Sir William Osler – “he who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.”
This can most probably be extended to all health-care professions.
Case Formulation/Conceptualisation – CBT
April 9th, 2011 by jamie No comments »Case Formulation – Priscilla
Biographical
Priscilla is a 42year old female. She is living with her husband of 15 years. She has been working as an events manager for the same company for 10 years. She finds her job challenging but rewarding. She is an only child. Her best friend from childhood, whom she feels very close to like a sister, was recently killed in a car accident. She has had no previous mental health issues.
Positive Attributes
Priscilla appears to have a very supportive family and has good relationships with both her husband and her mother. She has a good job that she finds rewarding and acknowledges her skills in time management, organisation and negotiation. She has come to counselling seeking help on her own will.
Questions to ask for next session/s
- How was/is her relationship with her parents?
- How is her relationship with her husband?
- Does she see these events happening as beyond her control?
- What is Priscilla doing when she gets dizzy and feels tense?
- Has she experienced these symptoms and problems before? How has she coped previously?
- What is she thinking when she feels stressed, gets dizzy and tense?
- Where (in which body part) does she feel tense?
Presenting Problems
Cognitions
“If I don’t calm everyone down and make them happy the show will flop and I’ll lose my job.”
“If I lose my job I will be disappointing my mother and also my husband. I will be a failure.”
“There is too much to do at work and now at home. Everything is piling up on me.”
“Everyone is counting on me.”
“I can’t handle it when things go wrong.”
Emotions
Priscilla is feeling very tired from the lack of sleep. She has only been sleeping 2-3hours a night. She is also feeling very worn out as there is a lot of responsibilities and things to do both at home and at work. She is anxious to get everything done on time and at a good standard and is worried at the amount of things she needs to do and in the time frame.
Behaviour
Priscilla has been arguing more with her husband. She finds it very hard to have a conversation with her husband that does not spiral out of control. As such she has not been engaging with her husband as much. She is irritable and over reactive at work.
Physiological
Priscilla has experienced dizzy spells and finds her muscles and posture very tense. She is jittery, restless and feels on edge most of the time, unable to sit still and focus on one thing for too long.
Assessments
Becks Anxiety Inventory (BAI) – Beck, Epstein, Brown & Steer (1988)
This is a 21-item questionnaire designed to determine whether a client has anxiety and if so the severity of it. This would be the first assessment administered to Priscilla to distinguish her symptoms and behaviours from a depressive or anxious state. It would also give a general idea on the severity of her anxiety if it exists.
Depression Anxiety Stress Scales (DASS) – Lovibond & Lovibond (1995)
This is a 42-item questionnaire designed to measure the negative emotional states of depression, anxiety and stress within a client. The principal value of using these scales in Priscilla’s situation is to determine and clarify the locus of emotional disturbance. If the test show that Priscilla is more stressed than anxious or more depressed than stressed then the intervention and treatment plan can be tailored as such to suit her specific needs.
Coping Inventory of Stressful Situations (CISS) – Endler & Parker (1990).
This assessment consists of 48 items that measure coping styles such as task oriented, emotion oriented and avoidance coping (distraction and social diversion). It would be useful to determine Priscilla’s dominant coping style such that the intervention can be tailored to focus towards that certain style. If she was to score high on the task oriented coping then behavioural or cognitive problem solving tasks would be more familiar for her whereas if she was an emotion oriented in coping she would respond better to cognitive changes through fantasy and role play. If Priscilla showed strength in coping by avoidance then involving her social support network may be most useful.
Trimodal Anxiety Questionnaire (TAQ) – Lehrer & Woolfolk, 1982
This is a 36-item questionnaire that measures the traits of an anxious client. This would be useful for Priscilla if previous assessments indicate she shows anxiety as it determines the level of anxiety in three domains: somatic/physiological, cognitive, and behavioural. From this the intervention and treatment plan can be tailored to directly address these problem areas such as working to relieve muscle tension and relaxation.
