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DQ#1: NOTE: Since you are in a counseling environment, be sure you do not disclose any client information that could compromise client confidentiality.
What activities did you participate in this week in your practicum site? Describe them. Did you enjoy them? What did you like the best? Worst? What will you change next week? Share your experience with your classmates.
The one activity that was somewhat nerve-racking to me occurred during our staff meeting. My clinical supervisor who oversees most of the interns and staff at my site asked the interns/staff during our last meeting to be ready to present a current unnamed case from start to its current status during our next meeting. Wednesday comes and it’s ShowTime. I guess since I just finished having my weekly meeting with him and fresh on his mind, he decided to call on me to go first. I felt like I needed to be an expert on the 12 Core Functions of a SA counselor. I had to explain the entire experience from the intake, assessment, my temp diagnosis, treatment plan, and preferred orientation with the client, any case management needs and current status of the client. After doing so, he opened the meeting up to have other staff/interns to ask questions about any of the steps during process; if they would do anything different alone the way, etc.? What I like best was that I embrace challenges and I was prepared, at the same time being a novice counselor/1st
experience and other staff having years of experience, I was “baptized’ by fire as a counselor. I was relieved when most agreed with how I handled things with the client, although a few recommended I add motivational interviewing (MI) with my Person-Centered Approach with this particular client; which I can accept opposed to them saying I was handling the client completely wrong. The worst part of this experience was that I didn’t know what to expect from the other staff/interns. During my entire presentation I was wondering what type of questions they would be asking? Would they be empathetic knowing this is my 1st experience and mistakes are natural? Or would they take me to the woodshed? I was relieved when there were only recommendations for best practices and no real criticisms to my approach. The changes I will make next week is implementing (MI) during my practice with this client.
Another activity I tried with a substance abuse group to recognize “high risk situations for relapse'” was to dissect a quote that is embedded in my head for 25 years from my high school coach. “ Discipline is the habit of acting in the moment based on decisions you made in advance, regardless of your feelings.” I wanted to group to try to apply this to their current situation being that the Drug Court referred most of the clients in this particular group. The best part of this activity was the responses from the different group members. Their responses enable me to identify their defense mechanisms and what stage of change. I say this because a few believed they were very disciplined and didn’t believe their substance use was a habit, yet they were all in a program. The worst part about this activity was a few didn’t want to participate in this activity, whereas most of my other activities, all would and have a healthy back and forth dialog w/each other; which made the group flow smoothly and rather quick. Next week I will go back to finding an activity that ALL would be willing to participate in. I realize that some clients would rather not reflect on or internalize their behaviors during certain stages of their recovery/sobriety.
My response:
Re: Topic 7 DQ 1
Though the group is a mixture of couples, those mandated by DHR and Drug Court, I decided on using facilitating a group discussion on “Men: Inside and Out: A House Divided.” The activity consists of the facilitator (me) explaining to the group that we are composed of selves we show the public/others, which is the outer self, and the self-one might keep from others (i.e., inner selves). The facilitator went on to inform the group that if the inner and outer selves are not in sink, it may be referred to as a house divided. The quote from Abraham Lincoln was used to try to help the group understand the concept, which is “A house divided against itself cannot stand.” Pictures were given to group members. One was represented the outer self and the other was for the inner self. They were able to connect the outer self/house with images they create through their behaviors, possessions, clothes, and relationships. Some were able to describe how they dressed, wear fancy jewelry, and act a certain way to please others, while the inner self (thoughts, feelings, values, and beliefs) was totally different from what others were seeing. At the onset the group had challenges connecting the dots regarding the inner self; however, I used examples of my inner self (i.e. contentment, inner peace, spirituality…, and independence). They were then able to understand and make the connection that in order to stay clean and sober they must get rid of the outer images that may put them at risk, and keep positive inner images that will aid in keeping them sober. Wow, what a great group!
My response:
Good afternoon Patricia
So I do love the fact that we do daily readings and then get to talk about those readings it helps to really get everyone’s insight of what they think the reading means to them. Also being able to mediate always is a great thing to do because it just helps to get mentally ready to talk about deep thoughts and feelings and get more grounded for the rest of the day. Then we do talk about the deep detail of thoughts that the clients are going through and it is suggestions are given and peers provide there own insight as well. Then I get to write the notes for the day which is so much fun and each and every time I do it I get so much better at it. And then if needed they ask me to do an individual session with one of the clients that may need a session for the day. After that then it is always a fun activity to get the mood to a more chill mood and ready for the afternoon. It is a super great site and I am learning a lot everyday and do feel confident in doing individual sessions which is great. I would like my supervisor to sit in more with the individual sessions to see if I am doing well so that I can get a bit more confidence in what I am doing. It is nice to given the correct teaching advice as well.
My response:
Good afternoon Lauren,
DQ#2: Good documentation skills make life easier for clinicians. What challenges have you faced in writing progress notes, treatment plans, and conducting intake assessments?
It makes it easier for me because I have a clinical background, so I am used to doing assessments, progress notes and care plans, etc. However, working in a group home is a lot different than work in a facility when you have the entire disciplinary team at your finger tips. What is different and challegening is not have a computer to access notes to review from the Social Worker, Psych etc. everything is still on paper in the group home that I work at. There are at least one group home that won’t even give you access to a clients chart. Frustrating to say the least. I have worked in the healthcare field for a long time and I must say I never ran into any issues like that, but I keep pressing forward and able to get the most of the information I need. I also find it difficult to write notes sometimes when a client is difficult to understand, the double listening ears have to be on. I do not get discouraged because when I go back to these group homes these clients are willing to chat with me even if it is for a few moments, I can get a pretty good assessment of how they are doing or not doing, and the staff usually can fill me in.
My response:
Good afternoon Catherine:
Re: Topic 7 DQ 2
I feel the issues I am currently having with progress notes, intake assessments and treatment plans are the verbiage I am using. I am so use to writing notes from a case manager perspective and now I am needing to use more clinical terms in a therapist point of view and not a case manager. I also struggled with the system they are using (clinical tracker) this is not user friendly and has taken me over a month to get this system down. The good thing is that I am determined and know the importance of needing to learn to do this correctly so I am not letting this get me down and I just keep on asking for assistance when needed.
My response:
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