{"id":326,"date":"2024-01-26T01:51:45","date_gmt":"2024-01-26T01:51:45","guid":{"rendered":"https:\/\/swpro.org\/amymejias\/?page_id=326"},"modified":"2024-07-27T21:54:37","modified_gmt":"2024-07-27T21:54:37","slug":"course-evidence-for-practice-behavior-9-2","status":"publish","type":"page","link":"https:\/\/swpro.org\/amymejias\/competencies\/competency-9-evaluate-individuals-families-groups-organizations-and-communities\/course-evidence-for-practice-behavior-9-2\/","title":{"rendered":"Course Evidence for Practice Behavior 9.2"},"content":{"rendered":"

Evaluate the efficiency and effectiveness of practice outcomes across systems<\/span><\/h3>\n

In my SOCW-611, Advanced Clinical Practice: Individual & Family Interventions class, we had to write an analysis paper that evaluated our CBT practice with a pseudo-client. We had to evaluate our responses, techniques, and ethical issues while taking into consideration the feedback from our mentor. In the writing of this paper, I used the social work knowledge<\/strong> and skills<\/strong> of reflective practice<\/strong> and feedback integration<\/strong>, increasing the social work value<\/strong> of competence<\/strong> in doing so.\u00a0 I used the cognitive processes<\/strong> of evaluation<\/strong> and analyzing <\/b>and the affective process<\/strong> of valuing<\/strong>.\u00a0 I used the theoretical framework<\/strong> of self-reflective practice<\/strong>.<\/p>\n

______________________________________________________________________<\/p>\n

Clinical CBT Self-Analysis Paper <\/strong><\/span><\/h1>\n

SOCW 611: Advanced Clinical Practice: Individuals and Families Interventions<\/strong><\/span><\/h1>\n

Segment One: Transcriptions, Comments, and Corrections<\/strong><\/span><\/h2>\n

Greeting the Client (with Confidentiality)<\/strong><\/span><\/h2>\n

Therapist:<\/strong> \u201cMy name is Amy Mejias, and I’m a licensed clinical social worker and I’m so glad they’re here today. What is your name?\u00a0 What do you like to be called?\u201d <\/span><\/p>\n

Client:<\/strong> Gave her name.<\/span><\/p>\n

Therapist:<\/strong> \u201cOkay. Great. So, have you ever gone to counseling in the past?\u201d<\/span><\/p>\n

Client:<\/strong> When I asked if she had gone to counseling in the past, she acknowledged that she had.<\/span><\/p>\n

Therapist:<\/strong> \u201cOkay, so I just wanted to talk to you briefly about patient confidentiality. That means that I can’t share anything that you told me today in our session, but there are a few exceptions to that. First of all, if you mention any kind of abuse, child abuse, elder abuse, or abuse of disabled people, that would need to be reported to the proper authorities to make sure everybody’s safe. Also, if you directly mention intent to harm yourself or to harm others, I would also need to put a crisis intervention in place to protect you and whoever else may be involved. However, if you do have suicidal thoughts, homicidal thoughts, or thoughts about death, please do mention those to me because we can kind of work through those together. If there’s something you’re unsure of, if it’s covered under confidentiality or not, we can kind of work that out and talk about it.\u201d<\/span><\/p>\n

Comment:<\/strong> I would say in retrospect that perhaps I could improve by going into detail about why confidentiality is important.<\/span><\/p>\n

Correction:<\/em><\/strong> (added to the end of what was already said) \u201cIn our therapy, your trust and well-being are my top priorities. This commitment to confidentiality makes this a safe and supportive environment for you to share your thoughts and feelings.\u201d<\/em><\/span><\/p>\n

Therapist:<\/strong> \u201cWhat are expectations, either from that experience or now when it comes to counseling?\u201d<\/span><\/p>\n

Client:<\/strong> The client went into her past experiences in counseling and the therapies that she had done in counseling in the past, and then she went a little bit into her current issue and what brought her in, which is some issues she is having at work with her boss that have brought her anxiety back.<\/span><\/p>\n

