Respond by offering additional insights or alternative perspectives on their diagnosis or provide alternate next questions and why you selected those.
NOTE( Positive Comment)
Areas that Were Done Well by the Practitioner
The practitioner started the session in an outstanding way by notifying the client that he has a confidentiality and privacy right and promised the client that every information discussed will be between both of them but can only be released with informed consent (American Psychological Association, 2013). The practitioner also notified that client that the confidentiality agreement can only be broken if he is likely to hurt himself or others. It was observed that the provider kept an eye contact with the client while the interview was going on which is a good communication strategy during counseling.
Initially, the client would not open up, but the practitioner had a great skill that retrieved the needed answers from the client. He specifically occupied the client with questions concerning what he loves doing when he is not in school and also regarding school life. The practitioner gave the client the opportunity to verbalize how he feels about his anger problems. The practitioner joked about teenagers not liking to communicate much with their mothers which the client agreed to and it enhanced the bond between both client and practitioner. The practitioner summed up the client’s issue as needing someone with a listening ear and not nagging at him to take their advice. This proves that the client and the practitioner were both focused on one another during the interview session ((Sadock, Sadock & Ruiz, 2014).
Areas Which Need Improvement
The practitioner did not introduce himself to the client formally at the beginning of the session or describe what he was about to do. Clients generally feel safe and easily opens up if they know what who they are talking to. Avoiding negative statements during an interview such as “that must have been kind of confusing” is important. Such statements could make some clients uncomfortable instead of empathizing with them and it can also increase their anger issues (YMH Boston, 2013). Negative statements can lead to the client displaying negative attitude mostly when it has to do with his mother whom the client already have anger issues with (Sadock, Sadock & Ruiz, 2014). The sitting position of the provider with one leg crossed on top of the other was not professional. Siting upright and leaning forward towards the client reveals that he is very interested on what the client is about to say.
The client verbalized that he comfortably talks about how he feels with his coach and a girlfriend. Although it is common with some teenagers, it is concerning that he cannot relate with any family member or close friend. The client made it clear that he hates when his mother nags at him to discuss things which he would not want to and it is viewed as a family and developmental issue. Adolescents deals with physical and psychological metamorphosis as well as trying to be independent, make impression on parents, and these issues could influence his emotions and conflict leading to his anger (Wheeler, 2014). It is obvious that not liking school could be the main trigger of his anger.
Next Question and Why
The next question would be finding out if the client has ever thought or planned hurting himself or anyone else since he is still faced with what he hates doing which is school and facing mum daily. Finding out if the client has used any substance in the past or currently is another important question. Substance use is one of the occurrences that changes the behavior of teenagers in their environment. My last question will be to find out why he did not like school. He could have been going through some academic challenges, feeling swamped, or oppressed in school which could lead to feelings of depression, suicide and or anxiety (Sadock, Sadock & Ruiz, 2014).
American Psychological Association. (2013). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060–1073.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Wolters Kluwer.
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). Springer Publishing Company.
YMH Boston. (2013, May 22). Vignette 4 – Introductions to a mental health assessment [Video file]. https://www.youtube.com/watch?v=JCJOXQa9wcE
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