You are on page 1of 12

JAMAICA THEOLOGICAL SEMINARY

A DIARY OF FIVE SESSIONS

SUBMITTED TO MISS DIRNELLA ANDERSON IN FULFILLMENT OF THE COURSE GUIDANCE AND COUNSELLING FIELD PRACTICUM 1

DEPARTMENT OF BEHAVIOURAL SCIENCE

BY MARK SMITH

KINGSTON, JAMAICA NOVEMBER 21, 2011

PRACTICUM INTAKE FORM Clients History Name: Stephanie Cobb Age: Sixteen (16) years of age Place in family: Third (3rd) for mother, Second (2nd) for father No. of siblings: Seven (7) Address: Bull Bay, St. Thomas Parents/Guardian: Sharon Pebble Mothers Name: Sharon Pebble Address: Bull Bay, St. Thomas Occupation: Unemployed Fathers name: Donovan Cobb Address: Bull Bay (not same home as mother), St. Thomas Occupation: Welder Guardian: N/A Address: N/A Occupation: N/A Religion: Christianity Church Attending: Seventh Day Church of God Present State of Health: Emotionally disturbed When last seen by a doctor: August 4, 2010 (when carried by the police) Referred by: Practicum Supervisor at the Victim Support Unit, St. Thomas

Presenting Problem: (What did the client say?) Carnal Abuse (According to the report from the police and the clients initial statement). The alleged perpetrator was a fifteen year old male (at the time of the incident). Observation The client was properly dressed with hair properly combed. She did not keep eye contact and constantly played with her hair or her fingernails as she spoke. She was also constantly yawning as if she was tired and needed to sleep. She seemed reluctant to speak of the ordeal. However, she spoke freely about other things, such as her school life and her friends. Diagnosis Client portrays a feeling of guilt and responsibility for the abuse, lack of trust, low self esteem, anger and unforgiveness, and a feeling of powerlessness. Treatment Plan (What do you intend to do to help the client with finding a solution to his/her problem(s)?) Help the client to tell the story of the nature, frequency and duration of the abuse; to identify and express feelings connected to the abuse; to verbalize the ways the sexual abuse has had an impact on life; to decrease statements of shame, being responsible for the abuse or being a victim, while increasing statements that reflect personal empowerment; to identify the positive benefits of forgiveness; to increase level of forgiveness of self, perpetrator, and others connected with the abuse; to increase level of trust of others as shown by more socialization and greater intimacy tolerance; to verbally identify self as survivor of sexual abuse. Proposed Theories: Rational Emotive Behavior Therapy (REBT), Reality Therapy and Gestalt.

Proposed Number of Sessions: (These should be in order of priority based on what in the clients view is most urgent). Eight (8) sessions, working with the treatment plan listed above. Evaluation of Session It was a fairly good session as trust was built, and the client seems more comfortable than when she first entered the room. She is also keeping eye contact and seems more focused. As she told her story, anger and disgust could be heard in her voice. She constantly blames herself by making statements such as if mi neva did go dung a him yard. Homework: She was given a homework of journaling her feelings. Next session we will look at the journal and try to identify and express feelings connected to the abuse. Termination At the end of eight sessions, once per week, unless mutually decided, termination will be on November 16, 2011.

PROGRESS NOTES

DATE: July 28, 2011 TYPE OF SESSION: (EG. Individual) Individual

START TIME: 11:00am

END TIME: 12:00pm

SESSION# 3

CLIENTS NAME: Stephanie Cobb COUNSELLOR(S) Mark Smith Content of the Session: What did the client say? (The session started with the processing of the clients journal). A part of the intention was to get the client to dispute her negative beliefs. Midway through the third session the client changes her initial story of being sexually abused by a fifteen year old, to being abused by her father. According to Stephanie, her mother is so much in love with money that if the abuse was reported to the police and her father was arrested, this would cause her mother to be so angry that she woulda kill mi she said. Observation The client spoke freely about her feelings toward her family and the community. She kept eye contact most of the time and only break it when I mentioned her relationship with her father. Anger could be heard from her voice as she spoke of the relationship. Her voice trembled as she told the story. However, after she finished the story she started to laugh and seem more relaxed. Interpretation of Dynamics: What did you see? The anger in Stephanies voice seemed to be saying that the relationship with her father is not a good one, and that she has negative feelings towards him. Stephanie seems afraid and/or nervous as she spoke of her ordeal. However her laughter after completing the story seems to be saying how relieved she was that she had told her story to someone.