Therapist:<\/strong> \u201cSo, it takes the effort of both of us, you know, to achieve goals. Of course, this is not something that happens overnight. You have experience in that before. So, yes, it\u2019s a process, and it is teamwork to get you to where you want to be.\u201d<\/span><\/p>\n

Comment:\u00a0 <\/strong>I feel like this section, even in practice, is not my strength because I always feel like I need to say more.\u00a0 I think if I rephrase it to get more specific perhaps that would improve it.<\/span><\/p>\n

Correction:<\/em><\/strong> (replacing my first dialogue) “What specific thoughts or beliefs do you have about counseling, based on your past experiences or your current expectations?”<\/em><\/span><\/p>\n

Agenda<\/strong><\/span><\/h2>\n

Therapist:<\/strong> \u201cSo, for today, to just kind of let you know the flow of how the session will go with me. I’ll kind of go over a little mood check to see where you’re at today, we’ll go into more detail about what brings you in and prioritize your problem because if you have several of them, we can kind of prioritize them and set goals regarding them. And also, talk about therapy options, particularly cognitive behavioral therapy if that ends up being a good option for you. And then we’ll work on a problem. Discuss some homework. They call it homework, but that sounds more intimidating. It’s kind of just like the continuation of therapy during the week until we meet again and go over any feedback you may have. Does that sound good?\u201d<\/span><\/p>\n

Client:<\/strong> She said okay.<\/span><\/p>\n

Comment:\u00a0 <\/strong>This sadly was the full length of our conversation on the agenda, so I could not add any more dialog, and I definitely fell short here. I reiterate what I said initially: I need to get more of the client\u2019s feedback, not only ensuring that it sounds good to them but also to see if there were anything they would like to add or focus on. \u00a0Maybe make the question more open-ended.\u00a0 I should have begun asking her what she may particularly want to work on that day and go from there, or start the agenda more organically when we were already in conversation about what brought her in.<\/span><\/p>\n

Correction<\/em><\/strong>: <\/em><\/strong>See below the Prioritized the Problem section.<\/em><\/span><\/p>\n

Prioritized the Problem<\/strong><\/span><\/h2>\n

Therapist:<\/strong> \u201cSo, what are some particular issues that you’re having that’s triggering you and what are your thoughts and emotions in regards to that?\u201d<\/span><\/p>\n

Client:<\/strong> The client went into more detail about a situation at work confronting her boss in a meeting with her boss\u2019s boss, about how the boss is degrading to people and mistreating her staff.\u00a0 The meeting didn\u2019t go well.<\/span><\/p>\n

Therapist:<\/strong> \u201cSo how are you feeling? What kind of thoughts are you having since that happened?\u201d<\/span><\/p>\n

Client: <\/strong>\u00a0My client felt gaslighted and not supported which left her feeling anxious and doubting herself, and her decision to speak up, and this has led to a lot of negative self-talk.<\/span><\/p>\n

Therapist:<\/strong> \u201cWell, I’m, I’m happy you\u2019re here today. I’m looking forward to helping you work through this and get back to a more positive point.\u201d<\/span><\/p>\n

Comment:\u00a0 <\/strong>I think this could have been improved if I had maybe asked her more questions about her situation and the impact that it had on her.\u00a0 I honestly get so nervous to hit all of the points that I need to get, that some sections, such as this one, lack as much substance that they could have had.\u00a0\u00a0<\/span><\/p>\n

Agenda\/Prioritizing the Problem Correction<\/strong><\/span><\/h2>\n

Correction:<\/strong><\/span><\/em><\/span><\/p>\n

Therapist:<\/strong> Which problems would you like to work on today?<\/span><\/em><\/span><\/p>\n

Client:<\/strong> The client went into more detail about a situation at work confronting her boss in a meeting with her boss\u2019s boss, about how the boss is degrading to people and mistreating her staff.\u00a0 The meeting didn\u2019t go well.\u00a0<\/span><\/em><\/span><\/p>\n

Therapist:<\/strong> How are you feeling? What kind of thoughts are you having since that happened?<\/span><\/em><\/span><\/p>\n

