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December 18, 2013

Written Critique of Mock Counseling Session

In counseling Linda, I took the perspective of cognitive behavioral therapy, which is done one to one, and this enabled me to be more focused on what to expect and what she was to expect from me. An integral part of this counseling was in using Gerald Egan’s soler, where non-verbal process of listening was essential. This was an essential therapy session since it was the first I heard, a mock session. Everything I did was with conscious effort to ensure that I did the best I could in order to lend my help. For this, I relied on Egan’s model to be able to set my goals as a counselor and determine how I would approach the counseling sessions. During the first session, I basically determined to gather as much information as I could about Linda, and decided that the most important concern we needed to work on was her communication with her husband. This was not a one-sided decision, but something that we did together, with me as the counselor and Linda as my client. An important question at this stage was what her past and current emotional health had been like, and how she had communicated with her husband prior to his sister’s financial needs. I determined to know the most I could about Linda so that I could get a proper understanding of her issues. Even though I considerably felt that these sessions would be of help, I also asked Linda if she would consider other modes of treatment as beneficial if the communication issues were depressing her. Would she consider medication, for instance? However, I knew that the 45-minute session was not enough for a proper understanding of her situation and, therefore, determined not to be presumptuous. For this session, the best course of action was to follow the Egan’s model (2009).

Establishing a Proper Working Relationship: The Reflective Practice

The first thing, with regards to Gerald Egan’s soler, was to sit squarely while with Linda in a manner that prevented me from any possibility of staring. It enabled us both to be comfortable. This entire write up shows my reflective practice on the way in which I interpreted the session. However, this was also a chance for me to allow Linda the opportunity to ask me any questions regarding the process. I wanted for Linda to decide herself if I was a proper match for the session. My approach was open for Linda to ask questions, and also she determined whether this therapy was appropriate for her. During the first few minutes, we went through the goals of treatment and decided on the length of the session, and whether there would be a need for other therapy sessions. Linda was confided that she wanted me for her therapist, and now that we were a good fit, she was ready to get the most out of this cognitive behavioral therapy. This was in fulfillment of Egan’s first step in goal setting (Egan, 2009). In this step, client and counselor go ahead and establish a proper working relationship that is defined by respect, empathy and genuineness.

The Interpersonal Skills for Effective Communication: Self-Assessment
Gerald Egan stresses on the importance of posture for the counselor, and adds that this could make them appear defensive if they, for instance, crossed their legs or arms. This is important in establishing interpersonal communication. Exploring the interpersonal skills gave me the chance to self-assess. The people that were subjects of discussion included the husband and his sister, and for this reason Linda thought that it was important to be assured of her confidentiality. It was important for me as a counselor to respect the feelings of my client and convince her that she did not need to worry about information leak. From the Egan’s model, I learned that success in any season would be achieved if I listened actively. For this session, I ensured that I kept up some non-verbal prompts as well as encouraged. Where necessary, I also used a variety of verbal prompts such as “I see,” “sure,” “I hear you” as well as paraphrasing some issues when I felt some clarity or emphasis was needed. Sometimes I felt it necessary to understand why Linda found it difficult to get along with her husband, and since I did not want to be direct, I used some open-ended questions that probed and summarized. Throughout the interview, I asked Linda specific questions as well as and empathized by naming the thoughts and experiences that I thought were part of her problem.

As a counselor, I have an opening for breaking confidentiality on a number of situations. Linda simply had communication problems with her husband that were caused by the financial difficulties of her husband’s sister, but it was not so extreme for her to threaten suicide or harm of others. Though the issue had become sour between the two, Linda still maintains that she could not think of harm either to her husband or his sister. After all, she was willing to talk, and there was no threat to any of the others involved.

Assessment of Strength during the Cognitive Behavioral Therapy
As this was my first counseling session, I felt that it was important to be forthright with Linda. By following Gerald Egan’s soler, I was able to lean closer to Linda so that she would know that as her counselor, all she said meant something to me. I needed her to be able to speak out her thoughts and express her feelings as well as analyze what may have been troubling her. I wanted her to explain the communication issues with her husband and how she felt about his sister in her own words. However, I am usually a little impatient, that is why I found myself feeling like pushing Linda forward to speak out due to the time constraints. According to Holm-Hadulla, Hofman and Sperth (2011), this is supposed to be a natural process through which the client should open up and talk about their feelings when they are ready to speak. Confidence and comfort can come from both ends as the counselor and the client can support each other. Since this was a cognitive behavioral therapy, the focus was on the singular problem of communication between Linda and her husband, and to move towards a solution we adopted a goal-oriented strategy (Holm-Hadulla et al., 2011). Linda assured me that this has been no just a ‘talk’ session, but an event during which she would learn some life lessons that she would be able to apply. Throughout the session, I was keen to maintain eye contact with Linda as this also helped to keep her relaxed knowing that I was paying full attention.