Developmental and Maintenance Processes
Predisposing
Her best friend from childhood, whom she treats as a sister was recently killed in a car accident. Priscilla has also had increased responsibilities at home as her housekeeper is away. She has also been engaged in a stressful and volatile situation at work where many different parties with different goals look to her for directions and decisions.
Precipitating
Priscilla has chosen to attend therapy as she has been having difficulty connecting with her husband. She finds that she is quite on edge, snapping and arguing at him more than usual. She is experiencing dizzy spells, finds it difficult to concentrate on specific tasks and is unable to sleep more than a few hours a day.
Perpetuating
I hypothesize that with the increase in responsibilities there is also an increase in pressures and expectations. It appears that Priscilla worries about her performance and about pleasing all the stakeholders. Worrying about it constantly makes her feel anxious, edgy and unable to concentrate. It also occupies her frequently and she is unable to connect with her husband in an adequate way. This leads to friction between them and she seeks to avoid interacting with her husband lest it lead to confrontations. This increases her worries.
Case Formulation
It appears that Priscilla is feeling very stressed and anxious from the increased responsibilities both at work and at home. This has contributed to her feeling increased muscle tension and an increased breathing rate leading to dizziness when she is encountered with a new ‘disaster’ or problem at work and home. She worries how her physical state is and how it will impede on her work performance and often stays up late worrying and unable to sleep. Thus she is tired and irritable.
Goals
Together with Priscilla we broke down her problems into three areas as mentioned above: physiological, emotions and behaviour. Within these problem areas we specified what exactly was unusual and impeding her usual routine and way of life.
Physiological
Tension in muscles – Recognise when muscles and body tense. Decrease this tension.
Dizziness – Recognise breathing patterns and notice when breathing increases which can cause dizziness and light headiness. Learn skills to breathe in a timely, slower manner.
Emotions
Worn out – Determine reasons why Priscilla is feeling worn out and to make some time for her to relax and to unwind.
Tired – to get a good night’s sleep (5-7hours) every night.
Pressured – examine when Priscilla starts feeling pressured. Determine ways to lessen feeling of pressure such as delegating more and taking on less tasks.
Behaviour
Withdrawing from husband – recognise when Priscilla withdraws from husband and figure out the situation surrounding this when it happens. Find ways of re-connecting with husband again.
Treatment
By targeting Priscilla’s physiological problems so that she is feeling more relaxed, experiences less dizziness and what may appear as “panic attacks” may then lead to her feeling more able to fall asleep at night and thus feeling less tired and worn out. This as well as cognitive restructuring may also help her address how she is coping with increases in her workload and her relationship with her husband.
Session 1
Gather an overview of Priscilla’s situation. Identify together with Priscilla specific problems. Discuss her expectation and goals for therapy. Provide psycho education surrounding anxiety and panic attacks. Explain to her that being stressed or being in a stressful environment can cause an individual to tense up in their muscles and body. This can cause uncomfortable sensations such as headaches, backaches and tightness in the chest. This can in turn cause an individual to worry, which can increase the tension. Having this tension and worrying about it can be tiresome and often these individuals will complain of being tired.
Explain what can happen when an individual is stressed is that they can start breathing faster and deeper. This is called hyperventilation and is the body’s normal reaction to threat as the oxygen received is used to supply the muscles ready for the ‘fight or flight’. However, if the muscles don’t use up the oxygen then symptoms such as rapid heartbeat, feeling faint and dizzy can occur.
Emphasise that some level of anxiety is normal and can assist daily functioning. However, in Priscilla’s situation her anxiety has increased to such a level that it is impeding her relationship with her husband and also causing recurring physiological symptoms.
It seems important to address Priscilla’s physiological problems first, equipping her with some basic skills to allow her to practice and utilise over the week til the next session. The progressive muscle relaxation (Jacobson, 1938) can help Priscilla identify the difference between a tense muscle and a relaxed muscle. Sometimes that tension can be carried in the body for such a long time that an individual may not even be consciously aware of it anymore.