Client:<\/strong> My client felt gaslighted and not supported which left her feeling anxious and doubting herself, and her decision to speak up, and this has led to a lot of negative self-talk.<\/span><\/em><\/span><\/p>\n

Therapist:<\/strong> Well, I’m happy you\u2019re here today. I’m looking forward to helping you work through this and get back to a more positive point. \u00a0<\/strong>Of these problems that you\u2019ve mentioned, which do you feel are the most important to focus on?<\/span><\/em><\/span><\/p>\n

Client:<\/strong> Responds<\/span><\/em><\/span><\/p>\n

Therapist: <\/strong>So, for today, to just kind of let you know the flow of how the session will go with me. I’ll kind of go over a little mood check to see where you’re at today, we’ll go into more detail about what brings you in and work on the problems that you prioritized. And also, talk about therapy options, particularly cognitive behavioral therapy if that ends up being a good option for you. And then we’ll work on a problem. Discuss some homework. They call it homework, but that sounds more intimidating. It’s kind of just like the continuation of therapy during the week until we meet again and go over any feedback you may have.\u00a0 Is there anything that you’d like to add or any preference on how you would like our sessions to be structured? Your input is important to me, so please feel free to share your thoughts at any time.<\/span><\/em><\/span><\/p>\n

Mood Check<\/strong><\/span><\/h2>\n

Therapist:<\/strong> \u201cSo today on a scale of one to ten. One means you’re feeling terrible, and ten means you’re feeling fantastic. Where do you lie on that scale today?\u201d<\/span><\/p>\n

Client: <\/strong>\u00a0The client stated she was at 6, that previous to this she was at an 8 or 9, and a few days ago she was at a 2 when this whole issue was happening.<\/span><\/p>\n

Therapist:<\/strong> \u201cOkay, I’m glad to hear it’s improving. Hopefully, we can work through and get you back to that nine that you were at.\u201d<\/span><\/p>\n

Comment: <\/strong>After my meeting going over this video, I learned that a good way to use whatever rating the client gives is to ask them what that rating looks like, which you can later use in discussing goals in asking what rating they would like to be at and what does that rating look like to them.<\/span><\/p>\n

Correction: <\/em><\/strong>(add in after the client\u2019s response that she\u2019s at a 6) \u201cSo, you said you are at 6 right now.\u00a0 What does that 6 look like for you?<\/em> (after she answers) So you said that you wanted to get back to being at 9.\u00a0 What does a 9 look like for you?\u201d<\/em><\/span><\/p>\n

Goal Setting<\/strong><\/span><\/h2>\n

Therapist: \u201c<\/strong>So, when it comes to goals, what would you say are your goals of therapy or, you with your mental health?\u201d<\/span><\/p>\n

Client: <\/strong>The client said to love herself more, stop the negative self-talk, and give herself grace.<\/span><\/p>\n

Comment:\u00a0 <\/strong>This was also it for the dialogue in this section, sadly.\u00a0 I jumped right into talking about CBT after this dialogue.\u00a0 I think this could have perhaps been more specific.\u00a0 I always felt vague asking this question because asking about goals can be so broad.\u00a0 Also, with her response I could ask what number on the mood scale that she would like to be at and get more details on that.<\/span><\/p>\n

Correction<\/strong><\/span><\/em><\/span><\/p>\n

Therapist: <\/strong>\u201cWhat are the most important goals that you hope to achieve through therapy? What changes to your mental health and well-being are you looking to achieve?”<\/span><\/em><\/span><\/p>\n

Client: <\/strong>The client said to love herself more, stop the negative self-talk, and give herself grace.<\/span><\/em><\/span><\/p>\n

Therapist:<\/strong> When I had asked earlier about what your mood looks like today on a scale of 1 through 10, you said it was at a 6 today,\u00a0 What number would you like to see it at?<\/span><\/em><\/span><\/p>\n

Client: <\/strong>We will say that she would say a 9 or a 10.<\/span><\/em><\/span><\/p>\n

Therapist: <\/strong>What does a 9 or 10 look like for you?\u00a0<\/span><\/em><\/span><\/p>\n

