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In this essay, will critical analyse the Therapeutic Alliance and how well the technique and skills were use during the counselling session. This was filmed in a College meeting room, with D who is a student. Moreover, the evidence indicates that it may be the nature of the client?s participation in treatment that is the strongest predictor of outcome.
The session started with greetings, introduction and a reason the DVD was recorded for a College. I asked she preferred to be called by her first name, and then I asked her the reason why she comes for counselling. D said that she wanted to talk about her kid?s minder. Next, we explore the ways in which CBT?s have fostered and maintained this orientation-specific ideal relationsh.D said the child minder is extremely clean, before you get into her house you have to take off your shoes. D said that the child minder husband wear gloves in the house because she does not want him to get things dirty. I asked D how many kids does the minder have to care for, D said five kids the youngest being two, D said that she can smell the stuff the minder use for cleaning the house.
D said the minder is good with kids but they know their boundaries, and know where not to touch. She is talking about this because she fined it uncomfortable. That when she goes into the minders house there?s a smell of bleach, then I asked her an open question so that she can tell me more. I asked D what is it that she want to achieve from counselling? D said that she doesn?t like dirty places, also doesn?t like a place that smell of bleach, she?s trying to understand this from her own view and find out why the minder does that. I keep on nodding my head so the D can feel understood when she is saying something. Furthermore, understanding specific thoughts and style moreover, processes of thinking can go a long way to explain negative feelings to clients themselves, who may well have been experiencing these negative emotions as particularly incomprehensible and frightening.
The aim of cognitive therapy is to understand both the person?s personal domain and their idiosyncratic way of appraising events. D and I in this session the connection, rapport, show her that I? am warm and genuine. D said that kids know that they are supposed to play or stick things on the wall, because the wall gets dirty. I asked D on the scale of 1 to 10 how clean is the minder D said 11% that is extremely clean. I asked D how did she feel leaving her kids with the minder, she said she feel good that her daughter is in a clean place, she wont get any infections. D at the same time she?s feeling sad, because if she can smell the cleaning chemicals how about the small lungs, D have mixed feeling sadness and appreciation that the minder is a clean person. A compulsive, perfection ?driven individual may create an environment that is highly structured and ordered.
D said you could drop kids six am; the house will be spotless the same way it was when you pick them up in the evening. Whether the minders have kids in her care or not the house is spotless. CBT is fundamentally a collaborative project between therapist and client. Both are active participants, with their own areas of expertise: the therapist has knowledge about effective ways to solve problems, and the client has expertise in his own experience of his problems. . I used my listening skills but at the same time showing interest, requesting clarification of understanding what she is saying. Building the Therapeutic Alliance. D explained that the first time she went to the minder house the house was clean but the cleaning stuff was not that strong because the minder used the air freshener to cover the smell. D said she liked that, it was comforting. As time went on, she did tell the minder about the cleaning stuff, that it could be too much for the kids breathing. D think that the minder did not seem to understand what D was saying. D went on saying that she does not want the minder to change, and she would not want her kids going to a dirty place.
D said she has been to other minder?s house?s they are filthy, but at the same time when she live her Kids she is thinking about the cleaning chemicals. D leaves her kids with the minder for ten hours, she has been doing this for two years, and they have never been ill. D concerned about the staff the minder is using to clean the house. I asked D if the minder?s cleanliness was the attraction that made her take her kids there. D said yes. Then I asked D a reflection question that the same thing that made her take her kids to the minder is now turning to be the only thing she does not like about the minder. D said yes.
D said the minder never let the kids near the kitchen, she has a playing area. The minder did assure D the chemicals are kept upstairs. The minder is obsessed with cleanliness that kids know that they cannot touch things. D think if she can smell it kids can smell it too, she also think that probably she the only one who can smell this staff, she think she?s emphasised are most the importance of capturing hot cognitions,i.e. those which seem to most directly linked to the client?s most significant emotions. Cognitive interventions will be most effective if they target these hot thoughts. D think that the only solution to this is to move her kids, but so far the minder?s she?s meet they are dirty, and not up to the job. Nevertheless, with her kids minder is articulate, accommodating, even though she has this big weakness she tick all the boxes, she is reliable. D does not know what to do D is looking for a solution, because D cannot give the minder rules to clean her house.
D concerned about her kids but have to take into consideration, the fact that D work long hours, and the minder have close relationship with the kids. D suggests that if she buys things for the minder it will look like an insult. Suggested that D speak to the minder about her concern. D said she is willing to try. D said she spoke to other parents but she is not sure how they feel. D does not want to influence other people that is the reason she come to see the Therapist. So that she can find a way to explain how she feels to the minder. The affect of this in future, when kids are coughing X think about the staff they are in hailing on a daily basis and wonder if is the cause, but they normally get well.
It is essential to ?train? clients through the therapeutic process to look for what is working and what will work, for them to acknowledge it for themselves and to give self-praise, especially when our clients are so used to noticing what is not working. Reflected to D what she said and clarify few things to her to make sure we were still in the same track. D said she feel better if she can talk to the Therapist about her concern she can talk to the minder. Ds worry is that how much she can do to influence the minder to change. D said she spoke to the minder when she knew her for a month. I asked D how long does she know the minder for now. D said two years, I pointed out the fact that maybe now that she has known the minder this long. D can speak to her again. I asked D if we were still in the right track and still discussing what she come to talk about. D felt reluctant the fact that the minder did not hear her then. How can she hear her now, but D looked at the two years period she has known the minder and thought maybe the minder may be willing to listen.
I asked D how did she feel about counselling session. D said she fined it helpful, and she can now look at her relationship with the minder because they help each other. We sat homework for D to speak to the minder, so that they can find a common ground, she can tell me all about it on our next session.
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