Dana Flanigan Techniques Midterm Transcript of Session I Counseled Adam in this Counseling Session Counselor: How are you doing? Client: Hi Counselor: I m Dana Client: Hi Dana, I m Adam Counselor: So what brings you in today? Open-ended probe Client: Um Well I m dealing with a situation at work where I m able to bid on another job which would be a step up for me Counselor: From? prompt Client: I work at the Rehabilitation Center in Olean um and right now I do service coordination um and that is all the services for about thirty people that is all the doctor s appointments.their medicating money and all that stuff and I would be able to move up to a different job that s with the quality department that basically investigates all incidents and I would be the head of that department and there s people that have worked there twenty or thirty years thirty-five years who can also bid on the job but I ve been given two good recommendations from my supervisor and his supervisor um I guess I m a little stressed changing changing jobs I haven t done this work all the time I do incident reports and things like that.but not overseeing a whole department of ten or fifteen people and I guess I m kind of anxious about like what s to come like worried Opportunity to paraphrase either during or after this long statement by Adam. Counselor: hmm What else besides it being larger stresses you out? Probe for clarification Client: Um supervising people um you know I have experience other places supervising people especially people who have worked there since before I was alive I m kind of worried about having to be in charge of them...like how are they going to react to me will they accept that I got the position over them will they try to backstab and find all your false, so they could get the position if they weren t qualified I m worried about just moving, I have a good relationship with the people I work with now..these other people I don t work with so I would
come into a whole new group of people and I just it makes me anxious and worried I m just trying to think there s a lot going through my head I would have new supervisors I like the supervisors I have now but I would have to move over to a new building and a new office and I don t know all the job responsibilities, so I would have to learn all of that type of stuff as well Counselor: You said it might be similar to what you do know, right? Brief paraphrase Although this was one short phrase, I was trying to summarize one major point that Adam had just made good Client: Um some of the things are um right now if there is an incident I get notified and I just follow up with it well basically I would just be managing the people who manage the incidents, making sure their getting it to all the appropriate people so basically I just don t know how that works right now I don t know like the paperwork aspect, who gets what where the forms are what are the rules and regulations by the state, in all the different environments um cause right now I just deal with people in a group home or people that live at home there s apartments and all that type of stuff that I don t deal with currently that I would have to deal with and I guess um I m just nervous, about learning new things Opportunity to paraphrase (basic empathy) his message Counselor: Yeah hmm.are there a lot of positives that come with the job though? probe I wanted Adam to continue to share his story with me, yet I wanted him to convey any possible positives, to this new opportunity, and if he were able to see these positives through his overwhelming feelings of anxiety I ll suggest that your intention was Client: uh yeah I think if I get paid more that s a major one um money is always good um meeting new people that s something I worry about but I get to meet a whole bunch of new people some of the relationships that aren t good with people I work with now, I wouldn t have to deal with those anymore um getting to move to a new building could be nice you know, some different scenery you know I m getting kind of bored with my job, as it is now I ve been doing it for about two years it s the same, day in and day out go meet the people, do the progress notes meet progress notes and it all starts over um, and there s not a lot of turnover with the clients I work with like I don t get new people very often so it s the same issues over and over again, years after years but um back to the positives like I said money working with new people I wouldn t have those stresses that I had when I was a service coordinator I wouldn t have to do the face to face meetings meeting people and dealing with that dealing with the issues of paperwork and stuff like that but yeah there s definitely positives about it
Counselor: So I mean there is a lot of anxieties that you have, but there s a lot things that you re kind of excited about? Paraphrase (chance to be more specific about his concerns and sources of excitement) Here I was attempting to give a short recap on the fact that although Adam is anxious about issues that may result in his new position, there will also be positives to the new opportunity good reframing of his situation though I d like to see you speak in more specific terms (not anxieties generally) or use specific examples. Client: Yeah a lot of the positives, that are going to change but I m just afraid to make a mistake asking myself should I do it (if its awkward) or shouldn t I do it and I m afraid of looking stupid in front of people chance to provide an empathic response to this statement Counselor: Does just cause I m trying to get an idea of what you re saying, what kinds of things scare you about looking stupid, what value to you hold in that? Probe for clarification Not a bad response although he has given you quite a lot of info about which you could frame an empathic response (e.g., reflection or paraphrase). I asked this question for Adam to tell me aloud what aspects of looking stupid scare him, in hopes that he could then begin to own that fear, so perhaps the two of us could phase that fear in a later stage in our counseling relationship Client: Um..I just don t want to look like oh look what he did he should have known how to do that, if he s the person in this job yeah and one of the big values I have, is not making mistakes with my work and now...um...you know, everybody makes mistakes but I pride myself on having it right the first time so I don t have to do it over and I just don t want to look like I don t know what I m doing, when I am in front of people Counselor: Do you feel that um again I m just trying to figure out exactly what you re thinking cause you seem pretty confident about the job you did for two years and although it s a little more complex and larger the job you re going to um...although you re anxious about several areas at least the feeling I m getting from you is that you ll have confidence to be able to achieve that do you think that? Good time to share this empathic response. I did not say this as well as I had hoped but I still think it was an excellent way to summarize the things that Adam and I had discussed so far in our session and really put it into perspective I liked your decision to do a minisummary/paraphrase. Your actual response might have been a bit smoother but was otherwise a good effort. Client: Yeah I know that I can do it it s just you know getting over I know they re small fears its nothing major I mean because obviously if I couldn t do the job than I wouldn t have