Ask Priscilla to set aside 10minutes at least twice in the next week for this relaxation. Suggest doing this at the end of the day before bed as a way of relaxing into sleep. Write down how she felt before, during and after this relaxation. Note any changes in mood, symptoms and interaction with others during the week.
She is very efficient at managing her time and appears to take well to having homework and being able to set time for her relaxation practice. Although she may not understand exactly how therapy will help she appears willing to set time aside during the week to try the skills.
Session 2
Go through the relaxation homework from the past week. Look at how effective it was. Discuss how it may not have helped and some possible ways of combating this such as setting aside specific time of the day to practice muscle relaxation, changing from afternoon to morning (or vice versa) and correcting procedure. Practice the correct procedure within the session.
Discuss with Priscilla the case formulation and together develop and implement goals and treatment plan. The short-term objectives are to help her deal with her symptoms more effectively through relaxation and breathing. The long-term objectives are to improve her relationship and bonding with her husband and to reconnect with her co-workers.
Increase Priscilla’s awareness of hyperventilation and the symptoms surrounding it. Practice monitoring breathing within session and talk about stimulants that can trigger hyperventilation such as tobacco, tea and coffee. Discuss how being stressed can cause an individual to hyperventilate which can cause symptoms to show up. Although these symptoms are frightening in themselves, they are not actually harmful. As such the onset of these symptoms can increase the individual’s stress levels, which can then form a repetitive cycle. Breathing in this manner can be very tiring which may have contributed to Priscilla’s feelings of tiredness. Determine when and how often she experiences these symptoms to figure out what may be triggering the over breathing.
Practice monitoring her breathing and breathing from the stomach and not the chest. Aim to slow breathing down to a breathing rate of 8 to 12 breaths per minute. Experiment breathing before and after muscle relaxation and discuss the differences. Walk through the re-breathing technique that can be used if the symptoms don’t go away after a few minutes. Practice this for no more than four or five times.
Ask Priscilla to set a time every day to practice muscle relaxation and to monitor her breathing throughout her day. Draw up and introduce the concept of daily thought record where she keeps a record of her emotions and thoughts. Define the difference between emotion and thought. Run through an example of a daily thought record. She will also write down when she starts feeling stressed or anxious, what happens to her body when this occurs and her breathing and relaxation skills she uses at the time. Daily thought record to consist of: Event/situation; emotion; thought; bodily sensation; skills used to combat.
Priscilla is a well-organised person and I predict that she will appreciate the opportunity to set time aside for these concrete activities and skills she has learnt. She may even be surprised how well the relaxation of her muscles have helped her overall in more than one aspect of her life.
Session 3 & 4
Go through the daily thought record. Together with Priscilla try and determine a pattern to her stressors and anxiety. Discuss how, if at all, the breathing and relaxation skills helped.
Together look at the thoughts she had during the week. Use examples of some of the worrying thoughts she had and look at any evidence that does and does not support it. We shall then take a cost-benefit approach to each cognitive thought Priscilla recorded during the week. Talk through how each thought is a pro/con in the short/long term. How did having that thought help her in the short term, which may then have disadvantaged her in the long term? Go through the likelihood that her thoughts at the time were plausible and then discuss how she may have come to believe and have those worries.
Introduce topic of accepting uncertainty. Worrying can be seen as a way of predicting and preparing yourself for future events, preventing the unknown from happening and controlling the outcome. However, all possible outcomes cannot be foreseen and some outcomes are unrealistic and not plausible at all. Identify and challenge some of Priscilla’s worries that do not tolerate uncertainty.
Set homework task for Priscilla for that week. Alter the Thought Diary so that it now consists of: description of situation, anxiety level, automatic thought, pro/cons of thought, alternative thought, anxiety level after. Go through the process with her so that she is clear on the task. Continue with relaxation exercises every day and breathing skills as required.
