Therapy Transcript: An Analysis of a Session
Clinician: Hi, How was your week? (Greeting and welcoming, open-ended question)
- Client: Okay, I guess
Clinician: You guess? Sounds like you’re not sure it was okay. Can you tell me more about that? (Reflection, sharing a hunch, open-ended question, elaboration, middle circle talk)
- Client: Well… I went snowboarding this weekend like I do every weekend and guess who was there?
Clinician: Mmm …tell me who was there? (Supportive sound, reflection, open-ended question)
- Client: Eric, my ex
Clinician: How did seeing him make you feel? (open-ended question, exploration of affect)
- Client: Well, I was angry because I saw him talking to another girl.
Clinician: Mmm… So you felt angry because you saw him talking to another girl. Was that you’re initial sight of him when you saw him talking to another girl? (Supportive sound, empathic echo, elaboration, reflection of affect, open-ended question)
- Client: No…I walked into the lodged and I saw him standing there…. Urrrrr…. whatever.
Clinician: Tell me more. (Elaboration, prompting)
- Client: Well…I saw him standing there. I don’t even know if he saw me at first but… I got like this excitement like….you know because I haven’t seen him in a while. And I felt a little scared because I kind of wanted to approach him but I didn’t know how he was going to act…if he was going to turn away or…. you know, say something stupid. And then everybody around him left and it was just them and it just seemed like they were flirting or something.
Clinician: It sounds like you were probably feeling a little jealous. (Reflection of affect, validation, labeling affect)
- Client: Yeah, I was.
Clinician: A lot of people would feel that way. Was there more to your weekend that you wanted to talk about? (Universalizing, elaboration, prompting, empathy, open-ended question)
- Client: No, I didn’t really see him after that. I kind of just stormed off, you know.
Clinician: Yeah. How do you feel right now? (Supportive sound, checking-in)
- Client: I got to say I feel more relaxed because I’m venting and that’s what you need to do.
Clinician: It’s very hard to lose you’re significant other and then see him with another person but I’m glad that you’re feeling more relaxed now. (Empathy, validation, reflection of affect)
- Client: Yeah…. it always makes me feel good to talk to you; although, some people say it’s kind of stupid.
Clinician: Mmmm, what do people say about you coming to talk to me? (Supportive sound, exploring influence of others, tried-and-true question, can be misconstrued as tangential questioning)
- Client: Well…. my friends fell like I should jus save my money and talk to them because to them it’s just like…. Well, why are we your friends, you know? That’s what friends are for. And my sister thinks that I shouldn’t be talking to a perfect stranger because they don’t know me very well. They don’t know the people I deal with. So, she thinks that maybe I should talk to people that are in my circle. And my mother, it just totally old fashioned and thinks that it’s for psychos you know that I’m losing my mind or something.
Clinician: Sounds like many people in your life have (cleared my throat) have umm…some ideas about you coming to see me. What are you’re thoughts about that? (Summarizing, reflection, open-ended question, eliciting additional feelings, prompting)
- Client: I think that as long as I feel good about it then that’s what’s important.
Clinician: Is the direction we’re going in okay with you? (Checking in, tried-and-true question, client as the driver)
- Client: Yeah. It’s fine.
Clinician: Okay (supportive sound)
Silence
- Client: You know, I got an A on that paper I told you about last week.
Clinician: Wow! Sounds great! You see, despite your recent experiences you still manage to do well in school (affirming client’s strengths, validation of accomplishment, empathy, supportive sound)
- Client: Yeah. I try.
Clinician: Mmm…Okay, ummm. Let’s continue talking about your loss of you’re boyfriend (refocusing, supportive sound)
- Client: All right.
Clinician: We haven’t talked about how you’ve been handling you’re feelings of sadness (initiating a new topic, prompting, elaboration of affect)
- Client: Well, I keep felling like I just can’t move on like …I have this baggage that is going to follow me with whomever I meet or…or any path I go in life.
Clinician: Does this baggage you’re referring to have to follow you around? (underling, reflection of metaphor, exploration of theme)
- Client: No.. I guess it doesn’t but……….I don’t know.
Clinician: Where do you think this baggage really comes from? (Exploration and elaboration, inner circle talk, open-ended question)
- Client: Well……I think it has something to do with my dad.
