PSY 607 Acquired/Learning Basis of
Client: Bob Monday
January 22nd, 2018 — Session 0
Presentation: Client presents as an adult male, divorced, with two adult
children. During session Client wore casual clothes (polo shirt with cargo
shorts and tennis shoes), and was hygienically clean. Initial interaction: Client entered session 0 and seemed withdrawn
at first, and did not make eye contact until about halfway through the session.
When asked exploratory questions, Client was willing to communicate problems
with counselor. Client seemed sad and discouraged when talking about difficult
experiences. Reason for counseling: Client
stated that he had a “difficult life” and has “lost everything”. Client’s wife
left him (6 months ago) and his children will not talk to him anymore. Client
has no emotional or physical energy to go to work and is broke (financially). Client
feels depressed, and believes it stemmed from a previous car wreck. Presenting concerns: Client has strained
relationship parents, wife, and children due to depression, excessive spending,
unemployment, and excessive video game play. Client says he feels depressed and
has a fear of driving on the highway that stemmed from a car wreck 3 years ago.
Client has been taking prescription medication for depression (Zoloft) for the
past 2 months after an emergency hospital visit. Additional Information: Client states that he is a “terrible
communicator” and that he uses video games “to pass the time”.
Expectations: Client stated multiple issues
going on in their personal life including relationship strains with their
family, depression & anxiety, unemployment, excessive spending habits and a
fear of driving. Client has expressed a desire to create changes in lifestyle
and is seeking aid for his emotional distress.
Actions: Counselor asked exploratory
questions to gain information about the client’s background and current
concerns. Interpretation: Client has
had a strained relationship with family due to several major reasons, a large
part of this strain appears to stem from Client’s previous car wreck in which
the Client is now scared to drive on the highway. The Client’s inability to
drive on the highway has affected his ability to get a job and keep in touch
with his children. Client has expressed feelings of depression and anxiety, and
is using unhealthy coping mechanisms to try and deal with these negative
emotions. Support: Client has a lack
of social support from family. Client has stated that he has one friend he can
confide in, and potentially a group of people he can use as a social support
Client is currently taking a
depression medication (2 months) and it does not seem to be working. Counselor
will contact a psychiatrist in order to see what changes need to be made in
terms of the Client’s medication.
Client has stated that there is a
lack of social support from family, but that there are friends that he may be
able to confide in. Counselor will encourage Client to build social
relationships with other people, and will use Behavioral Skills Training in
order to teach and build up appropriate social and communicative skills.
Client has a fear of driving on the
highway and Client had stated that when he got into the car, he felt feelings
of panic. Counselor will implement the use of fear and anxiety reduction
techniques in order to help the Client regain control of his emotional
A relaxation technique that would
potentially be helpful is a technique that can be used anywhere and does not
require much thought or movement (so as to not interfere with driving). The Client
will be taught diaphragmatic breathing exercises. Feelings of panic can cause
breathing to become erratic; this exercise will help reduce feelings of initial
panic and regulate breathing patterns.
Client will also be introduced to
multiple other relaxation techniques to choose from in case the breathing
exercises do not work well for him.
The Client will be introduced to
systematic desensitization in order to help practice relaxation while imagining
scenarios of driving on the highway. This will later lead into an
implementation of in-vivo desensitization in which the Client will be tasked
(under supervision) of driving on the highway for certain distances (starting
from very short distance of driving for a certain amount of seconds and will
gradually increase to longer distances in which the Client would drive for a
certain amount of minutes).
A possible resource that could be
used is a driving instructor course, where there is an instructor present that
has access to breaks on the car and would be in the car with the Client to help
guide him along.
Client has unhealthy spending habits
and also excessive video game use.
A functional assessment will be made
in order to find the contingencies of both behaviors starting with his
excessive spending. This will require the Client to help keep track of his own
behaviors as he will be keeping a journal. In this journal he will write down
when his behaviors occur, what happened before the behavior, and what happened
afterward. Once the three-term contingency for both behaviors is established,
then the counselor can establish an appropriate treatment for each of the
behaviors and establish new and healthier behaviors as a result.