Mock Counseling Session
John Doe
University of Central Florida
Abstract
Professional counseling can be very beneficial to one’s health and well-being. Counseling is used to help clients with change, prevention, or life enhancement. Unfortunately, many people are unaware of the potential benefits and complexity of true counseling. There are many theories and methods which are used to treat clients and regardless of the counselors preferred method they must be trained sufficiently at conducting counseling sessions and interviews. A mock clinical diagnostic interview was conducted with a mock-client and many important skill sets learned through the course were utilized. The counseling session is guided by both non-verbal communication and verbal communication. Active listening and understanding of the clients presenting issues guided the mock session.
The cosmic amount of different theoretical orientations and techniques used by psychotherapists can be overwhelming. The styles are constantly changing as new findings come out. Even psychodynamic theory, which is one of the oldest known theories and links back to Sigmund Freud, has been altered in certain cases to a more contemporary method which is “less dogmatic, more flexible and integrative, supported by evidence, more pragmatic, highly attentive to relational needs, less hierarchical and applicable to a wide range of clinical problems with vulnerable populations” (Bliss & Rasmussen, 2013). The varieties of techniques are ideal for certain situations and a counselor must pick and choose depending on their clients’ needs. Cognitive-behavioral therapy, behavioral theory, humanistic theory, existential theory, and eclecticism theory are just some examples of different styles employed in psychotherapy and are certainly dissimilar to each other.
Counseling has an impressive length of history and can be traced back to the Enlightenment period. Counseling is not necessarily a hard science in a sense because the lack of one specific guideline. According to the American Counseling Association, professional counseling is “the application of mental health, psychological and human development principles through cognitive, affective, behavioral and systematic intervention strategies, which address wellness, personal growth, and career development, as well as pathology” (Kaplan, Tarvydas, & Gladding, 2014). Counseling has many different specialties each suited for different scenarios. However, a common goal of all counseling is to help the client with change, prevention, or life enhancement (Hackney & Cormier, 2013). Unfortunately, many people that could benefit from counseling fail to give it a try due to cultural reasons, bias reasons, or simply are intimidated by the whole process. Some individuals might fear that seeking counseling would damage their family’s reputation due to strong stigma by close others, which might result in the individuals’ development of negative attitudes toward seeking professional help and a lack of willingness to seek counseling (Choi & Miller, 2014).
A mock clinical diagnostic interview was conducted to practice using the skills learned for counseling throughout the course. The interviewing process takes hundreds of times to fully master it and this was my initial interview. Probing is important in the clinical diagnostic interview and when a client states something with an imperative meaning the investigation should be made to further dissect the potential problems. Base lines of questions have been set forth to ask the client but are not meant to be strictly followed but rather as a dedicated guideline. Inferences based on what the client articulates should be given in detail by the client and redundancy should be avoided in the interview.
The counseling intake interview I would be performing is a very important process. “Intake interviews, as part of the assessment phase of counseling, gather information about the client’s reasons for seeking counseling, current and past functioning, social history and interpersonal style, and goals for counseling” (Mears, 2009). First impressions are vital while trying to establish a relationship with the client. If the client feels too uncomfortable with the therapist for any reason proper treatment may not be available or the client could even choose not to continue the counseling process. In this primary interview conducting a good starting rapport with the client will be the main goal along with deciding which psychotherapy technique to use in future sessions. With further counseling down the road and a stronger relationship with the client I could then begin defining the presenting problem, identifying and setting goals, choosing and initiation interventions, and planning termination and follow-up.
Before the mock interview I prepared myself emotionally and physically. Physically, I made sure I was well groomed and would be taken seriously by the client while at the same time seem approachable and not make the client feel awkward. The goal is to make the client feel comfortable enough to open up and even something so subtle such as counselor appearance can have an effect on the mood. I also made sure the mock office was a comfortable setting and ensured there wasn’t going to be any furniture between us which could produce a psychological barrier. As for my psychological preparation, I recited the questions to be asked beforehand so it would be one fluid motion when the time arrived. I also prepared probing questions and studied some Rogerian examples as a refresher to person-centered therapy.