As with many people Priscilla may be surprised at how many thoughts she has at certain times and how negative or skewed some of those thoughts can be. She may even find the thought diary to be useful and quite relaxing being able to jot down things during the day. She is familiar with the thought diary as she is constantly using her own diary for schedules, meetings and work.
Session 5
Discuss how Priscilla went in the past week in monitoring her thoughts and providing alternate thoughts. Check with Priscilla if there are any worries that she may still carry with her. Focusing on role-play and imagery, explore the worst possible outcome that could happen if those persistent worries were played out. Explain that sometimes our worries take on a fantasy-like perception in such a way that it is unrealistic and much worse than the worst possible outcome.
Discuss and look at Priscilla’s pattern of persistent worries. Utilising Priscilla’s skills in organising and time management discuss the possibility of allowing for “worrying” to happen at certain specific times such as in the morning or right after work. Suggest letting all her worries come out at this time and putting them in a box when she is finished. Allowing her to freely “worry” in these times gives her the space she needs to think through and deal with her worries but also restricts the time she has to do this. Encourage a quiet moment for relaxation after this as well. If she finds herself worrying during the day ask her to attempt to prolong it until the specified time. Emphasise that this box needs to be placed aside when she comes home so she is able to be fully available to her husband and her home needs. Introduce and explain safety behaviours. Identify her safety behaviours such as withdrawing from her husband to avoid conflict.
Role play a scenario in which Priscilla is given a few thoughts or worries on a card and is asked to have those occupy her mind as she interacts with me in a daily normal routine situation. Discuss how it felt to have her mind occupied whilst trying to connect with me and frankly share how it felt to be the person trying to connect with an “occupied” person. Reverse role-play if needed. Allow some time for Priscilla to voice and sort through her thoughts and then ask her to place them in the box and put them aside. Go through a quiet moment of relaxation and then role-play again. Discuss the effects of this.
Ask Priscilla to set aside time for her worry box and then relaxation each day. Continue her thought diary and ask her to make note of how she feels interacting with her husband when and if she does this. Talk about the next session and how it may possibly be the last session together. Ask her to voice her thoughts about this and address any fears she may have.
Priscilla may be surprised at the feelings she evokes during role play. She may not realise how she has been behaving with her husband for awhile now. She may also feel that this is already happening less as through relaxation and the thought diary she grows more aware of herself.
Session 6
Discuss with Priscilla how her week went with the exercises she did and any issues she had since then. Explore her relationship and interaction with her husband after the implementation of all her newly acquired skills of relaxation, breathing and the worry box. Work together to come up with some ideas on how she could form a closer connection with her husband such as setting aside some time alone, doing recreational activities together and also delegating some of the household chores and workload so the pressure is lessened. Discuss doing some physical exercise alone or together with her husband as a way or releasing tension and spending time together. Regular exercise during the day can be beneficial for elevating mood and improving sleep.
Go through an overview of the sessions and take another look at the formulation. Discuss how incorporating the relaxation, breathing, altering thoughts and thought processes has or hasn’t helped Priscilla overall. Discuss how she feels about therapy and whether she felt her goals have been met. Discuss possibility of further sessions.
I feel that perhaps at the end of session six Priscilla may be feeling more equipped to deal with the stressors in her life. She has some concrete skills that she is able to utilise and has a more open understanding of herself and her interactions and thoughts. Perhaps if the sessions have opened up more vulnerabilities and issues she may be interested in further therapy.
References
Beck, A. T., Epstein, N., Brown. G. & Steer, R. A. (1988) An Inventory for Measuring Clinical Anxiety: Psychometric Properties. Journal of Consulting and Clinical Psychology, 56, 6, 893-897.
Lovibond, S. H. & Lovibond, P. F. (1995) Manual for the Depression Anxiety Stress Scales. Sydney; Psychology Foundation.
