Client Assessment Plan in Counseling - Essay Example

?CLIENT ASSESSMENT PLAN Client Assessment Plan in Counseling Word Count: 4039 (16 pages) I. Biological Information A. The Information Provided The information provided was the following. Matt is a 34-year-old single male living with his mother. He works as an accountant, as of now. The reason he is seeking counseling is because he is very unhappy after just having broken up with his girlfriend. Apparently, his mother disapproved of his marriage plans, supposedly because Matt’s girlfriend had a different religion. Matt felt “trapped,” and felt like he was forced to choose between his mother and his girlfriend. He decided not to go against his mother’s wishes and decided to, thusly, break up with his girlfriend. After having done so, Matt is angry with himself. He is convinced that his mother will never let him marry and is very possessive of him. His mother is a very controlling, domineering person who is used to getting her own way. Matt is actually afraid of his mother. He criticizes himself for being weak. However, on the other hand, Matt admires his mother and respects her judgment. Sometimes he thinks that perhaps he made the right decision in breaking up with his girlfriend. Matt, at times, questions his own judgment because he feels it is poor. Matt works at a job several grades below what his education and talent would allow. On many occasions he has turned down promotions because he didn’t want the responsibility of having to supervise others or make independent decisions. He has worked for the same employer for 10 years and gets along well with his boss. In turn, he is highly-respected as a worker. He has two close friends that he has had since childhood. He has lunch with one of them every single workday and feels lost if his friend is away. Matt, the youngest of four children and the only boy, was “babied” and “spoiled” by his mother and sisters as a child. He had considerable separation anxiety as a child and had difficulty falling asleep unless his mother stayed in the room. As a child, he was often teased by other boys, and found it hard to stay away from home even when he was at university. Obviously, there are many other issues which may plague Matt if he does not address these serious issues. If he continues to live in the way that he has without some kind of intervention or rehabilitation, Matt may need some kind of restorative therapy or treatment in the future. B. Further Information Needed Further information which needs to be collected is as follows. The counselor needs to know the extent of the abuse or domineering behavior to which Matt is subjected. Does Matt’s mother verbally abuse him in any way? Is there any nonverbal abuse present in the home? Nonverbal abuse is psychological, and is often difficult to prove in a court of law. It’s more difficult to have to prove that someone is abusing one psychologically than it is to prove that someone is being abused physically. When someone is being abused physically, there are marks which bear witness. Psychological abuse, however, is an entirely different animal. Psychological abuse is something which must be documented by the abused person, with incidences ranging over a period of time. Basically, Matt’s mother has some serious issues, which Matt is now in therapy in order to resolve. Perhaps it might help to know if Matt’s mother would consider joining him at counseling so that an intervention might be staged. Or, perhaps one goal of directive counseling would be to get Matt to the point where he feels confident enough to move out on his own. However, these are all just ideas. In order for something to change, Matt must realize that he has to take action. He has to either remove himself from the situation in which he currently finds himself, or—if moving out is not an option—he needs to find creative ways to avoid his mother’s domineering nature or learn how to defuse her tactics and verbal barbs. Ultimately, Matt should—unless he feels to the contrary—move out at some point. This is a part of growing up, and he should take responsibility as a grown man to provide for himself. He has a job. It’s not like he’s living at home unemployed with his mother. Basically, Matt is living with his mother because they are co-dependent on each other, and that is largely what needs to be addressed in counseling sessions. Co-dependent behaviors are especially exhibited within Matt, moreso than in his mother. But, perhaps she is exhibiting some forms of co-dependent behavior as well, since she sabotaged Matt’s relationship with his girlfriend in order so that she could continue to live her life with her son unfettered by other relationships in Matt’s life. All these issues should definitely be addressed in counseling sessions, with the focus being upon Matt. II. Presenting Problem(s) This is an accurate list of problem(s) and comments on what the problems may have in common. Problems will be described specifically in behavioral terms rather than just be labeled as “anxiety,” etc. “In most instances, clients seek a counselor (or are encouraged to see one) to help resolve concerns or problems that are interfering with their daily functioning or causing discouragement or despair” (Hackney & Cormier, 2009, Ch. 5, pp. 1). One of Matt’s main, major problems is that he is way too attached to his mother. This is exhibited in everything he does—from the fact that he let his mother’s opinion make him break up with his girlfriend to the fact that he still lives with her. Thus, one of the main issues that Matt has to deal with is the fact that he has to move out so that his mother can relinquish control over him. Without that basic control, Matt cannot have a life apart from what he knows, regarding his mother. In other words, if he does not gain independence from her, he is not going to become independent in all areas of his life. He is not going to be able to stay at home forever—eventually he has to move out and move on, with his life. Perhaps one of Matt’s