Pen Profile of the Client - Essay Example

Session 1 The client’s name is Dereck McNally and he is a student at the University of Hull, Scarborough Campus. He is 77 years old and is in his second marriage. He had one child with his ex wife, one child with his second wife and 6 grandchildren. His second wife had two children already when they married. Although he has not mentioned thinking that this is a problem, life was not easy for Dereck when he was growing up. He witnessed the Second World War at Gateshead. Due to this war, Dereck and other 10,597 elementary school children were evacuated from Gateshead to safer areas (Welshman 2010). This evacuation lasted months, and it definitely had a psychological impact on Dereck. A man named Alexander who was evacuated at 11 years of age recalls “We were dumped at a roundabout with our labels on. People pulled and tugged at the children they wanted. It was a bit like a cattle market... people just waded in. I went with a lady and her daughter - she was like a second mum” (Welshman 2010, p 55). Dereck feels disappointed with numerous aspects of his life. Whenever Dereck is faced with a challenge, he gives up. As a child, Dereck was not performing well in his studies, which is evident from the fact that he failed his 11 plus exams thrice. As an adult, Dereck once owned a pub, holiday flats and a shop. At the moment he doesn’t own any of these properties because he got rid of them. Dereck is intimidated by his younger classmates. When he is faced with a problem, he does not ask questions because he believes that he will hurt his pride. He feels that it is too late for him to change who he is. Dereck is vigilant in pursuing his interests. This is evident from the fact that he likes counselling. Dereck has consistently attended classes and has been pursuing a degree in Psychology for nine months now. While growing up, Dereck realised he was good at sports. He played football at elementary school, where he eventually played for his town, his county and London. After school Dereck proceeded on to become a professional football player for 3 years. Dereck currently plays golf two or three times a week at a golfing society called Elderly Gentlemen’s Golfing Society (E.G.G.S). Dereck does not think he needs any counselling because he believes he has no problem. He believes that he does not need anybody to help him because he has nothing to complain about. Dereck thinks that he is conceited, proud and confident but all these traits can be attributed to the fact that he is insecure. He is afraid of attempting new things because he is afraid that he will fail. Dereck said it himself that he thinks he has no abilities, and it is this kind of thinking that is holding him back. Session 2 The most obvious character trait of Dereck that came out during the second counselling session is that Dereck is egotistical. Dereck was the captain at E.G.G.S for three years running before he lost the position. Losing this position was very upsetting to Dereck, and as a result he quit from the society. Another instance when Dereck’s ego was hurt was when he was a sales manager, but the sales director did not allocate Dereck a seat alongside the other managers on the high table. Dereck insulted the sales director and quit his job. Whenever Dereck faces rejection, he quits. Dereck also has a habit of blurting out whenever his ego is challenged. Dereck has accepted the limitations that come with aging. He is okay with him being twelfth in his psychology class that has fourteen students. Dereck is aware that he is not as fast as he was when he was younger, and he has accepted rather than allow himself to be depressed. Dereck has a sense of humour. He was surprised that his pier group accepted him despite the fact that he is 77 years old ‘pet’. Session 3 During the third session it became apparent that Dereck has trouble with time management. As much as he wants to succeed, he does not have the necessary incentives to push him towards success. Dereck is feeling overwhelmed by all his responsibilities which include schoolwork, gardening, trimming hedges, making cricket tea for his children and grandchildren, being an extra on television and film as well as golfing. Dereck enjoys the extra work such as gardening, but he keeps procrastinating doing his school assignments. Dereck realises that he has to do something about time management, failure to which he might end up dropping out of school, which he does not want because he enjoys his psychology course. To help him with his assignments, Dereck has consulted a student help called Dr Marley Eastwood who has given him a paper on research essays. During this session Dereck revealed that he has exceptional organizational skills. As previously noted, Dereck is vigilant in pursuing his interests. Seeing that he might be risking dropping out of school, Dereck suggested that he could make a timetable or he could get somebody to make him one so that he can manage his time better. Session 4 When he arrived at this session, Dereck was tan. He revealed that he had been on holiday at Northumberland. Despite the extra time he had on his hands, Dereck