COUNSELING REPORT

ADARO, Joanne R. 2008-21057 BS 198-WBYDX BA Behavioral Sciences

I.

BASIC INFORMATION

Name: Jane Sex: Female Date of Birth: February 23, 1992 Age: 19 Date of Assessment: September 7, 2011 Chronological Age: 19 years, 6 months, 4 days Address: Signal Village, Taguig City Occupation: office clerk Reason for Referral: Depression, Insomnia, Unhealthy Eating Habits II. SUMMARY OF PATIENTS CONDITION Jane was found to be manifesting signs of depression, which became the focus of the therapy. The cause of her depression seemed to be her unstable relationship with her boyfriend. She used to socialize and meet up with her friends a lot, but has now lost interest. She finds It difficult to sleep normally also. Insomnia has been a constant trouble for her. Feelings of worthlessness also assuage her a lot. Her motivation is low and she has no ability to make sound decisions about her goals and aspirations. Jane has related that she was always feeling down. She cries a lot, even if she considers the reason of her emotional display is petty. She usually feels irritable and bad-tempered too.

III.

THERAPY TECHNIQUES USED In order to assess the clients condition, the counselor used both Becks

Depression Inventory and Burns Depression Checklist to see if she was suffering from depression or not. And from the results, she was found out to have Moderate Depression. Also, she was assessed using Taylor Anxiety Manifest Scale in which

she was found out to be anxious from a lot of things and was troubled by various stressors.

During the counseling sessions, Cognitive Behavioral Therapy is applied in order to address the clients problem which was her depressive reaction to the unstable relationship she has with her boyfriend. Since the client tends to overthink which leads to her thinking negative thoughts, the main cognitive method used by the counselor was to dispute irrational beliefs. Also, this counseling technique was employed in order to answer the therapys general objectives which are: Maintaining stable relationships Encourage self-understanding Putting insights into practice

The therapy also recognized numerous short term objectives to be met in every therapy session. Specific tools were used in order to evaluate the clients progress in every meet up. The short term objectives are as follows: To assess clients relationship with her family To explore past and present relationships with the opposite sex in the hopes of learning her ups-and-downs in dealing with men To bring back severed relationships with friends To uncover strengths and handling weaknesses To find time for a hobby To explore perception of self and conflicts that may have affected the clients thoughts To overcoming insecurities To improve interaction with others To possess new abilities

IV.

CLIENTS BEHAVIORAL CHANGE

Jane, during our earlier sessions, cannot help but cry whenever our discussion arrived to something that was distressing to her. She had a lot of negative thoughts about herself and she seemed unsure of how to address her problems. But now, she looks more confident. There is self-assurance in her posture and an unmistakable sparkle that was not apparent in her personality before. Nakakatulong rin pala tong therapy no?, was her comment to me on our 7th session.

A. PHYSIOLOGICAL AREA In Janes case, some telltale signs of her depression were her unhealthy sleeping habits and occasional bouts of insomnia. She used to be able to sleep after 1oclock in the morning only and her maximum sleeping time was 5 hours. But now, she is able to sleep once 10 oclock in the evening hits the dot. Her unhealthy sleeping habits cau se her to have decreased energy to do tasks especially when shes at work. She now testifies that she felt a certain change in her energy once she became more at peace with herself and her perception of people around her.

B. SOCIO-EMOTIONAL AREA

Insecurities

Ayoko ng commitment, ayoko ng attachment, ayoko ng nakakasanayan. Aminado ako na kaya hindi ako nakakatagal sa isang relasyon dahil natatakot ako na mapamahal pa ako lalo, na baka masanay ako na makasama siya. Kaya ako nagta-timer dati para mahati ang atensyon ko. (Journal, May 12, 2011 entry) Based from what transpired during our counseling sessions, it was evident that the source of her depression was her unstable relationship with her boyfriend. The client used to have no qualms when it comes to having relationships, she was not afraid to

enter one because she felt that there is no danger of her getting hurt. However, everything changed when she met her current boyfriend and she felt that he may be The One. Since her boyfriend was also a player on his earlier relationships, she became paranoid and stressed whenever she sees someone who can be attractive in the eyes of her current partner. From her Body Dysmorphia Thought Record sheet, she finds herself often comparing herself to women who sh e seems to be her current partners type. She sees them as more beautiful than her and she feels that she is a loser because she does not look like them. But as she was able to realize that she has certain unique qualities of her own, she was able to like herself more. She now can see his exes and similar women as signs of her boyfriends past, and that they are now insignificant on her present. Sa totoo lang happy ako ngayon kasi wala na ako masyadong insecurities sa katawan. Panatag na ako kahit papaano kasi alam ko na maganda ako kahit mga imperfections pa din sa sarili ko o sa mukha ko mismo. Natutunan ko na i-appreciate lalo ang sarili ko. At naniniwala ako doon. Tamad ako magmake-up ni tamad nga ako maglotion eh pero ngayon natutunan ko na gawin ang mga bagay na iyon. Kasi naisip ko na hindi mo kailangan pabayaan ang sarili mo. Tsaka mahirap buhayin ang dead skins (deads na nga di ba). Tsaka kapag hindi ka naniwala sa sarili mo, ikaw lang din mismo ang mahihirapan (alam mo kung bakit?) kasi mas mawawalan ka ng tiwala sa mga taong magbibigay sa iyo ng mga compliments feeling mo tuloy inuuto ka lang. hanggang sa hindi mo na lang mapapansin may attitude problem ka na. (Journal, September 23, 2011 entry) Her shaky relationship with her parents was also a source of insecurity for her. But going back to exploring her family constellation, it was apparent that she was already able to appreciate her family despite their imperfections. On her mother, Mapagmahal ang Mama ko. Kahit na maingay sya madalas at madaling magalit kahit sumusobra na siya theres a part of me na hindi ko sya matiis. Hindi ko mapigilan na hindi magalit kahit minsan unfair na sya.

