Case Study of Three Counselling Sessions

This is the first of three sessions with Val. Val is a married lady, in her early fifties, she has one son. Val has agreed to take part in this counselling case study and understands it will entail three counselling sessions. She is aware that it will involve the use of videotapes for my training and that the tapes will be seen by my tutor, Val has given her permission for this. The sessions will be weekly and will take place within the college.

The issue that Val wanted to talk about, was a burglary that had happened to her about a year ago.

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At the beginning of the session with Val, I explained confidentiality and how certain disclosures might affect her. I also explained that this was the first of three sessions and the amount of time we would have for the session. I tried to put her at ease by asking was that okay after explaining what confidentiality was. I opened the session by say” what ever you want to talk about”.

Val had come to talk about a burglary, which had happened to her last year. As Val started talking in the early part of the session I was able to pickup her emotions of shock and disbelief that this had happened to her. I clarified early on in the session which burglary she was talking about as she disclosed she had, had another burglary the previous year. I feel I was silent for quite a long time in the early part of the session but I feel that this was necessary. Because Val seemed to pour out a lot of information in great detail about the discovery of the burglary at this point I said, “it sounds like you’re still quite shocked about it. I can feel the shock as you are speaking” This gave Val a chance to pause and look at her feelings and how she was feeling at that moment.

I missed a key phrase that Val used about feeling afraid of going back into the house by her self, as she phoned a friend to come to her aid. And she did not re-enter the house until the friend arrived. Perhaps I could have explored what the exact fear was, as she knew there was no one in the house at the time.

Val spoke of her husband’s arrival home to find her in tears and I think I tried to show empathy and immediacy at her husbands reactions to her – that” he was not supportive at that moment in time, when she felt she needed his support”.

I felt that a lot of the time until the latter part of the session I could only show Val with non-verbal communication my understanding of her situation. Val seemed the need to re-live every detail of her story to me – I tried to show empathy by allowing her to off load in as much detail as she needed, without interrupting her.

Towards the end of the session Val disclosed that she knew who had done the burglary and how they had gained entry to the house. I asked “did it help Val knowing how they had gained entry to your home?” She replies “did it help? I don’t know” I think I was trying to make her feel better by showing her that the entry point would not be used again because she could take more security precautions. I made Val aware that we were coming to the end of our time and summarised the information she had given me and asked if what I had said was correct. We agreed to make another appointment for the following week.

The feedback from my peers was on the whole quite good, although reference was made to my body language being static. I feel that I agree with this observation, as I felt uncomfortable in the setting in which this session took place. I also feel I adopted a sitting position in which I would not ordinarily sit. I felt that this session went okay but I did feel that I had not given the client much time because of circumstances and I felt the session was rather short, in which to try and build a relationship with the client. I did however try my best to show empathy and get into her frame of reference and hopefully I would have started to lay down the core conditions of person centred counselling. That of unconditional positive regard, congruence and empathy. If I have been able to show some of these then the client will feel secure and start building a relationship with me.

This was the second session with Val. I opened the session by asking Val” how she had been over last week” Val started telling me about her reactions to talking about the burglary last week and how it had been brought it back into the forefront of her mind. I reflected this back to her and Val said” I would walk into the bedroom and see the draws open as they had been on that day”. I asked if she was” uneasy being in the house now by her self”, as I was trying to probe to find out if she was having flashbacks of that day. But Val withdrew and said “no “. Perhaps the question was too direct if I had of re-phased the question and asked about her feelings of being in the house alone would have been better.

During the early part of the session I reflected back and paraphrased quite a lot. When Val started to talk about the police her body language and tone of voice changed. She seemed quite angry. I pointed out to her that she seemed angry – she seemed able to focus on her anger and explain why she felt that way. I feel a key point was when Val talked about having to re-ring the police and spoke quite abruptly to the officer on the phone – I said “so you projected your anger onto him but you weren’t happy about doing it ” she then started explaining how she felt. That her feelings were not took into consideration by the police on that day and later on. At this point I summarised her feelings and frustrations at the police. This I feel showed Val empathy, immediacy and an acceptance of her issues. It seemed to me as I if had validated her feelings for her.

Throughout the rest of the session Val seemed quite angry and frustrated at what had happened on the day and how she felt about her personal possession been taken. At one point she spoke of her husbands watch being taken. I responded by saying “rationally you know you can replace them but it’s the emotional attachments to the possessions, how they had been given and chosen with love”. Val agreed and seemed to be relieved at my understanding. At this point Val lightened the situation with a statement about her husband loving watches and would wear a different on each day, at which she laughed and I laughed with her showing deep empathy and understanding.

I feel I missed a key statement of how “devastated I was on the night having to go to bed” I think I missed this because I was out of the clients frame of reference, as she had spoken of precautions they had taken since. So I let myself move away from where she was at, at that moment. I had moved on but she hadn’t. If I had picked up this phase I could have said something like “you say devastated that’s quite a strong statement could you explain it a bit more”.

Towards the end of the session Val again mentioned that she knew who had done the burglary, she stated that “he had got away with it again”. As we were nearing the end of the session I made Val aware of the time. I summarised and said; “I feel that throughout the session I was aware of her feelings of frustration and anger about how she felt she had been treated and her disappoint with the way the police had handled her case”. I also said “perhaps in the next session we could focus on the person who had done the burglary and Val’s feelings about him”.