got hired for it and I wouldn t have gotten people recommend me for it and I guess I might have fears that the people that were in my department also applied for it and I was told by supervisors that they didn t recommend them for the job because they aren t team players and they don t they like to complain every time there is a rule change or when something goes wrong instead of just accepting it and learning from it.you know I m afraid those people are going to talk about me behind my back you know that causes me anxiety you know, I just don t want to have those people to talk bad about me Counselor: Have people often talked bad about you? Again, you fall back on the option of probing for clarification when a good empathic response (e.g., a paraphrase or reflection) could have both lead to clarification AND a sense on his part that you had understood what he was saying. I thought this was a good question for several reasons a) First, it allowed Adam to continue to tell his story while staying on topic yes. b) Second, it once again confronted the fear Adam was suggesting, making him personalize that fear, in a very non-confrontational manner Client: Uh not that I m aware of I guess it s just something that s in my own head only because the people I work with that aren t qualified for the position I ve seen them talk about other people where you know they ll be quiet when that persons in the room but when they leave they all huddle around a desk and they re like oh what an idiot this guy is look what this guy did..or how could he be qualified or like when a person leaves the department, they say we ll how was he qualified how did he get the job cause he did this or this I just know that s how they are then again I need to remember that s why they re not up for a position, because they re not a team player they like to start trouble they don t like to follow the rules that are set up they don t extra effort in I ve always been good when they asked me to do something outside of my job description um they had somebody who was you know, a behavior a large man who was a behavior problem in the building and mostly female staff worked in the back where he s in his classroom and he asked staff to volunteer fifteen minutes out of there day to go in the room he had a one on one staff to go in the room and relieve the staff so he could take a break and a couple other guys that applied for the position that I applied for said that s not part of my job description, I m not going to do it I thought its only fifteen minutes no big deal let the guy have a break so I went back there and did that and even though I know not that they talk behind my back, but they told me, you know why you doing that? That so stupid, that s not your job, and you got suckered in to that But I figured hey it s just helping somebody out its only fifteen minutes out of my day its one day a week...fifteen minutes it s just I know they talk but I guess it s just you know it s not stupid anxiety, but I should probably know better like it s not something I cant handle another chance to paraphrase or summarize this information
Counselor: Right well you should never feel bad about feelings that you feel opinion I mean because clearly they re obviously on your mind and they re bothering you paraphrase (another chance to provide an empathic response that communicated your understandings of Adam s experiences, behaviors, and feelings.) Client: Yeah Counselor: I don t know if this will help you at all, but when I first was going to become a counselor I felt in a lot of ways like you did I was working in a small place like that and went and got the education and I had anxieties for that too a lot of them and um and people you can take it from me people can overcome them self disclosure about an unspecified situation and behavior have you ever thought of not that I m trying to stretch it out here...um but I m assuming though that beyond your job you have anxieties toward similar things? Tack-on probe I started this off perfectly I was attempting to use my success as a counselor as a tool of self disclosure to provide my client some assurance that it gets easier and that he can overcome this however, I should have kept it short and sweet good insight Unfortunately, I did not stop there and made two significant mistakes 1. I made assumptions about what he was also feeling, instead of embracing what he was expressing in the moment 2. Not to mention, that I opened a whole new room of problems even though it was still related to anxiety, it is impossible to tackle the entire issue in the first half an hour we meet. Easy to steer a session when you rely too much on probes/questions. Client: Yeah, you know I think maybe that s you know those come into it to and you don t think about it because I think if somebody s anxious about things at work, then they re obviously they have to be anxious about other things I am too, I ve been married for just a year now um bought a new house you know have the mortgage to pay on that car payment I also go to school so money for paying the loans, and taking out more loans you know, all of those things together, I guess I really didn t think about it maybe it wasn t just the job making me anxious I think it s just one of many that all come together so, cause I know I do well at work, and there s no real reason for me to be anxious I guess maybe all those things the house the wife and you know This would have been a golden opportunity to correct the mistake I made prior and move on to a new stage in this setting i. I could have summarized a chance to restate what he has shared to this point. (that he is now embracing his anxieties as a whole no need yet to sympathize or interpret his situation and actions).