Client:<\/strong> She responds by saying she would be more happy again.<\/span><\/em><\/span><\/p>\n

Working on the Problem and Educating on CBT<\/strong><\/span><\/p>\n

Therapist: \u201c<\/strong>I know you talked about different therapy you had in the past. I’m not sure if you did cognitive behavioral therapy in the past, but have you in the past?\u201d<\/span><\/p>\n

Client: <\/strong>She said she did it in a group setting but not one on one.<\/span><\/p>\n

Therapist: \u201c<\/strong>I’d love to be able to explain it to you again.\u00a0 It’s always good to get a refresher. So, what happens with our thought process when it comes to negative self-talk and cognitive distortions, is that people have a situation that occurs, and then that leads to a thought, then that leads to an emotion, and that leads to a reaction.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 And so, I\u2019d like to kind of give you an example of how that process works and then how cognitive behavioral therapy works.\u00a0 I had another client, and who had a coworker that is normally friendly to them, but they passed them in the hall and said hi and the coworker didn’t say anything back.\u00a0 This client always had anxiety often anyway. But this kind of that led to the thought, like, \u201cWhat did I do wrong? Was she mad at me?\u201d \u00a0Which then led to feelings of hurt, like rejection and sadness.\u00a0 And those feelings led to her worrying about it for the rest of the day.\u00a0 When she saw her later, my client was completely cold to her coworker.\u00a0 So that’s kind of how the negative thoughts up off into our head, unsolicited can lead to a lot of negative, you know, when it comes to feelings and reactions.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 So, cognitive behavioral therapy, the way it works, it takes those negative and often untrue thoughts and changes them into more positive and realistic thoughts.\u00a0 So, for this client and her situation, I gave her the example that if instead, she thought \u201cMaybe she didn’t see me. She must have a lot on her mind.\u201d\u00a0 Now, with that thought I asked her what that led to her feeling, and she said she just kind of felt indifferent.\u00a0 It didn’t make her feel negative or, you know, um, and that would lead to something like her not thinking about it anymore that day.\u00a0 And when she sees her coworker later, you know, being fine with her, and they go on as normal.\u00a0 So, that’s kind of how cognitive behavioral therapy works. \u00a0And again, that goes back to the cognitive distortions, and those are thoughts that occur. They’re automatic. They just pop in the head without even trying.\u00a0 And then sometimes those thoughts can be negative or, often, I should say, unless we train them to be more positive otherwise.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 So, I know you mentioned one of your main issues is that you often talk negatively about yourself, in feeling like, you’re being stupid or things like that. So, that is a cognitive distortion. I have a nice list here for you that you’re welcome to have.\u00a0 So, you can see there are several different cognitive distortions that people have, and these are endless. Those are those automatic thoughts.\u00a0 So, the ones I would say, about those thoughts that pop into your head, are labeling or personalizing. So, labeling is when we take one small mistake that we have and we turn it into a really unkind name for ourselves, like you said, stupid.\u00a0 And instead of saying like, \u201cI’m a failure\u201d, it’s better to say, \u201cI made a mistake, but it doesn’t mean I’m a failure\u201d.\u00a0 We all make mistakes, and that is how we learn and grow.\u00a0 Personalizing is when we think that everything that happens around us, or to us, is because of something we did or because of who we are.\u00a0 It’s like thinking the world revolves around us. And that’s not true.\u00a0 You know, we see that events can also be caused by others, so, it’s not always just us.So, going back to cognitive behavioral therapy, I want to use an example of a scenario that you’re having, to show how the thought process works.\u00a0 So, we can use if you have a certain example of a situation that led to a thought, or I can use the one you gave about the situation that happened, that led you to come here.\u201d<\/span><\/p>\n

Client:<\/strong> The client agrees that is a good one, about the meeting.<\/span><\/p>\n

Therapist: \u201c<\/strong>So, that led you to feel like you’re stupid and have all these negative thoughts about yourself.\u00a0 And then what were the emotions that followed those thoughts?\u201d<\/span><\/p>\n