Endler, N. S., & Parker, J. D. A. (1990a). Coping Inventory for Stressful Situations (CISS): Manual. Toronto, Canada: Multi-Health Systems.
Lehrer, P. M., & Woolfolk, R. L. (1982) Self-report assessment of anxiety: Somatic, cognitive, and behavioural modalities. Behavioural Assessment, 4, 167-177.
Jacobson, E. (1938) Progressive Relaxation. University of Chicago Press, Chicago.
Naked Therapy – Does it work?
April 6th, 2011 by jamie No comments »… or is it porn that has been elaborately hidden behind a veil of nice adjectives?
When I first heard of naked therapy I was frankly very excited. I thought, wow, here is a new and exciting concept. Something that has ventured outside of the norms and is adventurous. This could be the future! Then I went onto her website and was disappointed to find that she is little more than a porn star who has grand ideas about being a psychologist. Shame, I do think the idea behind it could have been great. Could being the active word here.
So what do I personally think? As a postgraduate student who is only provisionally registered here in Australia my professional opinion may not have much power behind it but with the little that I know of Psychology and Counselling I think I stand a greater chance of seeing the pros/cons of naked therapy than a lay person.
Firstly, Sarah White is not registered to practice counselling (-1), therapy, psychology sessions. She cannot call herself a psychologist. She is in the midst of finishing her psychology degree but even of that I am not quite sure holds much truth. She says she has done psychology as an undergraduate and is currently studying a wide array of psychotherapeutic methods to prepare for her PHD dissertation. But is she studying this through private means or is she completing a psychology graduate program at a university? She doesn’t mention what field of psychology and counselling she is studying and she does not mention which postgraduate program at which university she is studying at (-1). Is she clinical, counselling, forensics… is she at NYU or Cornell University? Who knows! Certainly her “clients” don’t!
Furthermore, instead of listing her credentials and perhaps posting up her current CV/resume she instead posts up pictures of her modelling. HOW does this relate to therapy and what she can therapeutically provide in session?! You would imagine she could provide some photos of how a typical naked therapy session would look like, or the environment she is in when she is conducting sessions but rather she posts up pictures of herself SCANTILY clad in lingerie in a sexually provocative position on a bed (-1). Those photos do not add any value to her as a psychologist/therapist and I for one have lost some respect for her in that sense.
Sarah White goes on to talk about naked therapy sessions. She states that she does in-person as well as webcam sessions (-1). For webcam sessions, the first session does not require the client to have a webcam as it is a one-way viewing ie. the client can see her but she can not see the client (-1). Sound like cam girl much? I can understand the need for webcam therapy sessions and I believe it has added great value to the field of psychology reaching out to help thousands of people living in remote and rural areas. However, those sessions are two-way. Psychology, therapy, counselling…. the basis of them and WHY they actually work has been shown to be because of the THERAPEUTIC RELATIONSHIP. This therapeutic relationship is drawn from the empathic stance and alliance the therapist has with the client. This can be built upon from noticing and mimicking a client’s gestures, behaviours and tone of voice amongst many other factors. How can she work therapeutically without seeing her client?
She claims that the client is free and she encourages them to respond in whatever way they like during the session…. likewise if they are physically aroused (-1). So a client is basically masturbating whilst she purports to have a clinical therapy session with them? How is that possible? I wish she would elaborate more on that. I wonder if I am speaking for most people out there when I say that most humans don’t have a single wise/educated thought whilst masturbating. Do they know what she is talking about when they are physically aroused and responding to their arousal? Are they able to string together a coherent sentence at that time?
Some of her claims about naked therapy are actually quite thoughtful. She speaks about the lesser volume of men who attend therapy than women. The social stigma behind a man needing help, moreover mental and emotional help is still quite a big no-no in western society although it is slowly changing. Perhaps she thought that men can tell their mates that really, they’re not going to therapy, they’re just going to watch some lady strip and they can hide their therapy attendance behind the nakedness (+1). Nevertheless attracting men to therapy on the sexual basis (-1) starts them off on the wrong foot, not to mention attracts “certain” type of men in most cases.
