Clinical Reflections

+ I was more concise. It was difficult. But I stayed calm. I became more aware of my own process. I was able to help the CL open up a little more, explore her thoughts, and articulate them better. (How did you do that?)

Things Learned:

1. Reframing or transforming the stated goal: Keep something (thoughts, feelings, etc.) from happening --> How to deal with it when it does come up?

2. When the CL is more practically oriented, spend less time on meaning making and more on problem solving.

3. Be aware of categorical thinking. Keep in mind of the "both...and..." and thinking in a continuum. It is not about "either A or B." You do not have to minimize/deny a negative event in order to be secure. Minimizing it actually adds more anxiety. Accept it, see it as it is, and move on.

Solution Focused Therapy (SFT) etc - Oct. 26

* Insoo Kim Berg - Solution focused therapy

* Lyman Wynne - Unlikable CLs
- Countertransference factors
- Look for CL's strength
- Separate CLs from their problems
- Think systemically or interactionally;
- Negative feelings as mistaking the intent behind the person's behavior
- Afraid ~ suspicion about the therapist's behavior
- Hurt by a missed empathic opportunity ~ hostile, horny, "resistant"
- What reaction CLs intend to provoke
- What they are really feeling
- In couple therapy, ask the partner what she/he likes about the CL who has evoked your dislike
- Cultivate curiosity

Notes & Thoughts from Case Conference - Oct. 4 & 25

* CL not taking credit for the change and attributing to external circumstances; Try - contrast w/ similar circumstances in the past with different outcomes

* Try - Challenge by pointing out the discrepancy regarding more stress --> less stress?

* Make connections with difficult clients

* The balance and shifting between empathy/support and problem solving for various clients

* Learn to assess the CL's implicit needs and step back when appropriate

* Emphasize the CL's strength and expertise; support and probe

* Appropriate use of silence

* Reflect and know yourself, the personal characteristics, the stimulus value, emotional state of self

Clinical Reflections (from 5/4/07)

I wonder how an enduring attitude toward pain will change my therapeutic process. Instead of focusing on relief and comfort, focus on strengthening, enduring, and growing. Anyway, God is in the business of changing and transforming us.

Clinical Reflections

As I revisited the words in Momma and the Meaning of Life, I realized that there were so many things I could have done differently with J. For example, I could have asked, "What feelings did you take home after the last session?" instead of asking (or "accusing/scolding") about his behavior of asking personal questions. Now I can honestly acknowledge how irritated I was at the time by him. Yet, I was "graveled" as he pointed out. It is unpleasant, uncomfortable, humbling, scary, ... to come to such a realization. Will I ever make a good therapist? Did I help or did I do more disservice, damage, and harm? Enactment with examination and correction. How I need wisdom, insight, self-understanding, ... courage to face the weakness and own it, at the same time, motivation to learn, sponge-like absorption, intentional organization, digestion, and internalization, confidence and strength to persevere!

It is also surprising that how my feelings and assumptions color and shape what I receive, for example, my strong reactions to J.'s intake report, H.'s treatment goal setting. It is shocking to realize how selective and biased my attention and reactions can be. In one case, there was an exaggerating and amplifying effect. For the other, I literally blocked some information off! Be aware. Keep your feelings in check. Think of cucumber to stay cool. :-)

I wonder if this has something to do with my avoidance to start my case study write-up. Fears - what if I did not meet the requirement. I surely have made some mistakes. I guess the question is, if I did pay attention to H.'s stated goal during the intake, how I would have done the therapy differently. To be honest, I am not sure. ...

I will come back to it.