On her father, Gusto ko si Papa kahit papano, wala naman kami masyado pinag aawayan dahil naggi-give way sya. Minsan nakakaasar sila at nakakatampo pero madalas naman masarap sila kasama.

Negative Thoughts

Jane was used to getting hurt in her relationships with her friends, family and partners. Because of that, she sees herself anticipating her disappointment with every person who tries to befriend or become close to her. People may come and go to your life. You don't know how much time you *still have with them. Sometimes you take it for granted kasi akala mo hindi na sila mawawala sa buhay na katulad ng mga kapit-bahay niyo o mga matatagal mo ng nakilala pero wag mo kakalimutan na mas malaki ang bahagi ng tubig kesa sa lupa dito sa mundo, andyan ang distance kahit kaya mo lakarin gaano kalayao hindi mo kayang languyin ang pusod ng dagat (lalo na ang Phils. napapalibutan ng tubig) andyan ang kamatayan o kahit anumang mga pwedeng rason para ilayo ang mga taong malapit sa iyo ngayon. Nothing is permanent except change. Hindi sa tinatakot kita gusto ko lang i extend ang pang-unawa mo about sa pag lisan ng isang tao. (Journal, June 21, 2011 entry) With the help of the therapy, the client was able to understand and appreciate people around her more. She seems to be able to look past their imperfections now. In one instance, she became very suspicious of her boyfriends faithfulness because of a comment he posted on a girls photo. She suddenly broke up with him and was mad for days. But after a while, she said she realized that what she did was not right. She felt that she should have been more confident of her boyfriends loyalty. Narealize ko, who am I not to forgive? Finorgive naman ako ni [ex-boyfriend] before. Mas heavy pa nga ang nagawa ko. And I should know ung feelings ni [BF] kasi lumagay ako sa sitwasyon nya before.

She is starting to trust people now. She says that she is still afraid that she might get hurt, but she is confident that she would be able to accept things as they are and move on with grace. She also mentioned that she used to have suicidal thoughts. She wanted to run from her problems because she felt that they are overwhelming her already. But it seemed that once she was able to see beyond the wall she put up between her and others, she now has realized that others can also support her whenever she has problems. She does not need to carry the burden alone.

Facing the Future

One thing that has also caused distress to the client was her uncertainty on how she can face her future. Once she fell on a depressive bout, she has no idea how she can rise from it. Whenever she feels that she has already gotten past it, her troubles come back. With the problems that she is facing, she did not know how she can solve them or how she would adjust. She felt that she has failed her own expectations, and that also hindered her confidence in addressing issues that affect her life. But she has found out that God can help her during times like this, that it is also good that she let things be instead of trying to work things out by herself. Sometimes, problems are the ones which present solutions on how they can be solved. God, help me. I cannot do this. I cannot forgive, I cannot forget. Pero help me Lord to get through with this. Help me to forgive and forget. Help me be a good person. Pls help me po na maishare sa iba nag pagpapatawad at sa mga taong nakagawa sa akin ng mali. Pls help themselves be forgiven. Lord, I dont have any ideas kung ano ang mangyayari, pero I know that you want me to learn from these circumstances. I know that you have a plan for us. I know You will never fail us. You never fail. (Journal, October 11, 2011 entry)

V.

EVALUATION OF CLIENTS PROGRESS It was hard to track the clients progress because every session that we have,

there is always a new grievance that is brought up to be addressed. Because she has an unstable relationship with her boyfriend, whenever they have a fight or problem makes her regress back to her previous insecure self. In spite of her seeming confidence that she does not need anyone in her life, her boyfriend seems to have anchored himself in her life already. She cannot make decisions if he is not around, and she always consults him whenever she has to make choices. During the counseling sessions, it was found out that the client turns to her partner like that because of her excessive thinking. She finds it hard to concentrate on her thoughts which was why she needed to have someone close to her in helping her decide. Once she acknowledged pouring more of her thoughts on her diary, she found herself able to make satisfactory decisions about her life.