The feedback from my peers was quite specific in that I had missed a couple of key phrases and that my body language was very stilted and static again this week. I feel that although the feedback this week wasn’t quite so good, I had given the client more and because of having more time and had touched on more of her feelings. I also felt that the relationship with the client was building up nicely. I felt I had worked within the client’s frame of reference nearly all the way through the session, although during the feedback my peers did not feel the same. Where they thought I had left the client’s frame of reference was not at the same place I thought I had left it. As I have stated about I believed I left the frame of reference when Val talked of the devastation of that night. The observer thought that I had left the frame of reference when I spoke about Val projecting her anger onto the police officer on the phone. It was also mentioned that when a silence went on for a time I had not prompted Val in anyway. I totally agree with this, as I don’t mind the client being silent. As I think sometimes the client needs time to reflect in more detail about what has been said and what she is feeling at that time.

I feel that in being person centred as a counsellor you should give the client time both inside the counselling room and inside the client’s head to look at what they feel they need to look at. I also felt that again I let the client talk for quiet a long time without interruption and from viewing the tape this would seem to be so. Is this wrong? I don’t know, I just go with what feels right at that time. The observer also felt that I missed key words like “awful” and that I didn’t adjust to the client’s changes in body language. Perhaps changes in body language are something I need to work upon because I didn’t really see any. I felt on the whole I had reflected and paraphrased and summarised well throughout the session and again had tried to show empathy and understanding of the clients feelings. And where I felt it appropriate I have asked probing and open questions. One thing I did notice from viewing the videotape was that the client seemed to contradict her self. About what she was seeing last week when entering the bedroom, she said it was like walking in on the day of the burglary, so perhaps it had took her back to that day so perhaps it was my way of phrasing the question, which had been too direct.

In this third and final session I made an appropriate opening by reminding Val that this was our last session. I then continued by asking Val how she” had been since I’d last seen her” as she had, had to cancel a session due to illness. I then tried to refocus the session by saying, “can I take you back “. Val stated that she had been conscious of feelings that had been brought back while speaking about the burglary. I feel at the beginning of the session that I started to explore how secure Val in her home now. I reflected and paraphrased Val’s feelings and summarised by saying” at that time it was a total feeling of powerlessness at being so vulnerable”.

The middle part of the session was taken up with two major themes, the first being that of the young boy who had committed the burglary. Val was sure she knew who the burglar was. I think a key point was her saying “the good thing for me is knowing who done it”. It seemed to me that she drew comfort from this. I asked her to” explain her feelings of how it made her feel to know who had done it”. She then went into great detail and I think the fact that I believed her was a big step in our relationship. I think this helped her give voice to her suspicions and beliefs without someone being judgmental towards her.

I clarified throughout this part as Val brought in a lot of information and I asked a closed question as to whether the boy still lived in the street. Val said” he did “and I asked, ” how him living still in the street made her feel “. This was a again I feel a key moment as Val laughed and gave a big sigh and said, “how he had the audacity I don’t know” Val then went to explain the child’s upbringing and her views about it. Again Val seemed very angry and seemed to have contempt to towards the child’s mother especially. I reflected these feelings back to Val and she agreed by saying “absolutely one hundred per cent, totally Sheena.” I think at this point I was showing deeper empathy and immediacy and I felt the process of therapy was taking place.

The other major theme, was that of her husband’s reactions. As Val spoke I felt that she had gained comfort from her husband confronting the boy in question. However when I reflected this back, Val she was emphatic that this was not so. So I re-phrased the question. Again she said that was not so. At this point I clarified the information she had given to me, and she agreed with what had been said. I feel that Val was contradicting herself here, but choose not to look at the real issue. I think I challenged Val quite strongly here and maybe I shouldn’t have, because I feel withdrew and spoke of her frustration, about which she felt comfortable to talk about. Perhaps I was a little too close when taking about her husband and her fears of what could happen (I don’t know!).

Towards the end of the session I made Val aware of the time and summarised what had been said and felt during the session. I then went on to summarise the relationship and feelings over the last three sessions. And what I felt had happened in some of the other sessions, I reflected and recalled some of the things said and spoke of Val’s feelings and frustrations. I feel that I summarised well and showed my understanding of her issues. I then asked, “how the last three weeks had been for Val”. Val stated that she had enjoyed the sessions and had” felt it was something she needed to do”. I feel that the sessions were quite cathartic for Val and had brought some sort of closure for her. This also was I feel a good example of an ending in counselling. I said, “I hope it had helped “.

The feedback was on the whole quite good. One thing that was picked was the way I had phrased a question “what I would put to you”. I think I could have re-phrased it but at the time, that was how I thought would focus the client. Another thing given in feedback was the “dart board effect” again I don’t know if I agree with this, as I feel perhaps my challenge was too strong as I said earlier I don’t really know.

I think overall I have tried to be client centred in my approach to the client and I feel that for most of the time, I was. I feel that a relationship was established, as Mearns and Thorne point out “the relationship is all -important: if that is healthy then the counselling outcome has the best chance of being productive” (Mearns and Thorne 2000). I also think I was able to provide the core conditions in which the client could explore her feeling thus enabling her to enter the therapeutic process.