Also she’s not naked the whole time. She starts stripping down in the middle of a session (-1). Is this not distracting for the client? I know when I’m watching the naked news “www.nakednews.com” I lose track and tune out of the actual content when they start stripping. So stripping vs naked I’d suggest Sarah stick to being naked the whole time. There are so many distractors already in the environment and in the mind as it is.
I guess my very vociferous and damning rant about Sarah White and her naked counselling therapy sessions stems from the fact that I am disappointed. Clear and simple.
If I was to attempt naked therapy I would start all my sessions naked. Either fully naked or in basic undergarments. My (and the clients) nakedness is a matter of fact thing and our attitude towards it shall be nonchalant. It is not something to be paraded or boasted about. Rather, the idea behind it is to show the client that I, as the therapist, am a human being. I am not greater than you, I am not perfect. I have my vulnerabilities just as you (the client) have yours. I feel safe enough in this space to allow you to see all of me, physically. This is to show you and demonstrate to you that this is a safe place. Do you think this would work?
It’s blasphemous that Sarah White and Psychology be mentioned in the same sentence. -7 Miss White….
True story.
Case Formulation and Conceptualisation
April 1st, 2011 by jamie No comments »Biographical Information
Basic information about the client which may include demographics, sexuality, age, mental health history, family history and dynamics.
Presenting Problem
The reason they have come for therapy.
Assessments
What other assessments (medical or psychological) do you need to undertake to determine appropriate tailored treatment plans.
Developmental and Maintaining Processes
- Predisposing: factors that have existed in client’s life that have made them more vulnerable and susceptible to current symptoms and problems. These may include biological, social, distal, proximal.
- Precipitating: immediate factors that has triggered the problems that lead to the client attending therapy. ie. what bought them here.
- Perpetuating: factors that maintain the problem and keep it going.
- Protective: factors that increase the client’s personal and social resources, positive attributes.
Person’s 6 Step
Goals
Together with client come up with goals that the client would like to achieve with the help of the therapist and therapy.
Treatment
Treatment plans should be tailored and individual. One thing that can help someone may not necessarily help someone else with similar symptoms. Treatments can be planned from differing perspective from different schools of thoughts such as cognitive behavioural therapy (CBT), person centred therapy, psychoanalytical, humanistic, gestalt etc.
Qualitative and Quantitative Reviews
March 14th, 2011 by jamie No comments »Taken from: Jordan and Neimeyer (2003)
A Qualitative (or narrative) literature review involves a scholarly analysis of the existing literature, from which the reviewer draws reasoned conclusions about the state of knowledge in a given area of inquiry.
A Quantitative review (or meta-analysis) is a statistical technique (or group of techniques) that allows objective data from many different studies to be combined to produce a numerical answer to the question, ‘‘How effective is a particular type of treatment?’’
- Resulting measure EFFECT SIZE: standardized way of assessing to what degree people who receive the treatment do better on outcome measures than people who do not receive the treatment
- General effect size for psychotherapeutic treatments 0.8 = 80% of people receiving treatment better after treatment than those who do not receive treatment
Theories of Counselling
March 14th, 2011 by jamie 2 comments »Person-Centered Counseling
- Originated by Carl Rogers 1940s
- Emphasis on therapeutic counsellor-client relationship
- Humanistic, experiential-existential apprach
- Present oriented and holistic
- Encourages client’s self awareness, exploration, self esteem and competence
- Beneficial for people with adjustment disorders, relationship, occupational and identity problems as well as bereavement and grief
- This group of people usually already have some effective coping skills and are in good contact with reality. Thus they can be together in a therapeutic relationship with the counsellor on a more equal and effective level.
Behavioral Counseling
- B. F. Skinner 1930s/1940s
- Based upon the belief that personality is shaped by environmental factors
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Depression
March 14th, 2011 by jamie No comments »Definition of Depression.