There are a lot of things that still need to be addressed, especially her outlook on her life. As of the moment, she is focused on making her relationship with her boyfriend work out. She is unable to trust others because she has already experienced a lot of disappointments from other people but so far, she is making an effort to be more dependent on others. She is trying hard to be more trustful of her partner and despite numerous problems, she is able to lessen on overthinking and focusing on the parts of her life that make her secure.

Furthermore, she is also unsure of how she can face her future. She was so immersed in erasing her past mistakes that she has neglected anticipating events that would probably happen to her in the future. She feels that she has no goals in life because she is anticipating that she will just fail. Her family does not support her in pursuing her dreams which contributes to her lacking in confidence.

In terms of interaction with others, she is still needs to broaden her horizons. She is now uncertain on how to approach other people. She is still not considering making

friends with people from the same sex because she sees them as threats and not as friends.

VI.

RECOMMENDATIONS

From what can be gathered from the therapy, the client still needs to continue having therapy sessions. She is still learning on how to understand herself better, and she will need her familys support a lot also.

For the client: It is apparent that she tends to overthink about things, and usually she gets confused on how to address various emotions. It is recommended that she continue writing down her thoughts in her journal so that shed be able to read and understand them better after writing them. She needs to be more open to her family members. She recognizes their imperfections but she also should realize that they are the ones who are still with her despite others leaving her life. She should realize that her relationship with her partner may be the one making her world revolve right now, but it should not be the center of her universe. She is still young and opportunities will still come to her life. She should know how to address them when time comes.

For her family: It is advised that they become more supportive of the clients endeavors. They do not seem to have the best relationship, but her insecurities may have been heightened by their lack of support. Her fathers absence in the past has affected her which is why it is recommended that they address that issue also.

THERAPY NOTES

DAT E Aug. 22, 2011 Sept. 18, 2011

SESSIO N NO. 1

SPECIFIC BEHAVIORA L GOALS Initial Assessment To assess clients relationship with her family

METHODS/TECHNIQU ES USED Interview

REMARKS/OBSERVATI ON Refer to Initial Assessment Report

Sept. 22, 2011

Sept. 24, 2011

To explore past and present relationships with the opposite sex in the hopes of learning her ups-anddowns in dealing with men To bring back severed relationships with friends

Client is uncomfortable sharing about her family, and usually evades questions about them. However, once she started talking about them she seemed unable to stop. Our supposed to be 1 hour session turned to 3 hours. She poured all of her anger, hurt and questions to me and I was nervous at first because I thought I will not be able to address them properly. 1. Disclosure Client feels guilty from 2. Answer a worksheet past actions on her earlier enumerating her ideal relationships. She and abhorred traits in seemed to be curious the opposite sex, which about relationship with the also includes sharing the opposite sex which was traits possessed by her why she was so open to present boyfriend new experiences. 3. Thought record sheet

Probing Modified HOPE worksheet

1. Journals 2. Challenge unhealthy or misguided notions about having peers 3. Modified STOPP (Stop, Take a breath, Observe, Pull back and put in some perspective and Practice what

Client does not feel comfortable being with friends because most of her former boyfriends were introduced to her by her friends. She wants to make new connections.

Sept. 30, 2011

Uncover strengths and handling weaknesses

Oct. 4, 2011

Find time for a hobby

works) worksheet 1. Talking-out Cure 2. Situations of notable and ordinary day to day kinds of achievements are similar to what the client possesses. 3. ACE (Achievement, Closeness and Enjoyment) log 1. Journals 2. ACE (Achievement, Closeness and Enjoyment) log

Client claims to understand what she needs to do but she is confused about what to address first.

Oct. 8, 2011

Explore perception of self and conflicts that may have affected the clients thoughts. Overcoming insecurities

1. Journals 2. Thought record sheet

Oct. 10, 2011

1. Journals 2. Disclosure 3. Body Dysmorphia thought record sheet

Oct. 14, 2011

Improving interaction with others

1. Talk-out 2. Meeting former friends

Client feels that she will not be able to pursue hobbies because of her many responsibilities. Her shaky relationship with her parents also makes her think twice on having hobbies that she can spend a lot of her free time on. Clients self-esteem is fragile. She feels threatened by women who she thinks would attract her partners attention. She wants to be the person who is prioritized in the relationship. Client has noticed that her partners previous girlfriends were usually fair skinned women. She is a typical morena and what she finds lacking in her skin makes her a loser. Client was not yet ready to meet former friends/acquaintances. She was afraid to connect with them again. She claims that they have judged her harshly and that she hurt their feelings as well.

Oct. 16, 2011

10

Possessing new abilities

1. Journals 2. Modified Behavioral Experiment worksheet

Client is not yet confident to pursue hobbies or skills that complement her. She needs support from people who are close to her, but since the person she is closest to is her boyfriend who she has problems with recently, the support that she needs is still missing.