Client:<\/strong> The client responded it was embarrassment, sadness, and a little bit of fear.<\/span><\/p>\n

Therapist:<\/strong> \u201cHas that led to, um, any sort of reaction after, like example, avoiding people at work?\u00a0 Or just are not going to work, you know, things like that?\u201d<\/span><\/p>\n

Client: <\/strong>When I asked this, she couldn\u2019t pinpoint a reaction that had occurred because of this, but later recalled one farther along in the video that she started to look for another job.<\/span><\/p>\n

Therapist:<\/strong> \u201cHere is an example of cognitive behavioral therapy in that situation.\u00a0 So, the situation happened. But if you change that thought to being something, \u2018you’re strong, that you’re brave\u2019, for stepping forward, for standing up for what you felt was right. What kind of emotion would that provoke?\u201d<\/span><\/p>\n

Client:<\/strong> She had a genuine \u201cah ha!\u201d moment and began to cry.\u00a0 She said she is proud that she did it even though it was really hard to do.<\/span><\/p>\n

Therapist<\/strong>:<\/strong> \u201cAnd then what kind of positive reaction could that lead to?\u201dClient:<\/strong> The client said she would be able to walk with her head up high again. Therapist<\/strong>:<\/strong> \u201cSo, that kind of shows how cognitive behavioral therapy can help you reframe. So, it’s important to remember, I know it’s hard and difficult situations, but if you’re able to reframe, it can make a world a difference.\u201d<\/span><\/p>\n

Comment:<\/strong> One thing I should have done was talk less and listen more. I should have broken up my long dialog by asking her if she had any questions or anything to add to what I was talking about. I should have also kept information about her case together instead of interrupting it with the example client\u2019s case. I could have also shown her the homework briefly that showed the thought distortion process or another visual example of how CBT and thought distortions work.<\/span><\/p>\n

Correction: <\/em><\/strong>\u00a0<\/em><\/span><\/p>\n

Therapist: \u201c<\/em><\/strong>I know you talked about different therapy you had in the past. I’m not sure if you did cognitive behavioral therapy in the past, but have you in the past?\u201d<\/em><\/span><\/p>\n

Client: <\/em><\/strong>She said she did it in a group setting but not one on one. <\/em><\/span><\/p>\n

Therapist: \u201c<\/em><\/strong>I’d love to be able to explain it to you again.\u00a0 It’s always good to get a refresher. So, what happens with our thought process when it comes to negative self-talk and cognitive distortions, is that people have a situation that occurs, and then that leads to a thought, then that leads to an emotion, and that leads to a reaction (Show a visual example)<\/em>. Do you have any questions about this?<\/em>\u201c<\/em><\/span><\/p>\n

Client: <\/em><\/strong>She said she doesn\u2019t.<\/em><\/span><\/p>\n

Therapist:<\/em><\/strong> \u201cAnd so, I\u2019d like to kind of give you an example of how that process works and then how cognitive behavioral therapy works.\u00a0 I had another client, and who had a coworker that is normally friendly to them, but they passed them in the hall and said hi and the coworker didn’t say anything back.\u00a0 This client always had anxiety often anyway. But this kind of that led to the thought, like, \u201cWhat did I do wrong? Was she mad at me?\u201d\u00a0 Which then led to feelings of hurt, like rejection and sadness.\u00a0 And those feelings led to her worrying about it for the rest of the day. <\/em>When she saw her later, my client was completely cold to her coworker.\u00a0 So that’s kind of how the negative thoughts up off into our head, unsolicited can lead to a lot of negative, you know, when it comes to feelings and reactions.\u00a0 Do you have any questions so far about this?\u201d<\/em><\/span><\/p>\n

Client:<\/em><\/strong> She said that she understands so far.<\/em><\/span><\/p>\n