Therapeutic Interventions: What did you do? After counseling with her for awhile about not taking any guilt or responsibility for the abuse unto herself, I reminded her about the consent form she had signed and what it said about the counsellors legal obligation to report any such case. While she was not against me reporting this, she requested that I did it after she was gone. This I agreed to and ended the session soon after. (I spoke with my supervisor and the abuse was reported to the relevant authorities). Master Treatment Plan Goals & Objectives Addressed in Session: The aim of this session was to help client to verbalize the ways the sexual abuse has had an impact on her life, and also helping her to decrease statements of shame, being responsible for the abuse or being a victim, while increasing statements that reflect personal empowerment. I used the REBT therapy (The A-B-C-D-E model). My aim is to help the client dispute the belief by challenging the self-defeating beliefs, and help her to consider other possibilities. Homework: . I asked the client to place in her journal her feelings toward her father, then and now. Evaluation The client seemed angry at her father about the abuse. She needs counselling about decreasing her statements of shame, being responsible for the abuse or being a victim, and being able to increase the level of forgiveness. The session was not completed as planned. In the next session we will process her journal before we continue with the therapy started. TERMINATION DATE: November 16, 2011. _____________________________________________ Counsellors Signature _____________________________________________ Supervisors Signature __________________ Date ___________________ Date

PROGRESS NOTES

DATE: August 16, 2011 TYPE OF SESSION: (EG. Individual) Individual CLIENTS NAME: Stephanie Cobb COUNSELLOR(S) Mark Smith

START TIME: 11:00am

END TIME: 12:00pm

SESSION# 4

Content of the Session: What did the client say? (The session started with the processing of the clients journal). The clients journaling revealed that she hates her father and wished he was not her father. The feeling towards her mother was similar. She spoke about other members of the community in similar manner because they teased her about the incest. She hated her mother, who was the one to reveal what happened to the entire community, now more than how she hated her for the physical and verbal abuses. Observation The client was properly dressed. She seemed relaxed as she spoke. She still kept eye contact most of the time but looked away when I mentioned her relationship with her father. Anger could be heard from her voice as she spoke of the relationship. Interpretation of Dynamics: What did you see? Stephanies feelings toward her father revealed that she is not ready to forgive him, nor her mother and community for that matter; she said she needed some time to think about it. There is hate, fear, anger and embarrassment in her written, as well as spoken, words.

Therapeutic Interventions: What did you do? I counseled with Stephanie at length about resolving her feelings of guilt and shame connected to the abuse. She needed to know that she is not to be blamed for what had happened to her. I focused on the effect of consequence of disputing self-defeating belief. We explored some new emotional consequence as a result of challenging the self-defeating belief. Master Treatment Plan Goals & Objectives Addressed in Session: The client needs to verbalize the ways the sexual abuse has had an impact on her life, and decrease statements of shame, being responsible for the abuse or being a victim, while increasing statements that reflect personal empowerment. I used the REBT therapy (The A-B-C-D-E model). My aim is to help the client dispute the belief by challenging the self-defeating beliefs, and help her to consider other possibilities. Homework: As home work she was given a story to read from Jongsma Adolescent Homework Planner about a young girl, Jenny, who has experienced the hurt of sexual abuse. Questions to be completed asked Stephanies to list ways she has found helpful in dealing with her hurt or pain. Evaluation The client seemed more assertive in her behaviour and her language was more positive. However she still needs counselling on her willingness to try and increase the level of forgiveness for her father, mother and community members. In the next session we will process the homework before we move to any other activity. TERMINATION DATE: November 16, 2011. _____________________________________________ Counsellors Signature _____________________________________________ Supervisors Signature __________________ Date ___________________ Date

PROGRESS NOTES

DATE: September 12, 2011 TYPE OF SESSION: (EG. Individual) Individual CLIENTS NAME: Stephanie Cobb COUNSELLOR(S) Mark Smith