As my mock client walked in I stood up and greeted her. We sat down adjacent to each other and began the mock session. The communication within a counseling session is both verbal and non-verbal. I made sure to sit with an open, relaxed posture as to convey comfort with the process. I would be using the head nod at certain times to show acceptance and understanding of what the client has to say. I also was mindful of my facial expressions because it has been found that “long-held belief that counsellors must engage their clients in a meaningful and demonstrable manner as indicated by their non-verbal behavior appears to generalize to their facial expressions also” (Sharpley, Jeffrey, & Mcmah, 2006). Since the client is at the interview to express her thoughts verbally, I knew when to remain silent and when to speak. One of the most important things a counselor does is listen. The self-improvement of a client is seeking is actually within themselves and the therapist is there to help make that happen. Silence is powerful and encourages many positive effects.
Before this counseling intake interview began I dwelled into as much information on the client as possible and read all paperwork given on the client. Since the purpose of the intake interview is to gather information necessary for the evaluation and treatment of the client I made sure to take notes as we began. I was really interested to know as much as I could about the client so I had her clarify what she is like as a person and important figures within her life. I made sure to have her tell me any current complaints and any history of psychiatric problems as well. She expressed that she has a certain degree anxiety to me. Anxiety is not uncommon for her age, “mental disorders appear to be on the rise among college students and are having a significant effect on their attrition, with anxiety identified as one of the most common presenting issues” (Lindsey, 2014). The anxiety even affects some aspects of her life while lowering self-confidence and having somewhat of a negative impact on everyday things such as driving, working, and sometimes shopping. There were no visible medical complications except a lack of sleep at times due to the anxiety. This lack of sleep was very uncommon so it was not too worrisome. If there had been much sleep disturbance it could be linked to a more serious psychiatric problem as “sleep disturbance is significantly linked with an onset of major depressive disorder” (Batterham, Glozier, & Christensen, 2012). The most recent episode had been about a week ago. She said the episode seemed to increase as she gets older but could not decipher the origination or what triggers it.
While interviewing the mock client I used a variety of verbal skills used by professional counselors. I used open-ended questions, closed questions, clarification responses, reflection responses, minimal reinforcers and paraphrases. The main purpose of using these techniques is to “keep the focus on the clients, their stories, and their reactions” (Hackney & Cormier, 2013). As the interview went on she distressed a traumatic experience with an American Staffordshire Terrier when she was young, which could actually be the source of her anxiety. I then used an open-ended question to probe further into this problem. After further details I determined that this was an important life event that affects her even today so made note to follow up on this subject later on in future counseling sessions because a main goal during the intake interview is to lay the foundation for future interactions. Confronting a client too early in an emerging relationship could have devastating effects. I recited a summary statement of the traumatic event and story she told me to let her know I was actively listening.
After we had been in the interview for some time, I noticed she had resentment towards her father’s work schedule. I used a technique call the interpretation response for this and introduced a counselor-initiated interpretation. This response is used to assign meaning to a feeling that the client is having. The meaning of the feeling can then be moved in a different direction. I tried to use the information given as a question and had the client interpret the meaning. When the client interprets the meaning the therapist can either accept or modify what they have to say.
By the end of the counseling session I had probed more into the anxiety disorder the client had been describing. I suggested that there are many coping strategies that may help with the anxiety including perspective taking, communication strategies, anxiety relief tactics, diversions, self-reflection and self-help, and reviewing possible scenarios (Mortensen, 2014). I gave her the information on potential coping strategies and she agreed to come back for further testing to determine exactly what would be right for her.