Therapist:<\/em><\/strong> So, cognitive behavioral therapy, the way it works, it takes those negative and often untrue thoughts and changes them into more positive and realistic thoughts.\u00a0 So, for this client and her situation, I gave her the example that if instead, she thought \u201cMaybe she didn’t see me. She must have a lot on her mind.\u201d\u00a0 Now, with that thought I asked her what that led to her feeling, and she said she just kind of felt indifferent.\u00a0 It didn’t make her feel negative or, you know, um, and that would lead to something like her not thinking about it anymore that day.\u00a0 And when she sees her coworker later, you know, being fine with her, and they go on as normal.\u00a0 So, that’s kind of how cognitive behavioral therapy works.\u00a0 And again, that goes back to the cognitive distortions, and those are thoughts that occur. They’re automatic. They just pop in the head without even trying.\u00a0 And then sometimes those thoughts can be negative or, often, I should say, unless we train them to be more positive otherwise.<\/em>\u00a0 <\/em>Do you have any questions so far?\u00a0 <\/em><\/span><\/p>\n

Client: <\/em><\/strong>Responds she doesn\u2019t.<\/em><\/span><\/p>\n

Therapist: <\/em><\/strong>There are several different cognitive distortions that people have, and these are endless. Those are those automatic thoughts.\u00a0 So, the ones I would say, about those thoughts that pop into your head, are labeling or personalizing. So, labeling is when we take one small mistake that we have and we turn it into a really unkind name for ourselves, like you said, stupid.\u00a0 And instead of saying like, \u201cI’m a failure\u201d, it’s better to say, \u201cI made a mistake, but it doesn’t mean I’m a failure\u201d.\u00a0 We all make mistakes, and that is how we learn and grow.\u00a0 Personalizing is when we think that everything that happens around us, or to us, is because of something we did or because of who we are.\u00a0 It’s like thinking the world revolves around us. And that’s not true.\u00a0 You know, we see that events can also be caused by others, so, it’s not always just us.\u00a0 I have a nice list here for you that you’re welcome to have that discusses the different kinds of cognitive distortions.<\/em><\/span><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0So, I know you mentioned one of your main issues is that you often talk negatively about yourself, in feeling like, you’re being stupid or things like that. So, that is a cognitive distortion that you are having. <\/span><\/em><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 So, going back to cognitive behavioral therapy, I want to use an example of a scenario that you’re having, to show how the thought process works.\u00a0 So, we can use if you have a certain example of a situation that led to a thought, or I can use the one you gave about the situation that happened, that led you to come here.\u201d <\/em><\/span><\/p>\n

Client:<\/em><\/strong> The client agrees that is a good one, about the meeting.<\/em><\/span><\/p>\n

Therapist: \u201c<\/em><\/strong>So, that led you to feel like you’re stupid and have all these negative thoughts about yourself.\u00a0 And then what were the emotions that followed those thoughts?\u201d<\/em><\/span><\/p>\n

Client:<\/em><\/strong> The client responded it was embarrassment, sadness, and a little bit of fear. <\/em><\/span><\/p>\n

Therapist:<\/em><\/strong> \u201cHas that led to, um, any sort of reaction after, like example, avoiding people at work?\u00a0 Or just are not going to work, you know, things like that?\u201d<\/em><\/span><\/p>\n

Client: <\/em><\/strong>When I asked this, she couldn\u2019t pinpoint a reaction that had occurred because of this, but later recalled one farther along in the video that she started to look for another job.<\/em><\/span><\/p>\n

Therapist:<\/em><\/strong> \u201cHere is an example of cognitive behavioral therapy in that situation.\u00a0 So, the situation happened. But if you change that thought to being something, \u2018you’re strong, that you’re brave\u2019, for stepping forward, for standing up for what you felt was right. What kind of emotion would that provoke?\u201d<\/em><\/span><\/p>\n

Client:<\/em><\/strong> She had a genuine \u201cah ha!\u201d moment and began to cry.\u00a0 She said she is proud that she did it even though it was really hard to do. <\/em><\/span><\/p>\n

Therapist:<\/em><\/strong> \u201cAnd then what kind of positive reaction could that lead to?\u201d<\/em><\/span><\/p>\n

Client:<\/em><\/strong> The client said she would be able to walk with her head up high again. <\/em><\/span><\/p>\n

