Reflective case study in counselling

Reflective case study in counsellingPart I Case Assessment ReportNew Territories West incorporated Family Services CentreCase Assessment ReportA. Basic Case InformationName of Client madam CHANSex/ Age of Client F/36Name of Worker Dada WongNature of case CounselingB. Presenting Problem lady CHAN reported that she has been suffering from low mood, exhalation of appetite, headaches and insomnia for eitherplace a month. She had also lost motivation in doing household chores and would cry sometimes without designers.C. Social History1. Genogram2. Family backgroundCase client, bird CHAN, moved from Mainland China to Hong Kong 5 years ago. She married with her husband, Mr. lee side, in Mainland China. They have one son, two daughters in total, and living together. Son is 12 years old, will become F. 1 educatee in secondary school, and daughters are 8 years old and 3 months respectively. Madam Chan got pregnancy last year and Mr. Lee suggested Madam Chan to have spontaneous abortio n just now she refused. She insisted to give birth of the youngest daughter because she thinks it belongs to her. She expressed husband does non put much criminal maintenances, include physical and financial, on the youngest daughter. Madam CHAN reported their married relationship was fine when lived in Mainland China, but conflicts increase when move to Hong Kong. Client complains Mr. lee side sends most of his income for his parents in Mainland China and does not give much currency for their family. They have arguments about this issue always. 3. Emotional conditionMadam CHAN suffers from low mood, loss of appetite for over a month. She reported sometimes would cry without reasons and loss of motivation in doing housework at home. Emotional unstable when talking about her situation, she cried twice during the focus process.4. Health conditionClient expresses loss of appetite, headaches and insomnia for over a month. She aspects tired and lack of energy when at home, but no problem at working.5. Financial conditionMadam CHAN now works as a part-time waitress in restaurant, and responsible for taking orders and delivering dishes to customers. She earns nigh $5000 per month. Mr. LEE is an air-conditioner technician, earning around $12000 per month. Madam CHAN reports Mr. LEE does not contribute much income on own family, around $3000 per month, but gives most of money to his parents in Mainland China. She reported that most of the expenditures of family are supported by her own.6. Supportive networkMadam CHAN pays around $1000 each month for her younger tyke to take care the vitiate when she goes to work. She expressed the money also viewed as a help to sisters family. Client mentioned that her younger sister and brother have their own financial difficulties, therefore, she also needs to take the responsibility of parents financial supporting. Madam CHAN verbalize she only visited for her parents two times after move to Hong Kong in five recent year s.D. Case Analysis1. Underlying problemBased on the information collected from counseling Madam CHAN, it is believed that her headaches and insomnia symptoms are closely related to the stress on family financial situation.Madam CHAN expressed worries of limited income from being part-time waitress, whitethorn not be sufficient for supporting the expenditure of whole family. She complained Mr. LEE giving most of the salaries for his parents in Mainland China but little for family expenditures and children. They argued for this issue many an(prenominal) times after Madam CHAN moved from Mainland China to Hong Kong. She believes that family financial situation would be improved if Mr. LEE willing to share more monthly income to their family. She well-tried to ask for more financial supports from Mr. LEE but failed, and thought equivalent begging from him. She feels angry about that and gives up trying anymore. For this reason, she believes she cannot reply on her husband. In additio n, client complained Mr. LEE ignores the responsibilities of taking care of the children, especially the new born baby.On the other hand, based on the information got from Mr. LEE during interview, the third child is not he expected and wished. He believed the third child is a real burden on family financial aspect. He expressed the major reason of argument with Madam Chan is money diffusion.2. AssessmentCounseling done. From the interviews, Madam CHAN presented the concern about the financial problem of family. She cried twice when talking about the issue of Mr. LEE sends most of the salaries to his family in Mainland China. She said, Maybe our children are less valued than his family. That shows her anger about Mr. LEE behavior toward money distribution. She has expressed her worries about the maintenance of family income as one more child at home nowadays, expenses increase. She reported that feeling lack of energy when at home, suffering from low mood, headaches and insomnia f or over a month, however, does not have these problems when working. It is believed that her physical innervation symptoms like headaches and insomnia are due to the pressure and worries about family financial situation.From the interview with Mr. LEE, he expressed the new born baby is unplanned. He believes family situation in general would be better if without the third child. Mr. LEE expressed he has the money saving plan for children before, likes saving for their future tense study. That shows Mr. LEE willing to plan about the future of family. However, the new born makes the plan collapsed. He suggested Madam CHAN to have abortion but she insisted to preserve the baby. He was angry about that. Mr. LEE stated that Madam CHAN always ask for more money during