Stephen Thomas

HS 2850

Professor Irene Diritsky

Practicum Documentation #1

2) The client Christina and myself the intern , along with the I.O.P supervisor are meeting after

a therapeutic group session in the same room as the original I.O.P group session earlier in the

morning. The client Christina has been at our agency since 08/30/21, this is her first time at the

agency. Christina is a single African American female and is 28 years of age. The time of the

specific therapy session is February 2, 2022 at 12:30 pm. The client has been diagnosed with a

Bi-polar disorder, Depression, substance use disorder, and has also been diagnosed with Lupus.

The client is seeking abstinence from her substance use disorder and attempting to get her

mental health needs stabilized. Christine has completed 5 months of treatment at our facility

which is N.O.R.A located at 1400 E.55th st. Cleveland,Ohio. I am the co-facilitator in our I.O.P.

group and our direct supervisor is Jeff Ward.

4) In referencing the goals we discussed with the client, we stressed that medical, recovery, and

mental health needs, along with her S.U.D’s work hand in hand with one another. Nothing in

these areas can afford to be neglected for overall recovery to be successful. Christina said she

understood this fact and that she would work accordingly to meet all of her requirements. I

explained to her we would go over and monitor these items weekly And she said That would be

fine with her.

6) SOLUTION FOCUSSED – The clients problem statement was that “ she has high hopes for

success but can’t stay sober by herself “ I asked a solution focused technique “ what are you

doing for your recovery “ and she stated she gets to the meetings when she can because of her

work demands, and she tries her best to stay around sober people. I suggested she get a sponsor

with knowledge of the 12 steps, and that would help her an that area. Christina said she would

work on that. I told her our next meeting we would go over that and see if we were making

progress in obtaining sponsorship and she said ok. I did add that she would give herself more

options of sponsorship if she attended a couple more meetings this week. And Christina said that

sounded like a good idea.

MOTIVATIONAL INTERVIEWING. – Christina stated that her strengths is that she was logical

in thinking, however she presented in group that she cares about her using friends and can’t

terminate their relationship. “ reflecting back “ so I hear you saying you’re concerned about

keeping your friends which would sabotage your recovery rather than to love them from a

distance. Christina said that might not be a bad idea. I could still love them, but just not hang out

with them. I was just trying to get Christina to use her strengths in logical thinking to figure this

out on her own.

COGNITIVE THERAPY – Christina has an abusive relationship and believes in polygamy vs

monogamy. I began asking Christina in a solution focused technique “ what she could do

different “. Then she replied perhaps she could focus on one relationship at a time. I then went to

cognitive therapy and challenged her core beliefs and aske a couple of questions in the laddering

process, one was did she think it bothered her partner to have multiple relationships and why.

Christina said disease transfer might be a problem, maybe her partner would just like a
monogamist relationship. I used the process of challenging Christina’s core beliefs on

relationships by taking a closer look at her actions.

ALLOW CONSEQUENCES – Christina often misses one therapy class a week and is often

times late when she does come in. I asked Christina if she was aware that successful completion

of the program is that her attendance is necessary and that promptness was vital to completion,

and that she would not have the necessary documentation for the judge when she went back to

court, Christina said she had not looked at it that way and she would do what is necessary to

complete the therapy requested by the courts. I used to “allow for consequences for Christina to

take a closer look at her responsibility to the courts and to take a look at her willingness to

complete the program.

GIVE HOPE APPROPRIATELY- Christina has lofty goals, she had to drop her scheduled bar

exam to her SUDSs, and is missing scheduled medical appointments and her psychiatric

appointments. I explained not following up on all phases of her treatment plan would be a major

deterrent in reaching her goals and becoming an attorney. Christina said she is aware and has

intentions to do better. I did insure her that if she stuck to the treatment plan that she would

perhaps be able to live her long life dream of being an attorney, just follow through one day at a

time.

CHALLENGE – I have to keep my biases non-exsistent, it’s challenging but doable . I must

remain open minded. The issue was addressed by simply putting my biases to the side and focus

on the best interest of the client, and by focusing on the clients strengths we were able to come to

a satisfactory resolution. I don’t focus on telling the client what to do, I allow them to bring it to
their own resolution by using an solution focused therapy. So in all I didn’t have a challenge

because of preparedness and my own self awareness, and focusing on the clients strengths.

SELF EVALUATION – My behavior was quite adequate for all therapeutic conversation and

techniques. I love to challenge core beliefs by using the laddering process, it allows for open

mindedness and the ability to look at it from another perspective. Solution focused therapy is

also a favorite of mine because it allows the client to self reflect and evaluate different area in

their treatment plan. It even allows myself to take a look at different perspectives.

I OBSERVED, I INFERRED, I DID.

I OBSERVED Jeff a client, consistently complaining about the group house that he lives in next

door to our facility.

I INFERRED, I had inferred to this situation because in group therapy recently we were

discussing self awareness and the part that we play in all of our actions.

I DID RESPOND to Jeff that must be a difficult situation living in a house with 12 other men. A

solution based approach had me ask Jeff what he could do differently to resolve some of the

chaos that he described it as, Jeff said could attempt to be part of the solution and not the

problem and not taking sides all the time. I did allow for consequences and asked Jeff what

would eventually happen if someone got into a physical dispute, Jeff said termination of the

program would be the result of that. Asked Jeff to see what he could do different next week in

the house and we would discuss it at the next therapy session.

I OBSERVED – Tia a client being very rude to other clients in our group therapy session,

lashing out at almost everybody for anything.

I INFERRED – our I.O.P. session would not be effective with the constant interruptions and

lashing out by Tia, she said everything is bothering her and she is not trying to hear anything

from anyone.

I DID – I told Tia I was sorry that she was having a bad day, and that we all have those from

time to time and that’s understandable ( empathy ). Tia said thank you and said this new

medication she is on has her feeling very weird. I used A motivational interviewing technique

and asked her “ reflecting back – so I hear you saying your medicine is not working for you

effectively. Tia said maybe she will make an appointment with her physician and see if he can

prescribe something else more effective. Thank you she said, why didn’t I think of that !! I told

her to let me know on our next session what happened at the physicians office and if they were

able to help her, and she said fine.