START TIME: 11:00am

END TIME: 12:00pm

SESSION# 5

Content of the Session: What did the client say? (The session started with the processing of the homework from the previous session). Sitting alone in a corner and getting out of the community were some of the helpful ways listed in dealing with the hurt and pain. Stephanie cried as she spoke with her mother, who was the first person in the empty chair. Stephanies disgust at her mothers behavior and her desire for a better relationship between them both was the topic she spoke about to her mother. Observation Stephanie was properly dressed. She was cooperative, as if eager to reach a place where she would feel love again and be able to live again. Interpretation of Dynamics: What did you see? The exercise revealed that Stephanie believes that her mother did not trust her and that although Stephanie spoke of hating her, there was a cry for love and trust from her mother. Therapeutic Interventions: What did you do? Using the empty chair technique, I allowed Stephanie to play interchangeable roles of herself and her mother. I also asked some pertinent questions such as what do you want your mother to do to make you love her again? and what would you say to your daughter at this moment? These questions were used to direct, and keep in perspective, the conversation.

Master Treatment Plan Goals & Objectives Addressed in Session:

The client needs to understand that she can increase the level of forgiveness of self, perpetrator, and others connected with the abuse. The empty chair technique from Gestalt was used to help the client get in touch with her inner self and experience the conflict more fully. She needs to break out of self-torture and move on with her life. Homework: . As home work she is to write a letter to her mother expressing her feelings toward her and her desire for a better relationship between them both. This letter will be taken to the next session to be processed before it is actually delivered to her mother. Evaluation This was a productive session as Stephanie made a resolution to try and create a bond between her mother and herself. Stephanie is very cooperative and is trying to reach a place where she can move on with her life. For the next session she will be talking to her father about her feelings toward him. TERMINATION DATE: November 16, 2011. _____________________________________________ Counsellors Signature _____________________________________________ Supervisors Signature __________________ Date ___________________ Date

PROGRESS NOTES

DATE: October 5, 2011 TYPE OF SESSION: (EG. Individual) Individual CLIENTS NAME: Stephanie Cobb COUNSELLOR(S) Mark Smith

START TIME: 11:00am

END TIME: 12:00pm

SESSION# 6

Content of the Session: What did the client say? (The session started with the processing of the letter to Stephanies mother). The letter to Stephanies mother reveals that Stephanie desired love and trust from her mother. However, she decided that she was not yet ready to deliver it to her mother. We spoke about this for awhile. Afterward we decided to continue using the empty chair technique to express her feeling about the abuse to her father. It took Stephanie about five minutes to start expressing her feelings about the abuse to her father. She did not get far before she stopped talking and started to cry. Observation Stephanie was properly dressed. She trembles at the thought of speaking to her father. Interpretation of Dynamics: What did you see? There is still a level of fear and anger towards the clients father. She also still seemed a bit afraid and vulnerable.

Therapeutic Interventions: What did you do? Using the empty chair technique, I allowed Stephanie to play interchangeable roles of herself and her father. I asked some pertinent questions to direct, and keep in perspective, the conversation. After the conversation did not get very far, I allowed her to cry as I realized that she needed to get some of those pent up feelings out of her system. We processed those feelings. Master Treatment Plan Goals & Objectives Addressed in Session: The client needs to understand that she can increase the level of forgiveness of self, perpetrator, and others connected with the abuse. I used the empty chair technique from Gestalt, to help the client to get in touch with her inner self and experience the conflict more fully. She needs to break out of self-torture and move on with her life. This will help her to understand that hate and unforgiveness will eventually destroy her and hinder her from achieving her goal. Homework: As home work she was assigned to write an angry letter to the perpetrator which will be processed within the next session. Evaluation Stephanie is very cooperative and although the desired result was not achieved, there are signs that she is trying to reach a place where she can move on with her life. For the next session we will be processing the letter written to her father. We also decided that there was a need for an additional two sessions in order for Stephanie to get over the ordeal and continue with her life. TERMINATION DATE: November 30, 2011(changed upon mutual agreement to foster further counselling). _____________________________________________ Counsellors Signature _____________________________________________ Supervisors Signature __________________ Date ___________________ Date

You might also like