Assignment 1: Practicum – Client Termination Summary

Assignment 1: Practicum – Client Termination Summary

Students will:
Develop client termination summaries
To prepare:
For guidance on writing a client termination summary, review pages 693–712 of Wheeler (2014) in this week’s Learning Resources.
Identify a client who may be ready to terminate therapy. With the client you selected in mind, address in a client termination summary (without violating HIPAA regulations) the following:

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The Assignment
Identifying information of client (e.g., hypothetical name and age)
Date the client initially contacted therapist, date therapy began, duration of therapy, and date therapy will end
Total number of sessions, including number of missed sessions

Assignment 1: Practicum – Client Termination Summary
Whether termination was planned or unplanned
Presenting problem
Major psychosocial issues
Types of services rendered (e.g., individual, couple/family therapy, group therapy)
Overview of treatment process
Goal status (goals met, partially met, unmet)
Treatment limitations (if any)
Remaining difficulties and/or concerns

Assignment 1: Practicum – Client Termination Summary
Recommendations
Follow-up plan (if indicated)
Instructions for future contact
Signatures
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
Chapter 17, “Psychotherapy with Children” (pp. 597–624)
Chapter 20, “Termination and Outcome Evaluation” (pp. 693–712)
Please avoid plagiarism, the school Is very strict with this issue. Thank you
The client

Assignment 1: Practicum – Client Termination SummarySample Essay

Name: AO

Initial Contact with the Therapist: November 1st, 2017

Duration of Therapy: 12 months

Date of Termination Summary: November 1^st 2018

Number of Sessions: 60

Duration of Each Session: 60 mins

The Termination

In the entire course of treatment, the client had substantial improvement. She expressed her individual wish to terminate the therapy based on contentment and the extent to which she had progressed. She had also enrolled for a master’s programme which she noted will place new demands on her finances and time. Therefore, a termination date scheduled for 5^th November 2018 was set. The client fully attended the planned session for termination. She also expressed her gratification for the collaboration and the significant improvement she had made so far.

Client’s Presenting Problem and Major Psychosocial Issues

The client was a 28 year Hispanic Latino. At the time of presentation, she had had a bad conflict with her boyfriend with whom she plans to settle with. The client came for psychotherapy due to suppressed emotions; being socially withdrawn and inability express herself before friends, family and work colleagues. She made it clear that this was interfering with her performance at work and was full of fear on its possibility of limiting her potential for professional advancement as a business psychologist. She also explained about tensed moments with traumatic thoughts and flashbacks which started shortly after the death of her father in a road traffic accident, which she was also a victim. It is after this incident that she moved to live with her boyfriend.  She narrated that she grew up in a Hispanic household and leaving her mother to stay with the boyfriend before marriage was religiously unacceptable and resulted to conflicts with her boyfriend and her family (Maldonado, 2017).  She reportedly had no previous psychotherapy experiences and this was her first.

Services Rendered

During the treatment course, it became evident that the client avoided talking about the death of her father but was also having insomnia. The management of her insomnia became an essential part of the therapy. The issue of grief that surrounded her father’s death in a road traffic accident in which she was also a victim became another essential focus of therapy.

Overview of Treatment Process

The client underwent cognitive behavioral therapy to address her traumatic nightmares, insomnia and panic attacks (Falsetti, Resnick & Lawyer, 2018). It was easy to develop a trusted long-term therapeutic relationship which played a great role in successful health outcomes. Based on the subjective data, the client’s major issue was an inability to concentrate at work and in social life and inability to express her opinions and thoughts. A comprehensive analysis and exploration of the issues revealed that the client had for quite a long time lacked psychological space to express herself. At the beginning of treatment, she was aware of her role in her family as a conflict resolver and how she couldn’t address the same conflict in her life that led to distress. CBT helped her to free herself from this behavioral pattern and focus on her individual needs hence a lot of improvement in her relational and social life (Baldwin, et al., 2014).

The issue of traumatic flashbacks that contributed to insomnia was linked to PTSD in the road traffic accident that resulted in her father’s death in which she was also a victim. Her anxiety about conquering this thoughts, fears, and incidence were therefore explored. To address the issue of traumatic thoughts, exposure therapy was utilized and she could be able to look at the images of the fatal crash and talk about it and how she felt (Manber, et al., 2014).   She was also educated on sleep hygiene and how it could contribute to her performance at work and socially.

Goal Status

Significant strides were made by the client in the entire treatment course and the client was reportedly contented with her progress. She managed to attain specific goals one of them being the ability to express her individual needs and opinions when need be.  She also had increased social functioning in interactions with friends and family, was able to understand the feelings of others with an enhanced ability to resolve conflicts amicably. In the entire therapy course, the client made maximum use of sessions to not only explore but also clarify her individual aspirations in career and to address the specific issues that have persistently been preventing her from making amicable decisions.

Basing on how supportive the therapy was, the client found it easy to cope with the boyfriend’s obsessive-compulsive disorder and the recent loss of her father. Cognitive restructuring and behavioral assessments sufficiently addressed the client’s difficulty with traumatic flashbacks and insomnia which were all resolved at the end of the course of treatment (Teng, et al., 2015).  Generally, the client’s attention, mood, and self-esteem significantly improved by the time of treatment termination.

Treatment Limitations

Despite the fact that during sessions limitations were explored, therapy did not address adequately the existing conflicts that the client had about her religion. The client wished to develop a better and positive religious identity.

Remaining Concerns

The client expressed no substantial remaining concerns and neither was any noted by the end of treatment.

Recommendations

Despite the fact that the client made significant progress and attained her goals in the entire treatment course, for the purposes of ensuring and making maximum use of her psychological wellness and for individual understanding,  she will likely benefit from continuous exploratory analytic therapy in months/years to come.

Follow-Up and Instructions for Future Contact

The client was informed of no particular follow-up plan. She is free to contact the hospital’s help-line in the future if required.

(Signature)

References

Baldwin, D. S., Anderson, I. M., Nutt, D. J., Allgulander, C., Bandelow, B., den Boer, J. A.,  & Malizia, A. (2014). Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder, and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology. Journal of Psychopharmacology, 28(5), 403-439.

Falsetti, S. A., Resnick, H. S., & Lawyer, S. R. (2018). Combining cognitive processing therapy with panic exposure and management techniques. In Psychological Effects of Catastrophic Disasters (pp. 629-668). Routledge.

Maldonado Jr, D. (2017). The changing religious practice of Hispanics. In Hispanics in the United States (pp. 97-122). Routledge.

Manber, R., Bernert, R. A., Suh, S., Nowakowski, S., Siebern, A. T., & Ong, J. C. (2014). CBT for insomnia in patients with high and low depressive symptom severity: adherence and clinical outcomes. FOCUS, 12(1), 90-98.

Teng, E. J., Barrera, T. L., Hiatt, E. L., Chaison, A. D., Dunn, N. J., Petersen, N. J., & Stanley, M. A. (2015). Intensive weekend group treatment for panic disorder and its impact on co-occurring PTSD: A pilot study. Journal of anxiety disorders, 33, 1-7.