biggest fears is if he can survive without his mother. This is a common fear, and it is normal, among youth—“Will I ‘make it’ as a Brown person, on my own, unassisted?” Matt’s prevailing problem—which engulfs all his other issues—stems from a huge case of separation anxiety. This separation anxiety is fueled by the overwhelming sense of dread that one feels when one is confronted with with having to separate from a family member, friend, or loved one. Separation anxiety can cause in the client worrisome fears which are not easily overcome—characterized by several elements. These elements include, but are not limited to: panicked breathing; having something similar to a full-fledged panic attack; hyperventilating; wheezing; and not being able to breath properly. Matt is doing himself a disservice by living with his mother. He is a grown man with a full-time job; he wouldn’t be living with his mother if that weren’t the case. It is the counselor who must help him realize that he is currently in a mentally unhealthy environment and that he should move as soon as he gets the chance. These problems that Matt is having are all based on the common problem that Matt is still living with his mother, and therefore is still under the power of her influence. Basically, Matt is someone who desperately needs to “branch out.” Matt is currently at the mercy of his mother’s whims. It’s important that he realize how much power she has over him. Additionally, Matt must recognize his responsibilities as an adult, and, as such, adjust his living situation accordingly. He cannot continue on in the same pattern that he has been working within, because utlimately this will make him run-down and haggard. Living with his mother, Matt will only reinforce both his and his mother’s co-dependency on each other—thus creating a vaccuum that feeds off of itself. Matt needs to realize that his dependence on his mother is sabotaging his own independence. This notwithstanding, Matt has to ensure that he learns how to survive on his own. In other words, this co-dependency cannot continue the way it has for so long. At some point, Matt must “break away” and decide to become an entity separate from his mother. If Matt decides not to become independent, this is going to significantly impair his ability to develop into a well-rounded adult. His inability to “grow up”—in terms of leaving his mother’s house—will be drastically and significantly reduced. Compounding all of these problems is the fact that Matt seems reticent—or at least somewhat reluctant—to rectify his living situation and take charge of his life. Matt needs to realize that he is not the center of his mother’s universe anymore—he is no longer a child. As he journeys into the first steps of manhood, Matt’s own personality will begin to take shape. He is increasingly going to take on more and more responsibilities. Hopefully, by the end of his time living with his mother, he will be at the point in counseling where he has the footing underneath him to take the first footsteps forward towards independence. Undoubtedly, Matt needs to grow as a person, and—even though he may feel some separation anxiety in the beginning—Matt is sure to blossom as a person while finally living apart from his mother. It is of paramount importance that Matt gain his independence as soon as possible so that he might live a fuller and more vivacious life. It is expected that, with time and proper treatment, Matt can overcome his insecurities and shortcomings as a man—and can begin to focus on what he can do and what he is capable of—instead, not focusing on his failures. Eve though Matt suffers from various anxiety-induced and highly-charged situations infused with emotional energy—he has the potential to overcome these problems by being a positive force for change. He can do this by practicing to be a potential model husband and father in the future by taking these responsibilities as real and confronting them head-on, versus ignoring them. This is not only the responsible thing to do, it is the mature thing to do. The only way Matt is going to grow as a person is by cutting the proverbial ‘umbilical cord’ with his mother. Without a doubt, it is true that Matt needs guidance—and perhaps it is with the directive counseling that Matt could perhaps make an “action plan.” This would decidedly improve his ability to deal with real life situations and better his capacity to “take life like a bull by the horns”—learning not only how to be active but how to be proactive. It’s not enough to “be” in life, one must go beyond and “do.” So, it is imperative that Matt must make the most of of his life—or at least do more with himself, his visions, his goals, his plans—than what he has been doing this far up till now. III. Background Information A presentation of the problems is at hand. This section details what information needs to be collected from the client as it relates to the problems history and the impact it has had in the client’s life and in the lives of others (noting frequency, duration, and intensity of the problem). Matt should detail for the counselor when it was that he felt his mother began being too intrusive in his life. When did this problem start? What impact has it had on himself? Do others outside (or even inside) his normal circle of friends and family notice that something is wrong? How long has he had this control issue with his mother? How long do their fights last, if they have any? Has he ever raised his voice towards his mother, or vice versa? It would be helpful to know these pieces of information, so—if they are not pieces of information that are easy to come by—the counselor may have to do some prying. The counselor should try to draw out of the client—in this case, Matt—what is the root of the problem. When did his mother start to become such a big part of his life that he could no longer have much control over his own anymore? It only makes sense that one realize that Matt’s mother was there from the very beginning of his life—and, at