1.  Assessment

Assess the client including his or her problems, environmental factors which contribute to the client’s difficulties using the ecological-systems perspective.

           Mr. A is a voluntary client who reports recent emotional stress.  This is his first experience in counseling.  He is a 43-year-old gentleman, presents as well groomed, good hygiene, appropriate and casual attire.  He attentive with a suitable range of appropriate emotions.  His mood is friendly and relatively subdued.  Mr. A presents with organized thought processes; he readily provides relevant responses to most question and haltingly responds to more sensitive questions involving his feelings and issues involving his immediate family.  Fifteen years ago, Mr. A married; he reports having a good marriage.  Shortly after their fifth anniversary he discovered that his wife was having two ongoing intimate relationships.  Shortly thereafter, Mr. A filed for divorce and was awarded custody of his son, who is now 12 years old.  Mr. A describes his son as an excellent student, friendly, and generally well adjusted.  Mr. A, works from home as an architectural engineer, which enables him sufficient time and access to serve in his parental role.  Mr. A socializes, but has no intention of remarrying.

           Mr. A’s primary stress is focused on age-appropriate issues regarding his son:  Puberty, and potential negative peer influences regarding sexuality and substance abuse.  Mr. A has recently found pornographic materials on his son’s computer, much of which focuses on bisexuality.  Mr. A is motivated to provide care and support to his son, but is uncertain how to proceed; this uncertainty is manifesting in stress (e.g., sleeping fewer hours, inability to concentrate, easily distracted, generalized anxiety).  Mr. A considers the topic to be sensitive – he doesn’t want to embarrass or shame his son, which may exacerbate circumstances, hence he presented for professional confidential care and guidance.

2.  Interviewing & Counseling Skills

Outline essential interview and counseling skills which can alleviate the client’s emotional and environmental difficulties and to improve her or his coping strategies.

           Considering the sensitive nature of Mr. A’s concerns, empathy is essential; this conveys that his story and the depth of his emotions are being properly received.  Reflection is also a key tool, enabling Mr. A to know that he’s really being listened to carefully and it also gives me the opportunity to make sure that I’m receiving his story clearly – I expect he’ll correct any of my errors or omissions.  Even though the issue(s) that are concerning Mr. A are highly sensitive to him, I’ll use normalizing to let him know that the issues that he’s coping with are fairly common – neither him nor his son are thinking or acting beyond the realm of what’s socially and diagnostically considered normal; this needs to be done tactfully so as not to deny or invalidate his genuine emotions.  Considering his sense of embarrassment when discussing such issues, I’ll be sure to discuss the laws, ethics, and clinical protocols regarding client confidentiality.

3.  Empathy Skills

What skills did you use to demonstrate empathy in your interview?  Present some examples of dialogue.

           I used explicit empathy techniques, occasionally reporting what I was feeling as part of my response to his statements / responses.  For example, when he told me of his inter-struggle about deciding if he should inspect his son’s computer and internet browser history, he felt that as a father he should do this, but he also felt that this might be an invasion of privacy.  I told him “It sounds like you felt a real conflict with yourself, as if the part of you that’s your son’s friend is motivated to respect his privacy, but as a parent, you want to know what’s going on with him.  That’s quite an internal tug-of-war; it makes sense that you’re feeling stressful.”

           In another instant, when he mentioned his son’s positive attributes, he smiled with delight; I responded “I’m noticing that when you talk about your son’s skills for math, music, and being a dedicated friend, you show such pride and pleasure.”, to which he agreed and seemed to appreciate.

           Another time, when he mentioned the circumstances of his divorce, I replied “It sounds like you were pretty hurt when you found out your wife’s secrets” – he corrected me; he told me he was more furious than hurt, and I accepted that and thanked him for clarifying and helping me understand.

4.  Verbal & Nonverbal Communication

Describe the verbal and non-verbal behavior of your interviewee.  How did you interpret their behavior/message?

           Mr. A tends to make good eye contact and have some subtle facial expressions that concur with his verbal messages.  When discussing non-sensitive issues (e.g., work, leisure activities), he sits with good posture, hands and arms relaxed, and speaks flowingly with a good range of emotions; he laughs easily and appropriately, presenting as a bright and good-natured person.  When he discusses his stresses, he sometimes crosses his arms and his upper body seems to get tense.  When he discusses issues regarding (his son’s) puberty or sexual issues, verbally, his tempo slows and there are longer pauses between words and sentences; he also pauses before responding to questions regarding these issues.  Nonverbal behavior changes as well; when discussing such subject matter, he tends to gaze down, making only occasional (respectful) eye contact.  It’s clear in his words and observable physicality that this subject matter is an uncomfortable topic for him.

5.  Challenges & Solutions in Working with Client(s) Unique Attributes

Social workers often experience difficulties in working effectively with clients who have different cultural, ethnic, or socio-economic background.  In what way can you overcome the difference between you and the client in the case vignette for effective cross-cultural social work practice?

           Early in our first session, as Mr. A was disclosing the focal point of his stress (concerns regarding his son), he mentioned that I may not be able to help him due to the differences in our age and ethnic background.  I told him that I certainly understand his concerns; I respectfully explained that I once had an orthopedic surgeon repair my broken leg and that later my doctor disclosed that he’d never had a broken bone in his life.  Nevertheless, he did an excellent job on me.  I told Mr. A that in a similar professional way, I care about him and would like to help him feel better, despite our differences.  I told him that I fully respect how he feels about his condition, and it’s my job to listen, try to understand, and provide help in a way that suits his needs.  He seemed to be amenable to this, he smiled a bit and continued the therapeutic process in a more relaxed and forthcoming fashion.

6.  Challenges & Guidelines for Conducting Effective Interviews

What types of challenges did you face in interviewing family members of the client?  Identify the guidelines for conducting interviews with family members of the client.

           I’ve done considerable volunteer work in youth centers and conducted seminars detailing sexual awareness, healthy intimate relationships, sexual orientation, safe sex, etc., so at first, I was a bit surprised that this subject matter was causing Mr. A such stress.  Then I changed my perspective:  These sessions need to focus on Mr. A, specifically his needs, his emotions, his values, his state of mind, and how his culture frames this subject matter.  Although I’m pleased that I’m comfortable and familiar with all this, the main thing I need to do is keep what I know, but foremost, I need to continuously try to understand, respect, and adapt the therapy to align with Mr. A’s perspective.  I need to not only start where the client is, but to move at the client’s pace.

Resources Referrals

What agencies / organizations / resources could be helpful in addressing the needs for this client?

           I’ll conduct some research on literature that provides guidelines for parents to effectively discuss puberty and sexuality with their children and provide a list of book / article recommendations to Mr. A.

           Although Mr. A’s sleep problem(s) appear to be correlated with his stress, I’ve suggested that he confer with his physician to rule-out any physical disorders that may be interfering with his sleep.

           As our sessions progress, I’ll decide if it would be appropriate to refer Mr. A to PFLAG – Parents and Friends of Lesbians and Gays (pflag.org). 

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