Therapist:<\/em><\/strong> \u201cSo, that kind of shows how cognitive behavioral therapy can help you reframe. So, it’s important to remember, I know it’s hard and difficult situations, but if you’re able to reframe, it can make a world a difference.\u201d<\/em><\/span><\/p>\n

Therapist:<\/span><\/i><\/b> \u201cSo, going back to your goal of wanting to be at a 9 or 10 on the mood scale. I know you shared that you want to be happy again. So, in order for you to accomplish that goal, what do you think you might be feeling?\u201d\u00a0 <\/span><\/i><\/span><\/p>\n

Client:<\/em><\/strong> Responds that she would be feeling more confident and less insecure.<\/em><\/span><\/p>\n

Therapist:<\/em><\/strong> \u201cWhat thoughts may be going through your mind if you were feeling more confident and less insecure?”\u00a0<\/em><\/span><\/p>\n

Client:<\/em><\/strong> She may respond that she knows she\u2019s a hard worker and that she has integrity. <\/em><\/span><\/p>\n

Homework<\/strong><\/span><\/h1>\n

Therapist:<\/strong> \u201cSo, I know our session is almost done. As I mentioned, the homework. So, this is something I would like you to do for this next week until we meet again. This is a little thought record. And then there are a couple of copies that you can use. Or if it’s easier, you can kind of just keep it on your note on your phone, because I know it’s not always easy to fill out this paper. But basically, when a situation occurs, if there are any situations that end up triggering automatic thoughts, write down the situation, and what happened, and then write down whatever automatic thoughts popped in your head, whatever emotions popped in your head, and then if there was any adaptive response that you had to that. And then, if there are any outcomes that occurred from that. So, if you can, keep track of those things when they occur. You don’t have to do every single one, but maybe, just a few a day when they pop up. And here’s a little example, that shows you, and you can kind of point out with the cognitive distortion sheet, as well if you’re having any of those. \u00a0But we can go through some of those next week and do what we did today and try to turn those thoughts around, And then eventually you’ll be able to get the hang of it. How to do that on your own? It takes some practice. It takes time to train ourselves to do that and to think differently. But this is a really good start. And your being here today is a very good start.\u201d<\/span><\/p>\n

Client: <\/strong>She acknowledged that she understands.<\/span><\/p>\n

Comment:\u00a0 <\/strong>This was also the extent of the dialogue for this section.\u00a0 <\/strong>I feel like this one is pretty straightforward and that I did a pretty good job of it.\u00a0 If anything, maybe perhaps I could have asked for more of her opinion or input on the homework process.\u00a0 I don\u2019t even think I asked her if she was ok with doing this.<\/span><\/p>\n

Correction<\/em><\/strong>: <\/strong>(at the end of my dialogue) \u201cDoes this sound like something you would be able to do and are interested in trying out?\u00a0 Do you have any questions about the homework?\u201d<\/em><\/span><\/p>\n

Summary and Feedback<\/strong><\/span><\/h1>\n

Therapist: <\/strong>\u201cSo just to kind of summarize what happened today or what we went over. So, we went over expectations of therapy, discussed your problem, and went over what your emotions are today. Set some goals, go over cognitive behavioral therapy, and then we went over examples of that and cognitive distortions, and your homework. Do you have any feedback for me on what went positive in today’s session? Like, what’s been helpful?\u201d<\/span><\/p>\n

Client: <\/strong>The client said it was very helpful and I helped her with some objectives to view her situation in a positive way and helped her to reframe.<\/span><\/p>\n

Therapist: \u201c<\/strong>Do you have any constructive criticism of me? If you don’t feel comfortable sharing now, there is a feedback form that my receptionist has, that’s anonymous. So you can always do it that way, too.\u201d<\/span><\/p>\n

Client: <\/strong>She stated that she has no complaints<\/span><\/p>\n

Comment:\u00a0 <\/strong>This one was also pretty straightforward; however, I always feel odd listing off everything we just did and everything that I already went over in the agenda of the session. \u00a0If anything, it would be changing the \u201cLike, what\u2019s been helpful?\u201d at the end. \u00a0<\/span><\/p>\n