some point, Matt grew so dependent upon her emotionally, that her presence has ended up becoming such a large part of his life that he cannot do without her. However, this is an unhealthy relationship, for which Matt needs counseling to repair and overcome. Matt has to realize that this relationship between himself and his mother has stifled at least one other important relationship in his life—which was that between himself and his girlfriend. Since his mother did not approve of their relationship, Matt ended the relationship. That was not necessarily a “healthy” way of approaching the situation, and perhaps Matt now realizes that what he did—breaking up with his girlfriend—was a grave mistake, especially due to the fact that the relationship could help Matt blossom so much as a person. Another issue which should be examined is if there has been any previous symptoms of abuse of any kind that has taken place in Matt’s home—whether it be physical or verbal abuse. Of course, one would hope that this would not be the case, but one can never be sure unless one asks. Additionally, it might behoove the counselor to ask if there are any remaining issues which need to be summarily dealt with in due time. It could be problematic that some other issues might come up within the context of finding out more background information. However, it is hoped that this will only further serve to help in the assessment of the client’s issues—which will be discussed more in detail in the section which follows. The assessment will be based not only on this background information but also on the interview and observations which are completed within the first session between the counselor and the client (Matt). IV. Assessment Instruments (i.e., Interviews, Observations, Tests) Here, the appropriate use of an interview and other observations will be utilized. The rationale for this interview will be to garner further information on the person seeking assistance. Observations will be made as a way of assessing the situation. A. The Interview The interview is one of the most important parts of an assessment. This gives the counselor the chance to do an in-depth study regarding the clients’ needs. If the client is willing to volunteer different kinds of information about his background, personal and professional work history—as well as fill out a personality questionnaire—these tools could be very helpful to the counselor, who has to make an initial evaluation based on this data. Basically, the counselor has to make initial assessments for treatment and judgments aout what methods and/or approaches should be utilized. Definitely, Matt’s temperament is going to play a role in counseling therapy. Is Matt a combative person? Does he anger easily? A personality assessment—in addition to the interview—will help the counselor determine the approximate level of the clients’ emotional maturity as well as many other elements which are chiefly gained through assessment. If the client has previously been involved in another or other types of therapy—or has seen any other counseling professionals—it could be helpful to the current counselor to give such references a call in order to effectively and accurately gauge Matt’s temperament. The interview is meant to be only a small—but important—part of assessment. At any rate, the interview is an accurate way for the counselor to come to conclusions about what avenues will be considered in treating the client’s issues at hand. Hopefully, what is hoped is that the client will at some point move on with his life to the effect that counseling wil either: a) no longer be necessary; or b) have diminished to the extent that it will be less and less necessary or frequent. Once the client gets to the point where he no longer needs as much guidance, the counselor may then see the client on a contingency basis. If the counselor deems no more such counseling is needed, then the counselor may (at will) decide to end the sessions between the counselor and the client. However, if the client contends that he still wants therapy—for whatever reason—the counselor may agree to continue seeing the client based on the client’s wishes. If the client wishes to discontinue treatment at any time, the client may be referred to another counselor if issues are still being sorted out. B. Observations Observations of Matt’s behavior may aid in helping the counselor determine Matt’s temperament and how he will respond to various methods of treatment. Observations that the counselor may make would include the client’s body language. Ninety to ninety-six percent of all communication is non-verbal. That is why it is so important for the counselor to write down—during the session—if Matt’s body language denotes submission, shyness, a reticence to speak, or other behaviors that may “clue in” the counselor about the client’s personality. These subtle cues—revealed by body language—can definitely shape a counselor’s perception of the client. If the client is timid, for example, the counselor may want to work on developing the client’s self-confidence by improving his self-concept. Does Matt slouch? Does he have poor posture? Does he speak in low, hushed tones, or are his reactions more visceral, raw, and uncensored? Does Matt exhibit the finer points of social graces? Does he have any difficulties interacting socially? How does he feel around friends and family? How does he act around strangers? Is he an ambitious person? Is he an over-achiever? Is he an underachiever? Does he have difficulty staying focused? Did he have problems in school or was he a good student? These are all questions which should nad must be asked by the counselor in order to also assess whether matt might need some extra support, assistance, or referral—say, medication from a psychiatrist. All of the appropriate avenues should be pursued so that Matt’s behavior is not a result of any major underlying problems before moving to the next steps in counseling. Ideally, before Matt begins counseling, he should get a