In conclusion the mock clinical diagnostic interview conducted was excellent overall and helped clarify many details I was unsure of before I began. Learning about how beneficial counseling can be has given me a deep respect towards psychologists. The Professional Counselor, A Process Guide to Helping by Harold L. Hackney and Sherry Cormier really helped guide me through this mock-interview and this course as a whole. Being a counselor requires someone very knowledgeable and patient and this firsthand experience helped me appreciate the study that much more.
References
Batterham, P. J., Glozier, N., & Christensen, H. (2012). Sleep disturbance, personality and the onset of depression and anxiety: Prospective cohort study. Australian & New Zealand Journal Of Psychiatry, 46(11), 1089-1098. doi:10.1177/0004867412457997
Bliss, S., & Rasmussen, B. (2013). Reflections on contemporary psychodynamic theory in clinical social work. Journal Of Social Work Practice, 27(3), 211-215. doi:10.1080/02650533.2013.818938
Choi, N., & Miller, M. J. (2014). AAPI college students’ willingness to seek counseling: The role of culture, stigma, and attitudes. Journal Of Counseling Psychology, 61(3), 340-351. doi:10.1037/cou0000027
Hackney, H., & Cormier, L. (2013). The Professional Counselor: A Process Guide to Helping. (7th ed.) Boston: Pearson.
Kaplan, D. M., Tarvydas, V. M., & Gladding, S. T. (2014). 20/20: A Vision for the Future of Counseling: The New Consensus Definition of Counseling. Journal Of Counseling & Development, 92(3), 366-372. doi:10.1002/j.1556-6676.2014.00164.x
Lindsey, C. (2014). Trait Anxiety in College Students: The Role of the Approval Seeking Schema and Separation Individuation. College Student Journal, 48(3), 407-418.
Mears, G. (2009). Conducting an intake interview. In I. Marini, M. A. Stebnicki (Eds.) , The professional counselor’s desk reference (pp. 127-134). New York, NY, US: Springer Publishing Co.
Mortensen, R. (2014). Anxiety, work, and coping. The Psychologist-Manager Journal, 17(3), 178-181. doi:10.1037/mgr0000020
Sharpley, C. F., Jeffrey, A. M., & Mcmah, T. (2006). Counsellor facial expression and client-perceived rapport. Counselling Psychology Quarterly, 19(4), 343-356. doi:10.1080/09515070601058706
APPENDIX, TRANSCRIPT:
Therapist: Could you tell me about your childhood. What was it like growing up?
Client: Umm, I had a pretty solid upbringing. My parents stayed together and took good care of my sister and me. We moved a few different states because of my dad’s job and ended up in Florida.
Therapist: Oh?
Client: I didn’t get to keep friends for very long because of the constant moving.
Therapist: I understand that you had to move a lot as a child because of your father’s job and earlier you stated that you weren’t looking forward to seeing him during the holidays. Do you think you resent him because of the constant moving?
Client: I’m sure that has a lot to do with it. I just feel like he never made time for us.
Therapist: So you feel hurt by the fact that he was always working.
Client: Kinda, I know he loves us but I think he could have tried to spend more time with us.
Therapist: That must be very difficult for you. Is this something that you would like to address more during the course of therapy?
Client: Thanks, sure.
Therapist: Can you tell me about your relationship with your mother? What is she like as a person, and what was she like as a parent?
Client: I’m very close with my mom and in terms of the type of mother she was, she was always caring and like catering to others. Do you know what I’m talking about?
Therapist: So your mom is attentive?
Client: Yes, always putting the needs of others and the people she cares about before her own.
Therapist: Now I’d like you to describe a specific encounter with your mother, something that stands out. It can be an incident that’s typical of your relationship, really meaningful, really good, really bad, whatever comes to mind.
Client: I remember I ran off and got lost at a mall once when I was young and she searched frantically and found me despite how many people there were. I was scared and was crying and she came and comforted me.
Therapist: That must have been a chaotic time for you. Is this one of the reasons why you say she is so caring?
