B. A. is 52-year-old female with psychosocial health problems such as personal and mental emotions and social issues. B. A. is married with one son. She spends most of her time being isolated. Also, she has emotionally neglected her family, and most of the time, she engages in conflicts when relating with other people. Her mental and emotional state has rendered her jobless because it is hard for her to sustain the job when she gets one. Even though she seems depressed and gloomy most of the time, she still dresses appropriately. Her speech is also eloquent, and she maintains eye contact during the session. Although she has no suicidal thoughts, what worries me is that she is very pessimistic and full of negative thoughts, and most of the time she is very defensive of her thoughts. The patient has been diagnosed with major depressive disorder, generalized anxiety disorder, and has a history of alcohol abuse. Patient is currently being treated with Diazepam 5 mg twice a day as needed and Fluoxetine HCL 20 mg once a day. Medications prescribed by primary care physician and patient has not seen psychiatrist in many years.
During our encounter, she spent most of the time quiet and staring at me intensely. Her eyebrows were lowered and knitted together, and she seemed angry with everything. She hurled insults at me when I inquired how long she had been drinking. She appeared more frustrated because of receiving limited medical care, and her partner believed that some evil spirits had caused her state. She has mentioned that she often asks for money from her son so she can grab a drink with her friends, but he always denies her requests. Therefore, the anger towards her son and partner kept growing. She gets provoked easily.
I felt awful for my client during our encounter. It is disheartening to exchange verbal insults with your kid, and I felt an overwhelming emotion of sadness for my client. She also felt disrespected by people she is supposed to be close with, making her feel unsupported. This also made me feel sorrowful. At her age, she is supposed to be loved and spend quality time with her family. She wants someone who can understand her state instead of thinking she is possessed. I also felt sorry for her because she felt the need of drinking alcohol to numb her feelings. Engaging in community activities can be beneficial for this client and after learning that she refused to participate in community events, I felt disappointed. She was also not interested in joining Alcoholics Anonymous (AA), terming them to be off no beneficiary. Moreover, I was somewhat overwhelmed by my feelings for this patient because I could personally relate to some situations. Having said that, I avoided being too personal with this patient and did my best to provide unbiased guidance. I noticed that I was becoming frustrated when this client disagreed with me, and I had to pause before proceeding. I have noticed my self-doing this several times during the session.
I am delighted with the work of the therapist. The therapist has been encouraging the client to increase her activity level to reduce the stress she is going through. Also, she encouraged the client to do what was best for her health instead of brushing off some of her health concerns. In addition, she encouraged the client to continue searching for a psychiatrist within her locality for medication management.
I felt pleased that the client was willing to contact the nearby community hospital and be committed to the appointments with a psychiatrist. On the contrary, I would have followed up with the community hospital to make sure the client committed despite agreeing with the therapist that the client should do what was best for her. The client must show devotion and commitment if she needs help. I’ve also noticed that I made judgement before my client has finished telling her story. Allowing my client to finish his/her story before jumping into conclusion would be another thing that I would do differently next time. Lastly, despite respecting her decision, it is my duty to provide clients with quality care. Human life is precious and needs to be treated with consideration and utmost respect.
