Psychology

The session was conducted on the basis of the principles of Person Centred Therapy, Brief Therapy and Cognitive Behavioural Method of counselling. These methods are highly recommended in counselling. However the approach of this session was eclectic and specific skills and techniques from all methods were used with success in diagnosing the patient and in arriving at suitable goals that would help the patient in resolving her stressors.

I.  The therapy session lasted for twenty minutes, and required the application of various existential and psychodynamic techniques in order to formulate various goals and objectives that would bring positive changes in the behaviour of the patient. The session was brief therefore the identification of the problem and the analysis of possible changes in perception had to be brought in within the restricted time frame.

In contrast from other phenomological therapy techniques which require that the patient comes to a realisation about the incongruence in his own behaviour and either changes his environment or adapts himself to suit the environment. The therapy session was constrained by time and the patient was encouraged to identify the problems in her life which were causing her angst and making her feel frustrated and helpless.

An environment of genuine caring, acceptance and trust was created between the psychologist and   the patient, wherein the patient was able to talk openly and without hesitation about the various stressors in her life. There was a noted difference between the patients sense of self and her self concept, which was causing her confusion and frustration. The client has a tendency of blaming her stressors on her husband and her work environment which are coupled with the stress of the exams that she has to give in a couple of days.

The patient is troubled at the social level and in the I Thou level and fears that she will let her family and loved ones down if she fails the exams. The patient is also afraid that she will be ridiculed at office as everyone knows that she has taken the course. Another complaint that the client has, is that she has taken too much work load on herself as she has to juggle time between her office work, her university studies and domestic work. She  feels that does not have any time to relax and unwind, which is making the stress unbearable for her. Teaching the client relaxation techniques to avoid burnout and identifying the core issues and finding solutions for them was also one of the prime objectives  of the session.

II.       Skills and techniques from various methods were used in order to create this session i.e. techniques were adapted from the person centred therapy, cognitive-behavioural method. Various skills have also been adopted from the brief therapy method. 

Through the use of person centred therapy, focus was given to verbal and non verbal communication and to empathic listening and reflection. Therefore the client was made to realise that the psychologist had unconditional positive regard for the client and her situation was accepted with congruence and empathy (Gerber, 2002, p.10).

The goals and objectives based on the Person Centred Therapy can be described as making the client
Responsible for being different from others and for their own behaviour and self actualising this involves trusting one self and inner authority. Accepting of self and others as unique individuals, valuing self and  not requiring the acceptance of others while realising  that other are not perfect so there is no need to impinge self on others (Gerber, 2002, p.16).

Making the client more responsible for their thoughts, feelings and behaviour, helping the client remove the blockages that they are feeling, to help them make the transition from external to internal support. Helping the client through each impasse, by making them experience their feelings of being stuck and getting in touch with their frustrations (Gerber, 2002, p.13).

The goals of the session with regards to Cognitive Behavioural Methods can be described as Intervention to change the specific manner in which the client thinks and behaves that is sustaining the problem and by providing different rewarding or reinforcing consequences( Nelson-Jones, 2002 ,p.11)

Brief therapy evolved as a time limited psycho-dynamic therapy due to constraints in time and money and the objectives to for the sessions keeping mind the objectives of this method would be
Getting the client to identify the problem, make the client understand the way others perceive the problem, identify attempted and suggested solutions to the problem and help the client understand the situation in terms of self-gain, self preservation and maintenance of integrity and commitment to action (Gerber, 2002, p.6).

The therapy was conducted in two phases, The investigative phase wherein the psychologist focuses on core issues and problems. Recommendations and goals are set for the client that would help them alleviate the core issue(Gerber, 2002, p.13).

III. The skills that were used is this session have been taken from the various methods that were used in conducting this session, also known as an  eclectic approach to therapy. This approach allows the psychologist the freedom to choose from the most appropriate ideas and techniques from a range of theories and models in order to meet the needs of the client(Gerber, 2002, p.4)

Investigative questions were asked using what and how criterions in order to obtain historical data and to assess possible solutions to the problem that the client was experiencing (Gerber, 2002, p.14).Therefore extensive communications skills, awareness-focus skills had to be incorporated into the session.

An active role was taken by me, with suitable intervention strategies that were used to guide the patient from the identification of the issue to the changes in attitude, behaviour and perception which are required to achieve the goals that have been set for the patient to resolve the issue. Therefore the identifiable skills are creative problem solving skills, analytical skills and proactive guiding skills, to direct the patient through the various stages of the session.

