from her drug use and has been arrested over twelve times as a result of her addiction. Her last drug charge resulted in a six-year prison sentence at the age of twenty-three. The client is currently court ordered to successfully complete an in-patient drug treatment program for up to eighteen months. If she successfully completes the program, she will be released two years early from her sentence. The client has been diagnosed with 304.00 (F11.20) Opioid Use Disorder – Severe which continues to make her eligible for treatment. Client is Hepatitis C positive.

Case Study My client Maurice is a 25 year old African American male, referred to me from a 30 day residential program. He is entering an outpatient program for his heroin addiction. Maurice has entered inpatient treatment facilities in the past.

Patient stated that he was on detox unit in October of 2016. Patient stated that after his discharge and went to Salvation Army in Jersey City. Patient stated that he AMA'd from Salvation Army in February of this year. Patient stated that he felt that it was time to go get his own place, start working, and get his life together. Patient started working in construction Stated workin. got house care and within two to three months started using. Patient stated that he was stressed from life and physically tired from work as the reason for his relapse. Patient stated that he was fired two week ago. Patient will attend groups to identify coping skills for maintaining sobriety from drugs. Patient will increase socialization by interacting

Client has no know history of previous treatments. Client desires treatment due to unhappiness with current life style. Client states that his longest abstinence from alcohol is 4 days, nicotine an hour, and marijuana and cocaine 1-2 years over the last 5 years. Client recognizes several triggers for drinking episodes (social anxiety, loneliness, fear, feelings of inadequacy, and guilt). Client is not experiencing any cravings for chemicals at this time (currently using nicotine). Client states he has current problems with family resentments and anger, self-esteem, and anxiety that are unresolved. At this time, potential for relapse is moderate to severe. Client a limited support network and no relapse prevention plan.

On the initial client contact, Ivan was resting on his bed and did not wish to be interrupted for therapy. Our SIM facilitator prompted us to consider Ivan’s values and what was important to him in the situation, which were elements that shaped his ‘personal lens’ (Schell, 2009). The idea of being discharged was then mentioned and used as a motivator for Ivan to engage in therapy session. This experience has highlighted Ivan’s perspective and its influence on the therapist-client interaction. After Ivan had agreed to participate in therapy, verbal consent for recording the session was obtained.

On the first meeting with Bug, 10/20/2016, since I anticipated that she knew what a burpee was, the first thing I did was show her a video of what a “perfect” burpee looked like. Then I asked her to actively complete the burpee from the video I showed her to give me a good starting point and a general idea what we really needed to work on. She needed work on the push up portion of the burpee but there were other minor fixes she would need as well. In the end, I decided I would break up the burpee into portions and have her learn it this way. This was actually the plan I had set in motion from the beginning. The total time for this meeting was about 6 minutes and most of the time was watching the video of the burpee.