physical exam—just to rule out any other issues which could be for larger issues that Matt might not even be aware that he needs to deal with, therefore. Matt’s evaluation and assessment will, therefore, require some observation in the office setting. The key is to ensure that the collection of such information is as minimally non-invasive as possible—so that it doesn’t intrude with the session. The counselor should make notes to himself or herself as the first session continues. It is important that the counselor have enough opportunities in which the counselor can effectively observe Matt enough to make a valid and even-handed assessment. V. Types of Questions to Ask This is a review of the various question forms that might assist the clients to talk about their problems, the history of the problems, and the problems’ possible causes. Here are a few questions which the counselor might possibly consider asking Matt for an overview: What is the earliest memory you have of your mother? This is a deeper psychological question. In the interest of Freud’s psychoanalysis, this question is going to be asked so one can get a sense of how deeply-rooted Matt’s psyche is tied up with his mother and her demands and her will. If Matt has a strong connection with his mother, it is going to be difficult to treat the separation anxiety he may feel when he has to break his ties with his mother. Since Matt suffers from separation anxiety, it is important that the counselor pay special attention to this fact. It may be that Matt might need some kind of extra outside support in order to become independent from his mother successfully. How do you feel about your mother? This would be a great, non-invasive question to ask in order to reveal Matt’s true feelings about his mother. This question is designed to get Matt thinking about how attached he actually is to his mother. That way, he will have more insight into what (or who) actually motivates, inspires, and drives him to be a better person. We need to analyze how Matt feels about his mother. If we don’t learn this “connection,” it is possible that his counseling might be guided in a different direction. We need to know to what extent that Matt is emotionally dependent on his mother. In order to do this, he must be interviewed—which has already been addressed in this paper. Where do you see yourself in one, five, or ten years? This is important to get Matt to think about. He must have goals—and a life—outside of living with his mother. This must happen even if he chooses not to move out immediately because he needs to realize that his future directly (and indirectly) depends on his ability to sever (at least) some ties with his mother. If he continues to be clingy and co-dependent, this is not progress. Therefore, it is important to realize what we define as progress in the search to better Matt’s life and living situation. What are your goals for the future? This question will get Matt to start contemplating the future—even if he does not aspire to having a lot of plans. As the saying goes, “Fail to plan, plan to fail.” So, basically, one of the essences of this question is that Matt needs to basically think about his future on some kind of serious level. By getting Matt to plan his future goals in counseling—it will be more feasible to work towards those goals if there are actually goals to be had. If Matt doesn’t have any tangible, achievable goals, it could impair his ability to move forward in his life as well as in counseling. What do you feel is the problem or what are the problems that you would like to address in counseling therapy? Having Matt state himself, what are the problmes that he would like to solve, will help immensely for the counseling to start. It will give the counselor a sense of direction—a way in which the counseling should be directed. In other words, if Matt wants to focus on being more independent from his mother, it is most likely that the counselor will discuss things like helping him as he transitions from living with his mother to living on his own. Additionally, any other issues that matt would like to take care of in therapy should be connoted to the counselor so that these issues can be tackled as well. How does your mother make you feel? This question is designed to reveal the layers of Matt’s relationship with his mother. In other words, this is a relatively non-invasive question. However, it can reveal much about the extent of their relationship—and help the counselor know, by the way Matt responds, how emotionally indebted he is to his mother. If he is so constricted by his mother’s every desire that he can’t function normally, he is going to have to resolve these issues in counseling. This may be problematic for Matt’s mother, who definitely may not want to relinquish any form of control over her son’s behavior. What are some of the aspects about your mother that you wish you could change? This question will get Matt to think about what he despises about his mother. Is it her domineering behavior? Is it the way in which she presents herself? Matt needs to be prodded by his counselor to do some truly serious, deep thinking about the power control issues that exist between himself and his mother. What three goals are most important to you right now? Matt’s most important three goals should include: moving out of his mother’s house and becoming independent; improving his relationship with his mother to the point where his self-esteem is not affected by her impetuousness; and being able to develop healthy, close relationships outside of his best friend and his mother. These goals seem like they are reachable ones for Matt, and he should make his best effort to try to reach these goals with directive counseling. Directive counseling will help Matt to refocus and envision how he sees himself living his life in the future. This will help him immensely. REFERENCES Hackney, H. & Cormier, S.. (2009). The professional counselor: a process guide to helping, 6th ed. Pearson Education, Inc. Read More