Depression is an emotional, physical and cognitive state. Depression can affect anyone at anytime with symptoms that vary from person to person. Almost 1.5 million people in Australia alone suffer from depression and depressive states. On average, up to one in five people will experience an episode of depression oncein their life time. This is slightly higher in females than in males – one in four females whereas only one in six depressed males. As such depression is actually very common, much more common than one would suspect.
There are five main categories of depression. Major depression, » Read more: Depression
Projective Identification
March 14th, 2011 by jamie No comments »Projective identification is sometimes recognised in counselling and therapy. Projective Identification is when a patient’s unwanted feeling is projected out to someone or something else. Some examples of this in an every day situation would be perhaps a son who is late for a birthday party is feeling rushed and anxious he is late for the festivities. His anxiety is then projected to his mother who is dropping him off, resulting in her feeling similarly anxious. In therapy, if a counsellor is seeing a patient who has a history of being violent then the counsellor may similarly have a sense of impatience and “violently” direct therapy in a more confronting manner.
In some situations the projective indentification involves splitting the self and » Read more: Projective Identification
Reasons why people receive counselling
March 14th, 2011 by jamie No comments »Reasons why people go to counselling.
There are many reasons as to why people decide to attend counselling sessions. Previously, counselling and therapy were only considered an option exclusively for people who have serious mental illnesses. As psychology, mental health and counselling information are made more available and people are becoming more informed and aware, an increasing amount of people are taking the opportunity to see a counsellor/psychologist. Counselling can be of help to people of all ages and from all levels of society from young infants to the elderly.
Informal practices of counselling existed long before knowledge of » Read more: Reasons why people receive counselling
Jamie – update so far
April 1st, 2011 by jamie No comments »So a lot has happened in the year or so since I’ve last (personally) blogged. Here it is in short form:
- Exited from Murdoch’s Master’s class
- Graduated with a Postgraduate Diploma in Counselling (Murdoch)
- Declined invitation to attend 3rd (boring) graduation ceremony; received my $14,000 piece of paper in the mail instead
- Got accepted into the Master’s program at Monash University
- Currently collecting university student cards: already have 3 and counting – University of Western Australia; Murdoch University and now Monash University
- Currently working my way (slowly and progressively) through the Master’s in Counselling Course at Monash… via distance education! That’s a lot of postage stamps!
- Resigned from my job of 4 years with lots of tears and good bye’s
- Got offered a job working with a NGO (Non-government organisation) company Communicare as a programs facilitator.
- Realised I would have to give up wearing skirts as I’d be facilitating group therapy and counselling with men of domestic violence in prisons.
- Resigned from my new job after a week of training
- Got offered a new-new job working with the department of corrective services as a senior programs facilitator
- Will be earning twice as much as when I was a medical receptionist last month. Whooopeeee!
- Declined 4 job offers in a month and wrote two resignation letters in the space of 2 weeks
So after all the whinging and crying and lots more crying over the years about not getting a job, being a useless psychology student for so long I have finally (almost) made it into the “real” world.
It’s a great step forward career-wise and financial-wise. The only small teensy thing wrong about it (not that I’m not thankful) is that I’ll be delivering cognitive behavioural therapy. Which I actually have not given much time or thought to. Now I know as a starting psychologist I am probably more eclectic school of thought than anything else but something I know that I AM NOT is a cognitive behavioural therapist/psychologist. I AM NOT.
I’d rather be a yoga teacher.
Not that I am saying cognitive behavioural therapy is ineffective and useless. It’s not. But I do think there is more to a person’s problems than the physical symptoms and thoughts and behvaiours that they display. There is a person and a history behind all of that. And each of it individual and thought provoking and intensely interesting.
Until then I will be facilitating CBT via a programs manual day in and day out until I get to private practice and be able to make more difference in the world.
Until then…..
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