ii. Then I could have suggestively asked Adam if he would like to work on these anxieties one at a time and prioritize them good idea iii. Then give Adam another perspective on the anxiety he chooses iv. Then perhaps making some intermediate goals with perhaps a homework project for Adam v. Unfortunately the path I chose instead of this one is below Counselor: Do you ever feel anxious at any other moments in the day maybe what your neighbors are thinking or probe I told you, I messed up I had more than enough of the story to focus on with my client but for some reason I tried to extend the story and further unlock issues that he was not coming to my office in quest of dealing with at that moment I was just making it harder on myself I agree Client: Well that s the one positive thing, there are no neighbors Counselor: Oh really Client: That s good at least for that but I do worry about what do my in-laws think like if we re doing something like I said people at work my family not so much they re always proud of what I do no matter what Counselor: Right prompt Client: But my in-laws I don t know them that well as compared to your family so I m worried like do they like the house that we bought you know do they like that I m going to school and working you know do they approve of that I guess a lot of anxiety comes from me worrying about the approval of other people um no matter what it is it s more to think about its worrying about the approval of my in-laws the people at work the people I might be working with or even my wife sometimes or everything she needs me to do or I don t know all those things all get in my head and I don t know another chance to prioritize issues My job is to make his head uncluttered, by sorting out the issues not bunching them all up Counselor: And their approval is very important to you? paraphrase As I tried to wait patiently for the perfect opportunity, I filled the mean time with questions that were not helping me In future sessions I hope that I can improve on this Client: Yeah, mostly I think they are very nice people my parents are divorced but they re still married they always helped us my wife and I have been together for 10 years but
we ve only been married 1 just because I worked after high school...she went to college right away then she was done and I decided to go to college and then when she was back home working I was in school then I graduated and we finally came to a point in our lives when Counselor: It was time to settle down paraphrase Although this portion of the conversation should not had been, I thought this was a good way to show my client that I am in tune with what he is sharing with me yes an effective empathic highlight Client: We were able to get married because otherwise we lived in different cities I lived in buffalo and she lived here so it was all over the place but I do and her parents help you know transporting my stuff to school and they help us move back and that s very important you know there approval is important you know the approval of people at work that have given me a good recommendation I don t want to let them down like they recommend me and then I screw up he s now making it easy for you to come back to the main issue, his anxieties about the new situation at work. Counselor: So I guess my question is you have described you know several anxieties be specific you ve had and you know approvals and people talking about you and um not valuing your value (tack-on question and I guess my question is what do you think what are your feelings toward these anxious feelings do they just bother you a little bit or something you want to work more on?) Once again, an excellent job of recapping and summarizing however, when I draw it out I add too much to what I am trying to do just share your understandings of what he just said. For example, you could say something like this: Much of your anxiety about taking on this new position at work seems to be related to your desire to have approval from your co-workers. Client: I guess it s something that I want to work on to not have them because you know when talking to you they re not realistic I guess they re something to worry about, but not get that anxious over I think we need to come up with a plan of dealing with them better because like I said I if I am qualified for a job, like why not go for it Counselor: Right prompt Client: There s things you re anxious about, but not to the level that I m getting like so nervous like it s all I think about Counselor: Right prompt Client: And it makes me feel always on edge I shake my leg when I am sitting down just thinking about things um but you know I d like to come up with a plan to you know put
what is really anxious anxiety as opposed to things that I should just have a plan to deal with great opportunity to summarize this last discussion. That kind of a summary could be a good lead-in to exploration of his goal. Let him take the lead rather than do everything yourself. Counselor: Well if we could create a plan that could help you with some of these anxieties and maybe a couple of the issues that you have the best thing that I ve found that works is to come up with some goals because before you create a plan of attack you need to weed out some of the smaller things leading up to it keep your suggestion simple rather than to tack on added items. Client: Makes sense Counselor: It s a little bit complicated but what would be maybe some goals that maybe are a little bit realistic but a good place to start in this probe for strategies Client: That s how I feel, you know realistic like what I guess maybe you know have a goal like write down everything that causes me anxiety and then just leave it and come back to it and see which one of those is really something Counselor: Affecting? accent Client: Yeah or if there s things that are not Ill just say I don t have to worry about those um come up with a plan and with um maybe I guess along the lines with first of all just writing down you know what caused anxiety and also too I don t have a way to get rid of anxiety not a lot of hobbies between work and school those types of things take up a lot of time you know doing the bills and all that kind of stuff so I think those are maybe some things I could think about making a goal maybe even discussing anxiety with my wife I don t normally do that...or even the people at work maybe discuss with them yeah I don t I m kind of worried about this job you know is that something that s realistic should I be worried about it and discuss it with other people my worries because I kind of keep them to myself? Chance for you to summarize these issues. Counselor: I think that you may have touched on about four or five goals so what we could do is if you want is start with the writing down until next week and then we can go with the goals that you just mentioned except have a little more of a...a better vision of the path then we ll know exactly when you go to work when you come home wherever it is that you go just whenever you feel something that you feel anxious about, just kind of write it down and we ll read through them and then we ll specifically figure out what angles you want to take on the goals then we ll see what we can do homework and plan for next meeting Client: Sounds good
Counselor: Ok Client: Alright Counselor: Alright, well then I ll see you next week Client: Great, Thanks Counselor: Thanks for coming in As I explained through the dialogue, I made many strong statements throughout the session. I had a lot that I can build on as an aspiring counselor. However, there were many times when I made errors and miss judgments during the session. I will use what I learned from viewing this session to improve my skills on future sessions. Good plan