the conversation. He has implied the new born may not belongs to him during the interview, but he did not explain further on this point.3. InterventionIt is believed that the emotional problem of Madam CHAN may due to the stresses on worrying about not able to take care of the children and maintain the family income at the same time. According to the information got from interview, cognitive Behavior Therapy (CBT) Approach would be appropriate to adopt in the intervention. CBT addresses the interactions between how we think, feel and behave (Somers, 2007). It believes that the peoples feelings, emotions, thoughts are the responses to the outside world. Therefore, ones behaviors could be varietyd from changing their perception and cognition of the situation from the process of therapy (Somers, 2007). According to third house Iqbal (2010), CBT could reduce the stress and anxiety level, and the related symptoms would be relieved when go through the therapy or treatment. CBT states that behaviours could be changed by changing perception. Therefore, the stress related symptoms of Madam CHAN, such as headaches and feeling lack of energy, are expected be addressed if using CBT approach.E. Recommendatio n for Follow-upI would like to refer Madam CHAN for psychiatric consultation, to have medication treatments. It is necessary to relieve the physical discomfort of client immediately. Referral for psychiatric consultation was sent out.After addressing the problem of physical discomfort syndromes, it is recommend Madam CHAN to join education group about stress management in centre after having individual counseling, in order to describe the skill of handle stress in life.Counseling services in centre for Madam Chan keeps on for monitoring. CBT approach would be used on changing her perception about worrying the financial difficulties.For long term goal, joint interview and counseling of Madam CHAN and Mr. LEE is suggested for them. As both of Madam CHAN and Mr. LEE have plans on family future, thus, the joint interview would focus on encourage effective communication between each other, to discuss how to do the better distribution of family income.Signed by Intake Worker _________Sig ned by Supervisor _________Date _________ Date _________ReferenceHall, K. Iqbal, F. (2010). The Problem with Cognitive Behavior Therapy. London Karnac Book Company.Somers, J. (2007). Cognitive Behavioural Therapy Core information document. Vancouver Centre for Applied Research in Mental Health and Addiction, Simon Fraser University. .Part II Self-evaluationFrom the role-play practice, it was a good experience for me to feel the dynamic between worker and client. Within the practice, several communication and counseling skills have been used.Several basic communication skills have been used in the counseling practice, such as Questioning, Reflection of feeling, and Paraphrasing and Clarifying. During the counseling process, open and closed also have been used. For the closed dubiety, such as Have you discussed with your wife about the income distribution of family?, in order to know whether Mr. LEE and Madam Chan ever talked about the core problem. As Mr. LEE answer No, and followi ng an open question of Why? to Mr. LEE, in order to know the reason and the dynamic between them. In addition, Reflection of feeling can let me to know the exact feelings of clients, to order the feeling of disappointment or angry with Mr. LEE. The skill of Paraphrasing and Clarifying also help me to clarifying the meaning of Mr. LEE as he implied some wordings like he doubted about the baby is not belongs to him. I think it is important to clarify from him as it might be another core family issue in this case.Empathy is also one of the important elements has been used during the counseling process because it can let me to engage with Madam CHAN. Once she feels I am a person who could understand her feelings, she becomes more willing to talk and share with me about real difficulties she is facing. Therefore, empathy is one of the core elements within the intervention process.On the other hand, I had do a mistake in the intervention. I presumed the client emotion and attitude woul d be gradually better after each session. I anticipate Madam CHAN would turn to understand and appreciate Mr. LEE who has planned about their family future in last session. Therefore, I prepared a lot of suggestions based on Madam CHAN who is ready for consensus with Mr. LEE. However, my expectation failed. Madam CHAN does not want to agree with Mr. LEE, my suggestions were not suitable for client and seems I was not able to engage with her. It may due to I ignored the factors that they may have dynamic interaction during the week between sessions. From this mistake, I have learned that, as a worker, we should not presume the behavior and attitude of client. We could not include all the factors outside the intervention session. Also, behaviors are changeable. It was a good opportunity for me to learn, worker should prepare for changes every momentGenerally, I have urged client to change her mind and perception and ignore the emotional needs of client. As I would like to use CBT to b e my intervention approach, to make client believes that the situation is not really bad and would like her to understand that Mr. LEE also planned for family future, I hope to change her mind as soon as possible. Thus, I may ignore the emotion needs of client, such as addressing her anger about feeling insensitive of Mr. LEE. From this role-play, I have learned that, do not only focus on the intervention process but also need to cater and care about the feelings and emotions of client. It was a good experience for me to prepare the case work in the coming future.1