had not attempted to make a time table. I asked him why he had not made a timetable despite his superb organizational skills and Dereck said he was not used to doing the donkey work himself. Dereck said that he was used to someone else doing the heavy lifting. Dereck was not willing to give up on any of his hobbies or sacrifice his studies, and so he asked if I could help him make a time table during the next session. This shows that Dereck is committed to his education and his hobbies, and having a time table will help him manage his time better. Opening the sessions Explaining the purposes of the session During the second session, Dereck mentioned that he had faced some setbacks. I responded by giving him feedback, letting him know that those setbacks should be discussed during the session. When I asked Dereck a question, I would not interrupt him until I got his feedback on that question. Whenever a session was over, I would give Dereck homework that he would work on before the next session. For instance, in the third session, I asked Dereck to prepare a timetable. During the next session he admitted that he had not created the time table, and I therefore told him that I would assist him in making the time table during the fifth session. Boundary issues During the first session I pointed out that I was committed to the contract that Dereck and I had signed. When time for the session was up, I did a recap of the issues that had come up during the session. These issues were that Dereck needed to accept that he could not be a perfectionist all of the time, that age had put limitations on him and that Dereck felt limited in asking for help. When the time for the second session was over, I let Dereck know. I did this with sessions three and four as well. I would tell Dereck that I looked forward to seeing him the next week. Creating safety within the session During the sessions, I would use short sentences that Dereck would easily understand. In the second session when Dereck made a funny comment, I let him know that I thought he was a fun man. During the fourth session, there was an interruption when the mobile phone rang. I quickly apologized for that because I realized that the session was time that was dedicated to Dereck alone. During the fourth session, I let Dereck know that I had noticed that he was tan. This was intended at letting Dereck know that I was attentive to him, and that he would feel safe with the session because I was there to listen to every word he said. Establishing rapport with the client I welcomed Dereck to the first session by saying ‘Hello’. Before asking a personal question, I would let Dereck know that he could choose not to answer if he was comfortable answering the question. An example of such a question is ‘Can I ask why you think that is the wrong attitude?’ During the second session I asked Dereck, ‘Can I ask you where you got that impression that you engage your mouth before you engage your brain.’ Being polite helped establish rapport with Dereck. During the first session, I would let Dereck know that I had been listening to him. For instance if said, ‘Just a observation that I have noticed from the things that you have said, everything you have said to me, you have explained how you have done it well or your didn't do it all, is that a correct observation?’ When the second session started, I asked Dereck how he was feeling that day. During the second session, Dereck mentioned that he had faced some setbacks but he did not feel like talking about them. Knowing that if I forcefully told Dereck to tell me what setbacks they were, he would feel threatened. I therefore asked him to consider whether discussing those setbacks would help him, and by doing so he did not feel threatened and felt free to talk. Opening questions One of the opening questions I used during the first session to make Dereck feel free to talk was ‘Do you want to talk about anything specific? Any issues you would like to discuss today?’Another question was, ‘What do you like doing now? Do you want to talk about that?’ During the second session, I let Dereck know that he was free to raise any topic by asking him, ‘Is there anything you would like to talk about?’ During the fourth session, I welcomed Dereck by saying hello, and letting him know that it was lovely to see him again. Counselling skills Rogerian model of counselling Underlying Roger's approach is the assumption that organisms have a fundamental desire to improve themselves: to self-actualise. Self-actualisation is an organism's inherent drive to develop its capabilities in order to function well and progress (Rogers 1984, pp. 123-135). Dereck realised that for him to continue with his studies, he needed to take some measures. He could either drop some hobbies, or make a time table that could help him organise his time. I offered to help him with making a time table because I realised that in helping Dereck, I would be propelling him towards realisation of his dreams. Rogers (1978) examined a person's capacity for change within the therapeutic relationship and found that psychological dysfunction occurs when individuals are prevented from efforts toward achieving self-actualisation; to realise who and what they truly are. Rogers (1957) stated that ‘In order for effective personality change to occur and for a truly therapeutic relationship to exist between the client and therapist, it is necessary that the therapist and the client are in psychological contact, that the client is in a state of incongruence, that the therapist is congruent and integrated in the relationship, that the therapist experiences unconditional positive regard and empathic understanding for the client, and that there is an attempt and also some degree of achievement in communicating this understanding to the client.’ Of these criteria the three most fundamental conditions I was aiming to achieve were congruence, unconditional positive regard and empathy (Rogers 1978). Throughout the four sessions I unlocked Dereck’s potential psychological development through a relationship where I felt and conveyed genuine caring, sensitivity and non-judgemental understanding in a non-directive manner towards Dereck (Rogers 1984, pp. 123-135). Following Roger’s model I collected and presented information about Dereck, whereby I would see information conveyed from Dereck to me and I avoided explicit directions (Rogers 1959, pp. 181-256).During the counselling session I encouraged Dereck to express and explore self-directed inner feelings. I responded through reflection and through paraphrasing the emotional content, helping Dereck consider the meaning of his inner experiences (Rogers 1984, pp. 123-135). I accepted Dereck’s statements without judgement or interpretation attempting to understand them as Dereck would. My congruent attitude conveyed to Dereck, a genuine concern to understand the world from his perspective. My main objective in using Roger’s client-centred therapy was to bring Dereck’s experience and awareness back into congruence. The better the congruence of experience and understanding for the therapist and client, the greater is the likelihood of reciprocal communication (Rogers 1986, pp. 197-208). Once this transpired, Dereck was able to recount his experiences openly and accurately. Since congruence and empathy are closely related factors in client-centred psychotherapy, I needed to have an empathic appreciation of Dereck to see the world from his perspective (Rice 1984, pp. 182-202). Rogers (1978) believes that the therapist needs to accurately perceive and feel the client's feelings, then convey this empathy to assist the client in achieving greater comprehension and control over their behaviour and circumstances. An acceptance Dereck’s individuality and diversity was required for empathy. This is what Rogers (1978) calls unconditional positive regard. For therapeutic change to occur, I presented unconditional positive regard, communicating to Dereck that he is a worthy person (Rogers 1967). As Dereck became more aware of my acceptance through unconditional positive regard, an opportunity was presented for Dereck to relax conscious and unconscious defence mechanisms and to confront issues. Egan models of counselling Egan (1994) states that ‘Therapists should respect and value diversity and individuality, withhold judgements, act in a way that expresses that that they care for the client in a down-to-earth way, show warmth, keep the client focused and help them through painful situations’. Knowing that my values as a therapist are an important aspect in the helping process as they can influence client’s values, I was especially keen on time keeping. I was hoping that in showing Dereck how important time keeping was, I would be able to influence Dereck’s goal for making a time table. Therapists also need to be genuine in that they are comfortable and can be themselves in any situation (Bowen 1999, pp. 27-36). As much as receiving a phone call on my mobile phone was inappropriate, I did not panic but apologized and continued with the session. When Dereck expressed negative feelings such as saying he felt insulted when rejected, I was willing to consider the cause of Dereck’s negative attitudes towards his feelings and was willing to continue working with him in order to avoid being defensive (Egan 1994). I followed Egan’s guidelines regarding communication skills. For example I showed Dereck that I was being attentive with my body language by facing him, adopting an open posture, leaning towards the Dereck, maintaining eye contact and being relaxed and natural whilst adopting these behaviours. I was aware of Dereck’s bodily reactions that I utilised to aid an awareness of psychological reaction (Egan 1994). Egan (1994) encourages the use of active listening and expresses that listening involves observing the clients nonverbal behaviour, understanding the client’s verbal messages, listening to the context of what the client is saying and also listening out for things that the client says which may need to be challenged. One of the things that Dereck said that I challenged was the fact that if he wanted to keep all his hobbies, he had to plan his time. When Dereck said he had experienced some setbacks that he was not willing to talk about, I