Teaching and educating skills based on the cognitive behavioural method were also used , in order to modify the patients behaviour or wrong information processing pattern. Therefore this method requires that the psychologist has to give suitable knowledge and skills to the client regarding burnout issues and possible remedies (Nelson-Jones, 2002). It must also be remembered that empathetic understanding and congruence are two skills that formed  the very backbone of this session (Tolan, 2003)

IV.   
a. Relationship skills I was able to reassure the patient, who was very apprehensive that most people felt uncomfortable at the beginning of their therapy and was able to convince her that I regarded her with genuine concern for her well being. My relationship with the client was built though out the session by reaffirming what the client was saying in a few sentences. My role was participatory and active as I gave my inputs to the client as we both discussed possible solutions to her concerns.
b. Congruence Skills I was able to develop congruence with my client at the very onset of the session by making her feel comfortable and by asking her to talk about the first thing that came into her mind. I also gave my honest opinions and encouraged her to open up through empathetic communication skills (Tolan, 2003)

c. Intervention skills I used suitable intervention strategies to guide the session through the various sessions of the therapy. I began the investigative phase of the therapy by asking the client to describe the issues that she was facing in her life and the work that she was juggling.

Once the core issue had been identified as  stress and possible burnout ,as well as ,  fear for social standing and acceptance. The patient was guided to the next level by analysing the possible solutions to stress management which included taking out time for her to relax and enjoy herself, by making her take onus for her decisions and not fear the consequence of failure on her social standing and acceptance.

d. Empathy The client was encouraged to talk about her issues by convincing her that she had an interested audience through verbal encouragement and non verbal gestures through out the session (Tolan, 2003).I was also prove to the client that she was accepted and held in positive regard because she was able to open up and speak about her feelings and emotions without hesitation.

e. Analytical Skills  I asked the client several open ended questions that would guide the session towards the identification of the core issue, i.e. Is your sense of responsibility influenced by your culture. This led to the realisation that the client felt guilty if she did not fulfil her responsibilities or the expectations of other people. Possible solutions to the problems were considered by asking other open-ended questions to the client.

f. Creative Problem solving skills It was identified that the client was suffering from possible burnout symptom which is a condition, wherein an individual is working under physical and emotional stress for a certain period of time. Possible solutions were discussed with the client and these included taking out time for the client to relax from the stress of work, study and domestic responsibilities. She was also made too look towards the benefits of her work for her future that made the current stressful conditions bearable.

g. Collaborative Training Skills The patient was made to identify the attitudes and behaviours that were maladaptive and was encouraged to make the necessary changes in her lifestyle and attitude that would relieve her from the stress  of her everyday life by asking her relevant questions i.e.  if there was one thing that you could do to relax yourself what would that be (Johns, 2003)

V. I could have given the patient more time to speak towards the end,   but this could not be done as I the session was conducted under constraints of time and I had to guide the patient through the various phases of therapy. I should have given her more knowledge about time management skills by suggesting to the client that You can work up  a time table for yourself and allot each activity a certain period of time  .

I could have also asked her to enlist the help of her husband in completing domestic work as his non contributory attitude has led to the near burnout symptoms of the patient. Though I reassured her that she still had other alternatives available even if she did not pass her exams, I could asked her to prioritise and not be ashamed of asking for help from family and friends to get over this trying period.

VI        I believe that I was able to bring the session to a positive conclusion as we ended the session with the correct diagnosis of the problems and I was able to win the trust and gain congruence with the client.  We were also able to resolve the angst, helplessness that the client was feeling at the beginning of the session. Her attitude and perception under went a marked change and she took responsibility for her choices.

She was effectively guided in the session to focus upon the various problems that she was facing in her life which included the course that she had taken up, the domestic work that she had to do at home, the stress of the job she had taken up and fulfilling the expectations of the various people around her. In the course of the session these problems were effectively identified and I gave suitable relaxation techniques to the client as I diagnosed a possible burnout if the client carried on with her current schedule of work and responsibilities.

She realized that she always had other options available to herself even if she failed her exams, she did not have to fear the judgement of her colleagues at office and she set definite goals for herself .She  has decided to take time out for herself and visit  friends and relieve herself from all the pressure that she is feeling.

I was successful in applying the rules of person centred therapy, brief therapy and cognitive- behavioural counselling methods in this session. It must be noted, that the investigation of the issue and the resolution of the problem was done within the constraints of a limited time-frame.