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Re: Topic 4 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 at your practicum site? Describe them. Did you enjoy them? What did you like the most? Least? Will you change something in your process for next week? If yes, what will you change?
Thus far, during my Pre-Practicum experience, I encountered a variety of different situations, both direct and indirect client. However, to be more direct, there are different activities the therapist use when during the group sessions. On Tuesday during the morning group, the therapist (intern) and I facilitated a group consisting of music therapy. The session was on feeling, and we used music therapy in order for the clients to see if they connect or not with the music played. For example, some related the song to losing their significant others. It was interesting to see none related the song to not using substances any longer. There were those that said certain songs made them sad or happy.
I thoroughly enjoyed this exercise. What I liked most was that the clients’ open up about their relationships with family, significant others, and friends, and how substance use has caused them to loss their wives, husbands, children and other things in their lives. There was nothing that was my least favorite during this session. We laughed a lot and consoled those that cried. There is nothing that I would change about the group session. Though I believe in prayer and meditation, for clients’ in early recovery music can touch ones soul and can heal.
My response:
Good afternoon Patricia
I participated in a group with my preceptor and the subject was why we drank. We got into an indepth conversation regarding why individuals drink, we had a handout that provided multiple reasons why people drink and on reason that stood out to a couple of clients was we drink to cope with life and invite death. That was a pretty powerful statement. As a Registered Dietitian I deal with individuals everyday in the acute care setting that have severe medical issues because of the prolonged alcohol use. As I asked a few questions to the clients, I was able to have an honest conversation and an anatomy and physiology lesson with the clients. The engagement in conversation was amazing, at the end of the discussion a few individuals had a commitment level from abstaining for alcohol was a 10. What was hard was to see the pain in their eyes, silence at times and how broken they are; but they engaged in conversation when I spoke about how alcohol destroys your body and we started taking about healthy changes.
Next week going to revisit why we drank and discuss some nutrition and how to deal with some of the cravings when withdrawing from alcohol.
Individual counseling has been challenging with the clients who have schizophrenia, sometimes they will speak to you and sometimes not. Next week, I have an individual who spoke to me about fear and I have been working on some ways to combat the fear this client is feeling. I discussed it with my preceptor and it is a go. I am hoping the client will be open to speak to me next week. I never know what I am going to be facing until I get there depending on the atmosphere I may have to do a little tweeking in my approach other than that I am right where I am suppose to be.
My response:
Good afternoon Catherine
Topic 4 DQ 2: What is the overall structure of the site in which you are completing your practicum? Describe it. What type of funding streams does your site have (i.e., how do they bill or how are they paid)? Describe them. How has the funding source affected the clients at your site?
The center where I am currently working at is funding through not-for-profit agencies and funding from the state and government. The demographics consists of low income familes and youths that were required by the state in enroll into the program due to events that put the in the juvenile misdemeanor or felonies that were committed when they were under the age of 18 years old. The state and government is very watchful over the program because in order to keep certain programs up and running, their must be full participation from the clients which doesn’t always happen as planned. Because during the summer months, youths don’t like to come to the facility for various reasons, mostly it’s summertime and they’d rather be doing other things but talking to their therapists. The clinicians try to explain to the clients that they need to abide by the rules because if no one comes to the facility then the government will think that the programs are no longer needed and they will get cancelled. I was told by the director of the program to which I am working under, that they have got to think of ways and other funding sources to keep things available at the facility, or they are in jeopardy of losing all the funding that’s left.
My response:
Good afternoon Tarmera
Class,
The site I work at is an outpatient private practice. We have an IOP type program in which stands for Intensive Outpatient Program. When a new client starts they first meet with the Dr. After the Dr. has spoken with them they then get scheduled for an assessment and then begin IOP services the very next day whether it be morning or night group. When a client is in IOP they are to attend 24 sessions in which is set up as 3x 3 hour sessions weekly. They also have to attend an individual session weekly as well with a counselor here unless they are already attending therapy on their own within another location. Once a client has completed their 24 sessions of IOP, they then step down to OP in which they will only need to attend once weekly. The amount of sessions required for OP varies from client to client determined by their counselor.
Regarding insurance, I am actually the case manager for my practice and communicate with all the insurance companies regarding insurance authorizations and approvals. I have a tracker that I keep that has every active client within our practice in which annotates which insurance company they have, when their authorization was sent out, how many approved sessions they have and the date that they expire on. Once a client completes their assessment, I then send an authorization out to their insurance company. The authorization includes their initial appointment with the doctor, their biopsych as well as their treatment plan. Most insurance companies will approve 24 sessions right off the bat with exception of Blue Cross/Blue Shield, they will only approve ten sessions at a time for whatever reason. The insurance companies that we take are Cigna, Blue Cross/Blue Shield, HPN, Sierra Health and Life, Medicaid and we are currently in works with establishing a contract with the VA.
Center for Addiction Medicine (2019). Addiction Help Retrieved from: https://addictionhelp.com
My response:
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