Individual Counseling Reflection

During my foundation year of the MSW program I provided individual counseling services to a 23-year-old female patient at Kaiser Permanente. This case summary analysis and reflection paper is based on the sessions I provided to this patient. During the intake session, the patient reported she was admitted into the emergency room for a total of three times in the last 3 months due to persistent panic and anxiety symptoms. The patient indicated that she began to excessively worry about "the possibility of dying and becoming ill" and that her increase in symptoms were was triggered by her role as a caregiver. She indicated that her mother is diagnosed with Multiple Sclerosis and her grandmother has both Chronic Obstructive Pulmonary Disease and …show more content…
She was undoubtedly proud of her progress thus far and I soon realized that there was no need to aggressively motivate her in pursing things that were too far out of her confront zone. I reminded myself that these were not her initial goals of treatment. Her goal was to “feel like herself again” and reduce her symptoms of panic and anxiety. Consequently, I realized that as she gained successful coping skills, she eventually, possibly years from now, obtain success in achieving higher level goals such as of securing a job or returning to …show more content…
She persistently stated that she had a fear of dying and getting sick and was constantly worried she will not wake up the following day. I personally believed that she may have felt this way because many family members had a significant diagnosis and she lost her grandfather to a heart attack unexpectedly a few years earlier. Caregiver stress also may have been a significant factor in the increase in her symptoms. She was a consistent support for her elders and a mother of three young children. Caregiver stress, in addition to actual health concerns that run in her family genetically, may have triggered her panic attacks and thus a generalized anxiety disorder. Early in treatment I determined that as this was the patients first time in counseling, journaling could assist her in reflecting how her cognitive distortions are influencing her feelings and behaviors. This intervention worked as she enjoyed writing and she was able to see the influence her belief system had on her actions. With this new tool, she could now identify themes that she consistently catastrophized. As it became clear that she could reframe her belief system, the working alliance became stronger and I observed an increase in her confidence in combating her symptoms. I continued to role model by providing her with a variety of interventions such as worksheets as a guide and the