Empirically Backup for Cognitive Behavioral Therapy
Many researchers have conducted some enormous amount of deep empirical research that backs up the Cognitive Behavioral Therapy as one of the preferred treatment methods. In conducting my research to treat Linda, I read the Handbook of Cognitive-Behavioral Therapies by Keith S. Dobson and a number of published articles that included Andrew C. Butler’s “The empirical status for cognitive-behavioral therapy: The review of meta-analyses.”

Appropriateness of Perspective is chosen
I find cognitive behavioral therapy appropriate because as a form of psychotherapy, it has been effective in the treatment of a number of psychiatric conditions including anxiety, depression, fears as well as obsessions. CBT is effective as medication from mild to severe illnesses, and can work both in the short- and in the long-run. It is especially appropriate in this case because it can maintain the client’s (Linda’s) gains and the risk of recurrence of relapse is reduced.

In integrating the theory to my discussion, I realize that Linda’s central problems stem from her thinking, and perspectives about the situation at hand. This is one more reason why CBT has been chosen for this counseling session, where it is hoped that there will be a modification of the negative and the distorted patterns of thought to some that are more realistic and adaptive. According to CBT, the negative patterns of thought often contribute as well as maintain the unhealthy behavior and emotional distress. It is possible that the client in this case may be suffering from anxiety conditions and depression, especially obsessive-compulsion disorder that strains her communication with her husband.

Gottman Method Couples Therapy
An alternative to CBT for this counseling session, aspects of which were sparingly used, is the Gottman Method Couples Therapy. This is a therapy designed to help married couples to break through certain barriers and achieve connection, understanding as well as intimacy in the manner in which they relate. This is a relationship therapy that is goal-oriented, structured, as well as scientifically-based. The intervention strategies were based on empirical data that was gained by Dr. Gottman after researching 3000 couples. Couples that undergo this relationship therapy are expected to attain some increased affection, closeness and respect. It is also expected that there will be a greater understanding between couples and that discussion of conflict will be calm.<…>

Skills that Demonstrate Empathy
Throughout the counseling session, it was essential for me to show Linda that I was present in both body and mind, and I acknowledged her presence both verbally and non-verbally. Being attentive gave me the chance to respond to the basic verbal messages when she spoke about her communication problem with her husband. However, it was only during the appropriate moments that I felt that it was necessary to ask questions and this was done in a supportive manner that allowed for clarity. As earlier stated, though, there have been certain gaps in my practice that I noted needed some advancement, and this included interpretation of her feelings, meanings and desires without being indulgent. Though I tried to synthesize and bring together her experiences, at times I felt that I could not provide a very clear focus.

The Expected Results and Effective Writing Style
In “The philosophical challenges within counseling psychology,” Matt Shorrock (2011) states that even where the Egan Model has been applied, it is not to be expected that cognitive behavioral therapy would cure one’s condition. Even the case of a person like Linda who has the unpleasant condition of dysfunctional communication with her husband it does not mean it would not go away automatically. For a successful encounter with a counselor like me, a client would be advised to approach the issue of therapy simply as some form of partnership that is mutually beneficial. For the client, it is essential that they both are honest and open throughout the talk sessions. When it gets to the level of treatment, my advice for a client who is intent on achieving success in therapy is that he/she must stick to their treatment plan.

Application of such psychological approaches as the Egan’s model is crucial in helping clients walk through issues and find some practical solutions. However, the relationship between the counselor and the client must remain as a partnership where each relies on the other for the purposes of achieving success and important mileage in solving issues. It would be inappropriate for the client to expect instant results, and even worse for the counselor to create such an impression. In the case of my client, for instance, the time was limited and the issues involved were emotional, which meant that no instant solution would be formidable. If there are discrepancies during the process, it is also important that the two speak about them.

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