Counselling session:

I was supporting a teenage girl with anxiety and low self-esteem. We had built a good relationship and I cared about the client.

I felt very nurturing towards this client and I was very aware that I wanted her to feel better. I was aware that I wanted to “cure” her or rescue her. I explored this with my supervisor, and we discussed the transference that I might be seeing her as a daughter, we also explored what she was saying to me and her body language. We discussed counter transference and how she could be seeing me as a mother figure. 

(Joyce, P.& Sills C, 2014)

After discussing this with my supervisor I ensured that when I introduced creative work, I would give choices. Using creative work was also good because the focus was on the client rather than me talking and then she would discuss what she had produced.

Thinking about my role now I am very aware that for an intervention to be effective you need it to be client led. Our role is not to cure but to be the facilitator. 

As stated by the reach out document “our role is to give some information about the interventions and to support our patient but that the sessions should contain shared decision making and that most low intensity psychological treatments require the patient to work outside of the sessions and you are there for guidance and to explain the interventions but they make the decisions and use the tools.”

P. 24-25 Reach out (3^rd edition)

I have learnt from this experience that it is important to ensure that I do not go into “rescue mode” and that I remain client led. I am therefore going to start by ensuring that when I introduce goal setting it comes from the client.

As argued by Farrand and Woodford “goal setting helps you to decide what to change, what to achieve and then work towards achieving this in a structured way, putting you in charge”

(p.5 Farrand P. & Woodford, 2013) 

Specific: Young person to set their own goals

Measurable: To record the sessions to ensure that the goals were client led.

Achievable: This is an integral part of the assessment and I will be able to check this regularly during my training as I will be videoing my sessions and having supervision weekly.

Farrand, P & Woodford, J. (2013). Goal setting in Low Intensity CBT.: Cedar.

Joyce, P. & Sills, C. (2014) Skills in Gestalt: Counselling and Psychotherapy; Sage

Reach Out- Low intensity Manual: National Programme Student Materials to Support the Delivery of Training for Psychological Wellbeing Practitioners Delivering Low Intensity Interventions.

 

 

 

What: In my work supporting a young carer who was very overweight I allowed the expectations of other professionals to influence the work that we were doing together. Our plan for our work together became about how to address her weight issues rather than the impact of her role as a young carer.

So What ?: In this situation there was a lot of outside influence on both of us, a number of professionals were involved and the family was under pressure to make a difference with regards to her weight. The young person was aware of the impact that was having on her family who were already dealing with a number of significant health issues. I was already working with the young person to support her to participating in activities with her peers and to reduce the isolation that she felt due to her caring role. The focus of our work however, became about her weight which I did not feel confident to deal with and which she agreed to because she was eager to please. I tried to deal with the issue indirectly through encouraging her to be more active, so we would spend our sessions going for walks together and chatting but because it was at a very hot time of the year she really struggled with this and it was clear that she really wasn’t enjoying herself (and nor did it lead to her losing weight or being more active at other times). We eventually reviewed her goals and I encouraged her to choose new ones that really mattered to her rather than what she thought other people expected of her, she chose goals that involved seeing and spending more times with her friends.

Now What? I must be alert to and mange influences such as other people’s expectations (parents and professionals) that can come into play for myself and a young person in our direct work.

Specific: Really support the young person with setting goals that are their own by creating a space where they feel safe to talk freely and by validating what they are going through. 

Measurable: Routinely checking with young people to see whether they are happy with the goals they have set .

Achievable: Ask parent to leave the room if it feels as though their expectations are becoming the focus. Advocate for the young person with other professionals using psycho-education.

Resources: Use recordings to reflect with my supervisor on what happened and talk to peers.

Time-limited: Review after a 6 month period

Well done.