Week 4 Assignment

For the Week 4 assignment, you will view an intake session between a client and counselor and identify possible initial intake assessment strategies based on current literature. You will also identify a possible theoretical framework that will be appropriate for working with this client.

More specifically, describe the type of initial intake assessment methods you would use for the first two counseling sessions (examples include structured or unstructured interview, behavior observations, and depression/anxiety rating scale). Consider the types of questions you would ask or background information you would want to know about the client portrayed in the video. You can also discuss the type of assessment tool or tools you might use with the client, but this is optional. Make sure you address initial intake “assessment” broadly based on the information from the text as well as the media segment. In addition, identify a theoretical framework and/or evidence-based treatment that is appropriate for working with this client.

After watching the Clinical Case Study of John video provided below, complete the following:

Introduction (1 paragraph).
Brief description of the client (1–2 paragraphs).
Description of a theoretical framework or evidence-based treatment that can be used to work with this client. Be sure to support your conclusions with scholarly sources (2–3 paragraphs).
Overview of an intake assessment process for this client including background information to explore. Include possible initial intake assessment instruments if applicable and detail what additional information you would need to know to continue working with this client. Be sure to support your conclusions with scholarly sources (2–3 paragraphs).
Explanation of the factors to consider when working with a particular population, based on relevant or scholarly sources.
Summary and conclusion (1–2 paragraphs).

 

John’s Clinical Case Study Transcript

Dr. Carl Shire:

Thank you, John, for coming in today. Let us begin by just sharing with me what is going on in your life right now that encouraged you to seek counseling.

John:

Well… it was really my wife's idea for me to come to counseling… but I know I needed to come. I guess I just did not want to feel even worse about my life by coming to a shrink. I always thought I could work out things on my own, but this one has got the best of me.

Dr. Carl Shire:

It sounds like it was a difficult decision to come in, but you are looking forward to working things out.

John:

Yeah. Like I said, I have always handled my problems before, but I am just having the hardest time with it this time. It just seems like my whole world has been turned upside down and… it is all my fault. I have jeopardized my marriage and my job but I cannot seem to figure out why I keep doing the things that I do, and I seem to have no motivation to stop doing them.

Dr. Carl Shire:

Tell me more about how you feel you are jeopardizing your marriage and your job.

John:

Hmmm… Let me see, where to start. It might me easier to tell you how I have not screwed things up. Even thinking about it gets me so frustrated… Well, it started about two months ago when I decided that I did not want to be in the army anymore, and I just felt down about how the world was going. I had a short tour in Iraq, but not in the dangerous parts. But I would just hear these stories of death and war. It just really got me down. I just started doubting everything. Life… everything. That happens sometimes there though. It seems normal.

Dr. Carl Shire:

So what was it like for you when you got home?

John:

Well, I got home about six months ago, and when I came home I… I was okay for a while. I was glad to be home and was so happy to see my wife and son and just – it just felt good to be home.

Dr. Carl Shire:

It sounds like things in your life took a turn?

John:

Yeah… yeah, you could say that. As I said I… I was okay for a while and then I just started loosing motivation to go to work at the base. I was going in late… which… you just do not do in the army. And I just was not getting any work done. My sergeant kept getting on my back but – it does not seem to matter. I just cannot get motivated. And the worst part is – is my sleeping. I just cannot sleep. Well I say I cannot sleep although I spend a lot of time in the bed trying to… that is why my wife started getting tired of me.

Dr. Carl Shire:

It sounds like your life has really been affected by all of this. Your motivation to go to work is low; your boss is noticing; you also said that you are having a lot of trouble getting quality sleep; and your wife is noticing. What else is going on?

John:

Yes, um… really not only my boss and my wife see it, my parents see it, and a couple of my buddies call me out on it. I know that I need to kick this depression – or whatever it is – but it just seems so hard. I have just lost motivation and do not care about anything… Well… it is not that I do not care. I do, that is why I am here but I cannot seem to make myself do the things I need to do. For me… I have noticed that I have a hard time remembering things, and I just get frustrated. Man, I get angry so easy. Like this weekend, I got frustrated because my son wanted to play baseball and I was too tired. He kept asking me and asking me. Then finally I snapped and I told him to leave me alone… That is my son. He does not deserve that.

Dr. Carl Shire:

It sounds like that situation with your son… really saddened you.

John:

That is what gets me down the most. I am disappointing everyone around me. They all care about me and help me out… my wife, my parents, and my buddies, but I keep disappointing them. And to add to the disappointment they all keep telling me that I need to stop drinking because it is making things worse.

Dr. Carl Shire:

Tell me about the drinking.

John:

Well… there is really not much to tell… but, well, I decided about two years ago that I would not drink much anymore. I was exercising, staying in shape – really so I could keep up with my nine-year-old son. I also began to notice that I only did it when I was not feeling good about my life. Well… actually, I did not figure this out on my own. My wife is good about helping me see things more clearly, you know, so the past two years were good, everything was good. Um, I was only having a beer maybe once a month or so… Well, I have been drinking more, especially in the past few months. And my wife is concerned. I know it does not help anything but – it just makes me forget about how crummy I feel.

Dr. Carl Shire:

So what is the drinking like now?

John:

I think I have a few beers, almost every day. And more on the weekends.

Dr. Carl Shire:

Okay. You have shared a lot of important information about what is going on in your life now. I think I have got a good picture of how this depression is impacting your life, your job, your relationships, and marriage, and even impacting how you cope with things, like by using alcohol. You have given me a good picture of the struggles you experience everyday. I am wondering if you could think about what you would like to achieve as a result of coming to counseling. How do you envision your life changing?

John:

That is a good question… It is one I think about every moment of every day… It definitely makes me frustrated… sad… disappointed at myself for letting things get this way. I just want to be happy, like I was before. I want this depression to go away, and I want to feel good again. And I want my wife to not look at me with that disappointment, and I want to feel like I really want to go play ball with my son. I want all of that.

Dr. Carl Shire:

That is a lot. And I think all of it is possible with your motivation. So, where would you like to start?

John:

Hmmm… I need to get rid of this depression and anger. I think that would help a lot. Then maybe I would feel more motivated to do the other stuff.