Correction: <\/em><\/strong>(replacing the end of my dialogue) \u201cWhat do you think went well in today’s session? What aspects of it were particularly helpful for you?”<\/em><\/span><\/p>\n

Segment Two: Reflections & Issues<\/strong><\/span><\/h2>\n

Ethical Issues<\/strong><\/span><\/h2>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The ethical issue that arose regarding my CBT video, is that I somehow missed that it wasn\u2019t supposed to be done using a real scenario.\u00a0 I didn\u2019t realize that until I was about to upload my video.\u00a0 When I contacted my friend to see if she would do this video with me, she said \u201cOh definitely!\u00a0 I am having a situation at work and would love to talk to you about it.\u201d\u00a0\u00a0 I thought this would be great because I would particularly have empathetic ears to the situation.\u00a0<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Once I read that it couldn\u2019t be a real situation, I could have just kept quiet about it.\u00a0 But I felt it was the best and ethical thing to do to let Dr. Baker know.\u00a0 And she was amazing at helping me find a good solution, which included my friend signing an informed consent, which she more than gladly did.\u00a0 When it comes to what I could have done differently, I could have paid better attention from the beginning and noticed that it said no real scenarios, and therefore could have told my friend to use a fake one and that we could talk about the real one after when I was not recording.<\/span><\/p>\n

Clinical Mentor Consultation\u00a0 <\/strong><\/span><\/h2>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I felt that the consultation of my CBT session was a great benefit.\u00a0 My clinical supervisor really helped me look at some of the skills in a different way, which also would expand dialogue with the client and paint a clearer picture of their mental and emotional state.\u00a0 One example of this is during mood check, asking them what the number they give looks like to them.\u00a0 I didn\u2019t even think about this before.\u00a0 To me, I hear they are a six, and I think \u201cOk good, they are pretty level\u201d, but a six can look different to different people.\u00a0 She also said that this can be used in goal setting by asking them what number they would like to be at and getting details on what that number looks like to them. \u00a0Another great example she gave was using the score that they got on whichever inventory they took and discussing how it looks consistent with whatever the number they said that they were at today in their mood check. \u00a0\u00a0<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 As I mentioned above, meeting with my clinical supervisor regarding this was very beneficial.\u00a0 I will admit, I was very nervous before, as was anyone else that I talked to.\u00a0 I think not only is it painful to listen to myself on video, but I just wasn\u2019t sure how the process would go or what kind of feedback I might receive.\u00a0 However, once I was in the room, besides having to listen to myself, I became very comfortable.\u00a0 It wasn\u2019t micromanaging as I was worried it may be in my head, which was an irrational thought since my clinical supervisor isn\u2019t like that anyway, it was pretty relaxed with some great feedback.\u00a0 Her feedback as we practiced in class was also very helpful and I have taken notes on many points and implemented them into my CBT practice.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Though I still do not plan to get my LCSW licensure or work in clinical social work, I still feel like I can implement many skills that I learned in this class, particularly during my practicum in working with the residents at the Chattanooga Housing Authority site that I work with.\u00a0 Not that I would be doing CBT on them, but using active listening skills particularly, and also implementing other aspects such as goal setting as well as looking at situations more realistically would be beneficial, such as what we did in class with that worksheet.\u00a0 There are several residents that have some paranoia problems and discussing their situations with my field instructor, we discussed how going over that could be beneficial to them.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Evaluate the efficiency and effectiveness of practice outcomes across systems In my SOCW-611, Advanced Clinical Practice: Individual & Family Interventions class, we had to write an analysis paper that evaluated our CBT practice with a pseudo-client. We had to evaluate … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":855,"featured_media":0,"parent":58,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-326","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/pages\/326","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/users\/855"}],"replies":[{"embeddable":true,"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/comments?post=326"}],"version-history":[{"count":10,"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/pages\/326\/revisions"}],"predecessor-version":[{"id":907,"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/pages\/326\/revisions\/907"}],"up":[{"embeddable":true,"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/pages\/58"}],"wp:attachment":[{"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/media?parent=326"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}