challenged him, letting him know that it was by sharing his setbacks that I could help him. Therapists using Egan’s model must have good communication skills, the ability to establish a working relationship, help clients challenge themselves, be able to clarify problems, set goals, develop action plans, implement plans and also evaluate the situation (Greenberg, Elliott & Lietaer 1994, pp. 109-139). All this was accomplished because by the end of the fourth session, I had established a working relationship with Dereck, I helped Dereck challenge himself and he sought help with his English. Dereck also challenged himself and ended up getting a student teacher that would help him with essays. At first when Dereck came in for counselling he had no idea what the problem was. By the end of the fourth session I had clarified that asking for help was not a sign of weakness, and making a time table would solve Dereck’s time management problem. As a part of Stage 1 Dereck identified and clarified blind spots in order to see different perspectives on his problems. Egan (1994) states that ‘We all have our unique perspectives on life based on our personal experiences and knowledge’ These unique perspectives can shape our beliefs about ourselves. Dereck believed he was confident and proud because of his childhood experiences. When he was left to fend for himself during the evacuation of 1939, Dereck gained self-confidence from the fact that he survived a difficult situation. In order to help Dereck see new perspectives I had to adopt the use of challenging; whereby I encouraged Dereck to examine internal and external behaviours that are self-defeating, harmful to others, or both, and then worked on changing that behaviour (Mearns 1994, pp. 34-36). In Stage 2 we defined Dereck’s preferred situation and what he needed to get what he wanted. We discussed his strategies to what he needed to do to get what he wanted. Finally, in stage 3, we discussed the action stage, defining how Dereck would start making his goals come true (Egan 1994). Ending of the counselling sessions Whenever I realized that the time allocated to the sessions, I would let Dereck know that time was up. Knowing that there were issues that were still on Dereck’s mind, I would ask him to let me know what they were so that we would discuss them during the next session. I would ask Dereck if there was anything he needed further assistance with. I would also ask Dereck if there was any way that I could help him achieve his goals. In the case of the first session where some issues were brought up but had not been discussed in detail, I told Dereck that we would be discussing those issues during the second session. During the second session, I asked Dereck to think about the acceptance of rejection, which a key issue during the second session. After asking Dereck about issues that he would have liked to be discussed during the next session, I would conclude by summarising up. For instance, in the concluding the first session, I recapped that during the session we had discussed Dereck accepting that he could not be a perfectionist all of the time, that age has put limitations on him and third was that he felt limited in asking for help. At the end of the third session I suggested that Dereck make a timetable as homework. I welcomed Dereck’s feedback for instance I did not rush him when he said that it would be a big help for him if I helped him make a timetable. In helping him make a timetable, Dereck felt that I would be doing something practical for him. I confirmed that the next session would be in a week’s time. At the end of the session I would acknowledge Dereck’s exit by saying ‘Thank you’ back. References Bowen, M 1999, 'Psychotherapy: The process, the therapist, the learning', The Counseling Psychologist, vol. 5, no. 2, pp. 27-36. Egan, G 1994, The skilled helper: A problem-management approach to helping, 5th ed, Brooks Cole, Belmont, California. Greenberg, L, Elliott R & Lietaer, G 1994, 'Research on Experiential Psychotherapies', Educational Change and Development, vol. 3, no. 3, pp. 109-139. Mearns, D 1994, 'Personal therapy is not enough', Journal of Humanistic Psychology, vol. 25, no. 4, pp. 34-36. Rice, L 1984, 'Client tasks in client-centered therapy', Person-Centered Review, vol. 1, no. 2, pp. 182-202. Rogers, C 1957, 'The necessary and sufficient conditions of therapeutic personality change', Journal of Consulting Psychology, vol. 21, no. 2, pp 95-103. Rogers, C 1959, 'A theory of therapy, personality, and interpersonal relationships, as developed in the client-centred framework', Voices, vol. 18, no. 4, pp. 181-256. Rogers, C 1967, On becoming a person: A therapist's view of psychotherapy, Constable, London. Rogers, C 1978, Carl Rogers on personal power: Inner strength and its revolutionary impact, Constable, London. Rogers, C 1984, 'Gloria: A historical note', Journey, vol 2, no. 4, pp. 123-135. Rogers, C 1986, 'A client-centred/person-centred approach to therapy', The NAMTA Quarterly, vol. 8, no. 4, pp. 197-208. Welshman, J 2010, Churchill's children: The evacuee experience in wartime Britain, Oxford University Press, p 45. Read More