Practicum – Client Termination Summary

Practicum – Client Termination Summary

Presenting Problem

The client is a 22 year-old white American woman. She is currently in her final year of university and lives with her boyfriend. She is also a part time worker in her family’s company. She presents to the clinic seeking help in dealing with expression problems and feelings of social discomfort associated with social withdrawal. She says that her condition is limiting her academic, social and occupational productivity. She is afraid of failing in her academics which would affect her professional and personal development. As such, she occasionally experiences intense panic attacks and anxiety. The client’s family objected her living with the boyfriend before getting married officially which they termed as going against the cultural beliefs of the family. Failure to meet the expectations of her family also gave her anxiety, insomnia and panic. This was her first professional psychotherapy consultation. Practicum – Client Termination Summary

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Major Psychosocial Issues

The client suffers from serious insomnia as discovered during the progress of the therapy. Her sleeping patterns demonstrated abnormalities with regard to sleeping time and sleep maintenance. She is also depressed by the death of her mother which took place at the early stages of the treatment. This caused constant grief and mourning which demanded the application of coping and relaxation interventions.

Types of services rendered: Individual

Overview of the Treatment Process

The treatment process began on October 6th, 2010 and was set to officially end on December 28th, 2012. The sessions were conducted once in a week. The client was provided with supportive-dynamic psychotherapy which helped in understanding her situation and developing the best possible approaches to resolve them (Dunlop, 2016). This was also combined with the cognitive behavioral therapy that entailed changes in behaviors thoughts and emotions of individuals with the aim of improving her outcome and quality of life. A good rapport was created between the psychiatrist and the client after the discovery that she experienced difficulties in opening up about her situation, thoughts, needs and emotions. However, the above interventions assisted in the treatment of her insomnia, social withdrawal, panic attacks as well as management of her fears and expression. Afterwards, the client was granted a psychological space that supported her opening up to clearly articulate insights concerning her feelings and desires.

Creation of awareness formed the foundation of the client’s therapy. She learnt of her problems, identified probable triggers in her environment, accepted the need for help and learnt the coping mechanisms. She learnt how to handle social interactions including relations with her boyfriend, her family as well as her colleagues at work and in school. This created a sense of responsibility in her that influenced independent thinking which consequently supported the development of positive relationships.

The following sessions sought to address the emotional autonomy and the mental independence of the client. This helped the client to separate her personal beliefs, desires and aspirations from the traditions and family influences (Carkhuff, 2017). This sought to improve her decision making, improve her emotional stability and be able to pursue personal goals with minimal interferences from other parties. From this session, it was evident that the client focused her attention on satisfying the needs of her family at the expense of her own. The decision to move out of her home to live with her boyfriend was the main cause of insomnia, anxiety and panic attacks since her family did not approve of it. Psychoeducation and relaxation techniques were employed in managing these mental disturbances (Dunlop, 2016). Self-care techniques were also employed in coping with the loss of her mother with whom she was largely attached. With time, she was able to talk about her mother without feeling sad anymore. She also demonstrated normal sleep patterns from sleep hygiene interventions. Practicum – Client Termination Summary

Nature of Termination

The client has shown tremendous improvement since the beginning of the treatment. The therapy was terminated following her financial constrains associated with increased responsibilities from school and at home. The client reports that her incoming wedding preparations could also affect her financial capabilities to compensate for the remaining sessions. She also reports that engaging in multiple activities will limit her adherence to session time and feels that she has recovered sufficiently enough to act independently. She appreciates the positive progress and the transformation she has had during the treatment and is grateful for the collaborative efforts that have improved the quality of her life. The session was set to officially end on December 28th, 2012. In spite of the early termination, the client availed herself for the final planned session whereby she expressed her appreciation for the improvement of the quality of her life. She was also grateful for the services and bid her farewell.

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Goal Status

The major goal of the psychotherapy was to manage the key psychological issues affecting the client. During the course of therapy, the client made significant improvement and was satisfied with the kind of progress she was making towards expressing herself, socializing, sharing experiences, needs feelings and thoughts regarding her problems. She reports to have gained social skills and thus has been able to engage in group discussions at school, at work and at home. Moreover, the client has gained self-care skills and understood the need to put her personal dreams before the expectations of her family and other people dictating her lifestyle. She has also learnt coping and relaxation techniques related to depression, stress and sadness associated with the death of a loved one. Consequently, she reports to have improved her academic and career performance which has made her recognize her full potentials and pursue them effectively. Her sleep patterns have significantly improved to normal and thus, she reported the completely recovered from withdrawal, social discomforts, panic attacks and insomnia .her self-confidence and esteem has also increased over time. Practicum – Client Termination Summary

Treatment Limitations

The psychotherapy did not address the underlying cultural identity dilemma held by the client effectively.  However, it tried to examine and perceive the matter in an open-minded and culturally sensitive approach (Baruth & Manning, 2016).

Remaining Difficulties and/or Concerns

No significant remaining difficulties /or concerns are expressed by the client. As at the completion of the treatment course, no remaining difficulties or concerns were observed.

Recommendations

The client could benefit from progressive analytical/ exploratory psychodynamic therapy. This will assist in the optimization of psychological wellbeing, achievement of therapy goals and improvement of overall recovery as well as prevention of relapses. Practicum – Client Termination Summary

Follow-up plan

There is no specific follow-up that was indicated for the client.

Instructions for Future Contact

The client was given the counsellors contacts to facilitate consultation.

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Counselor’s Signature                                                             Date

 

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Supervisor’s Signature                                                            Date

 References

Baruth, L. G., & Manning, M. L. (2016). Multicultural counseling and psychotherapy. Taylor & Francis.

Carkhuff, R. (2017). Toward effective counseling and psychotherapy: Training and practice. Routledge.

Dunlop, B. W. (2016). Evidence-based applications of combination psychotherapy and pharmacotherapy for depression. Focus14(2), 156-173. Practicum – Client Termination Summary

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