Clinician: I see…Talk to me about that. (Supportive sound, elaboration, prompting)
- Client: Well, I guess growing up my dad never made me feel like I was important…. always saying things to belittle me and stuff like that. And then…when…Eric would do that stuff to me, you know like, he would go riding and not pay any attention to me or…just play poker and…disregard whatever I said to him, it kind of made me feel the same way, you know?
Clinician: So you’re feeling like your boyfriend reminds you of when your father used to…..make you feel like you weren’t important(Reflection of feelings, paraphrasing, exploration of transference)
- Client: Yeah…well…I guess it’s all my fault though, you know because I just can’t control my attitude (internal locus of control)
Clinician: So you can’t control you’re attitude huh. (Reflection, underling, prompting, exploration of internal locus of control)
- Client: I guess if….I guess I can if I really tried.
Clinician: Are you saying you haven’t really tried? (Underling, problematic type of questioning).
- Client: Well, I don’t thinks so.
Clinician: Earlier you were talking about how your boyfriend reminds you of your dad…(refocusing, promoting, exploration of transference)
- Client: Yeah.
Clinician: Tell me… How do you think that all ties into with your attitude? (Elaboration, prompting, open-ended question)
- Client: Umm…I..I just can’t control my mouth sometimes. Like I think that I just provoke them by just things that I say, you know. Maybe to them it stupidity, I don’t know, but, I guess I say things to hurt them and then it just instigates a fight automatically.
Clinician: It sounds like this attitude your referring to may be a way to protect your feelings. (Underling, reflection,
- Client: Mmmm….(silence) Like, that it hurts me?
Clinician: Yeah, like that it hurts you. (Supportive sound, reflection, empathic echo)
(Silence)
Clinician: You know, anger usually comes right after hurtful feelings and the attitude may be a way to cope with those feelings. (Exploring affect and behavior, labeling)
- Client: Yeah…. I guess you’re right…..I do feel hurt sometimes but ……I just wish that it wasn’t like that, you know?
Clinician: How would you like things to be different? (Future oriented question, prompting, and empathy)
- Client: .I just don’t want to feel angry…I wish…. I just wish I didn’t care so that it didn’t bother me so much and I could just let things go. I just can’t do that. I just can’t let things go and let them be.
Clinician: Yeah, I understand…Tell me, what else happens when things do get to you (supportive sound, elaboration, paraphrasing)
- Client: Well….I cry…I yell…I throw things…I do stupid things.
Clinician: Mmmm..So you cry, you yell, you throw things or do stupid things. (Supportive sound, dot-dot-dot reflection, reflection of pattern)
- Client: Yeah you know, like when I saw Eric with that girl…. I started flirting around with these guys that were there…mmm…yeah.
Clinician: So there is more to your weekend. (Underlining, elaboration)
- Client: Yeeaah, I guess.
Clinician: Mmm. So you saw your ex, Eric with that girl and you started to flirt around with other guys and then…(supportive sound, reflection, summarizing, prompting)
- Client: And then I just felt like complete and utter crap because he didn’t pay any attention to me or maybe he just didn’t see me. I don’t know…You know I could just keep my eyes on the guys and him at the same time even though I tried my best. I just kept thinking that I probably ruined our chance of getting back together. But then again, why should I even bother trying if he walked out on me.
Clinician: so seeing Eric with another girl hurt you. and then you felt a little jealous… which in turn made you angry… and in order to cope you decided to get back at him by trying to make him feel jealous and he didn’t pay mind to you. Then it sounds like you wound up feeling a little guilty. Does that make sense to you?(paraphrasing, reflecting with affect, checking in, clarifying)
- Client: Yeah, I guess it does.
Clinician: Okay, let’s revisit the parallel you made between your dad and your boyfriend. (supportive sound, refocusing on theme)
- Client: Wooo…. wooo, my ex-boyfriend.
Clinician: Ex-boyfriend. Did losing your ex-boyfriend remind you of losing your father? (Underlining, addressing transference, could be misconstrued as empathic failure, open-ended question)
- Client: No because my father never walked out on me.
Clinician: Do you mean he didn’t physically walk out on you? (Exploration, open-ended question, problematic question if client not ready to explore)
(Silence)
- Client: Umm…I guess…I guess your referring to the fact that even though I see my dad physically we still don’t talk or haven’t talked in so many years
Clinician: Yeah. What are your thoughts on that? (Supportive sound, empathy, prompting, open-ended question)
- Client: I don’t’ know. I haven’t really thought about it. But, to be quite honest I don’t even want to talk about that right now.