Therapist : Hello, J.d.

I always feel slightly off when returning to clinical practice after a break, whether that is one week due to SIM or a whole month for Christmas break. I felt like my sense of direction was disheveled this week. My first morning with a client I found myself lost on were to even start with her care. I forgot to introduce myself during my first morning and I found myself relying on the outline sheet for a head to toe. Even finding my way around the unit made things take slightly longer than I would have liked. As the day progressed I began to get back into the groove of things. Going into the second shift my morning was much smoother and I didn’t have to look at my head to toe guide as I preformed my assessments. I felt more comfortable with my charting and was able

In this first session, and using the initial consultation notation form that the client has filled in previously as a base, the therapist will now begin to ask more specific questions relating to the client’s

At the end of my day, I assessed my stress by answering three questions, did I feel worried, overwhelmed and depressed about not completing all my tasks, did I feel tired, impatient while driving and did I handle irritations and become angry more than usual? Did I feel like

A sixteen year old teenager refuses to leave home and the therapist must review the situation from a MRI therapeutic approach. First, the MRI approach would not focus on the problem or how it developed but rather what efforts have the parent made to reach a resolution. MRI stems from the premise that families use practical attempts at resolving their situation but the attempts are ill-advised. MRI’s main focus is aimed at dilemma driven solutions; there is no advantage in long term change or what capacity the problem serves within the family.

My clinical day of week 3 started pretty much with the same routine. I had to shadow a CNA preceptor and helped her throughout her assignment. By late morning, I have encountered a patient that at first refused to have a conversation with me despite my efforts of searching the right therapeutic questions that will make her open up to me. I founded the situation to be a little bit frustrated and made me feel unsuccessful that I was not be able to form a relationship with the patient. I did not know what to do or what to say. She just kept staring outside the window without saying anything. At lunch time, she surprised me when she approached me and expressed her apology for her earlier behavior.

Betty presents in therapy that she has not been able to get in together since her and her husband’s home was destroyed by a tornado. She describes the night of the tornado in detail and how she feels responsible for breaking her husband leg when trying to get him down to their cellar. She reports that she is having trouble sleeping and keeps replaying the events of that night. She also shares that she is the president of the local NAACP chapter and usually is involved in organizing relief efforts for the community, but is unable to participate because she is a mess emotionally and mentally.

I hope you are feeling better. Just forwarding this paperwork from Omega, although I sent it yesterday since looks like I got it again twice. Figured you most likely would not be in today, so went down and introduced myself to Laura and delivered her travel folder so she is good to go. Take care of yourself and feel

S: How was your clinical experience this week? This week was an okay week. I spent most of my time trying to get back into the swing of things. I was a little rusty at the beginning of the week but it got better as the week went on.

The beginning of each CBT session begins with an agenda being negotiated and set. This may include a review of the past week, mood check, review of homework, main topics for discussion in the current session, homework for the next week and feedback on the session. It would be adjusted to suit the needs of the patient (Reneeke, Dattillio and Freeman, 2006).

Teacher stated individual was hollering at her and the students, throwing things, and hitting on others.

My Story: Today, was an awesome, extremely busy clinical day; I absolutely loved it. I saw five total patients. The first patient that I saw was with Laura, this patient was diagnosed yesterday, 2/7, with cirrhosis of the liver and HEP C. The patient’s chart says he has a history of anxiety, however, the patient stated that his anxiety started when he was told in the ER on 1/25 that he could have cirrhosis of the liver (more information in part D and E). This patient was very interesting, and I was amazing by how much he was going through; I felt bad for him. I did vital signs and my part D and E with this patient, and built a therapeutic relationship with this individual. I completed my part D and E on my first patient, due to not knowing if other patients were going to cancel because of the snow, as well as I didn’t know what patients I could see because the NP, Tanya wasn’t in the office in the morning. At the end of the visit, the patient asked me if I would be coming back again. This made me feel good, because I knew listening and being there as support for this patient helped him. The rest of the day I followed the

I think that you have made agood progress duing this week. You felt better,and submitted all your assignments, your assignments due during these days were submitted on time. You did not miss any of your meetings. As we taked about, an honest conversation is very important when you are feeling that things are falling appart . My job is to provide the kind of support you need during difficult times.

Due to the extreme changes in Vanessa’s life, the therapist has chosen to administer the Beck’s Depression Inventory (BDI-II), as well as Beck’s Anxiety Inventory Tests (BAI). Both tests will determine if the client’s feelings in the past week to two weeks are symptoms of either depression or anxiety. Depending on her score on the BDI-II, she could be experiencing minimal, mild, moderate, to severe depression. The BAI will indicate whether the client is experiencing minimal, mild, moderate, to severe anxiety. These tests should help the therapist in providing the best treatment plan for the

This week was I was relaxed and nervous. I was relaxed because I am done with my individual assignment, and nervous because we have presentation. I think group member before us as set the presentation standards high, and we as a group need to at least try to match the level. Other than reading and working on the presentation I had two case studies, 9 discussions board posting to finish. I am poor public speaker, I get extra nervous to talk in front of the class. Hope I can manage to talk for two minutes, and explained what I read and research on my topic.

The set up was similar to my clinical routine. On entering the room, my teammates and I greeted her and asked her how she was doing. She was alert and oriented. She sounded exhausted. She was having generalized pain. I asked her if she was feeling short of breath she said “no.” She was already on 3L of oxygen through nasal cannula with an oxygen saturation of 93%. Her skin was warm to touch and her pulse bounding. She had crackles throughout her lung field. During my clinicals, I learned to link my patient’s assessment findings to her labs and orders. I also practiced using the SBAR to contact the physician. I attended an interdisciplinary round at the oncology unit where the team was planning palliative care for a patient. I noticed that the team was more directed towards pain management and therapeutic interventions. The team also made sure to include the family and the patient in the care. During the simulation, we contacted the doctor for an order of morphine.