I have been working with a 13-year-old Hispanic female who was referred to counseling due to behavioral and academic problems in school. At first, my thought was that this was sort of the cliché case and so perhaps it would not be as complicated as I thought it would be. However, as I was learning more and more about this case, as usual, what is on the surface is just that, superficial and a small component of the whole picture.

When I chose my concentration in community counseling, I figured I would work with various clients but for some reason it didn’t occur to me that I would be working with children. My preference is to work with adults because although you can still get sued, at least an adult has a choice and can make or should be able to make an adult decision. Internally, I guess, this thought gives me a sense of less responsibility when dealing with adults but for a child, a counselor needs extra caution. This is not only because treating a child may highly influence him or her, but also because in essence, the parents are being treated too, even if they are not the “identified client.” This whole triangle and its effects is what makes me nervous about cases with children.

With that said, I think this is not solely the reason why I do not think about this case as much of others. I believe the reason is more because I do not agree with the parenting style and lifestyle of the mother. It makes me highly uncomfortable because I do have my own biases, which I always work on, but it is still challenging for me when these biases are in my face. How can I tell this parent that perhaps what this child is doing is a reflection of what is happening at home without offending her? This child has had multiple stepfathers and at that, the most recent is one she really “hates because he tries to be my real father.” Now, in exploring that feeling it sounds like this man is stern beyond what she is used to and as she has reported, verbally abusive to her mother. The problem here is that this child seems to be getting progressively worse and although I have met her for four sessions, she seems to be decompensating, as per the mother.

So perhaps the reason why I don’t think of this case as much when I really should is because I am stuck and I don’t know how to help her. The good thing is that I seem to be connecting well with her, enough to have inspired some trust in her where she opened up about personal issues. I believe that on some level at least she has the support of a female adult since she feels she is not getting this from her mother. However, it seems though her anger is not subsiding outside of the counseling session and I almost feel pressured by the mother, although she is not directly pressuring me, to make changes in her daughter.

I have realized that this could possibly be pressure I am putting on myself because I usually tend to take on huge tasks because it keeps me moving. Or, maybe it is similar to how this child is feeling. I don’t know but if it’s the former, usually when pressure overcomes me, I put it on my to do list. I think this is what may be happening here. The problem is that one can’t put a human life on a to do list. For this reason, I have chosen to face my fear and called in this child’s mother and stepfather. I don’t know what I would say but I have a plan on discussing different parenting styles and issues with blended families in an effort to help them identify where they fall in the continuum. I figured this would at least help the parents understand some of the behaviors that may be manifested by this child. I am hoping it goes well.

Well, I had my first no show this week. I wonder what that means. I don’t know if I should be worried that therapy is not working for this person or just accept that I will have cancellations and that it won’t be my first or my last.

Needless, to say, I say in my office toiling over it because I had no clients. In addition, I was supposed to have another new client last Wednesday, a 25 year old male who had his first son with his 17 year old girlfriend and he beat his 1 year old son. Charges are pending for child abuse and his girlfriend is actually the client of one of my colleagues. Here goes that issue I remember always talking about in class.

The one where the professors ask you to think about what clients you will find yourself having a hard time working with. It’s difficult to think about it though. I want to be as empathic and accepting of everyone. In fact, when those questions were asked, I always had a hard time answering them because I couldn’t really narrow it down to any one issue that I would have a hard time dealing with in a counseling situation.

I always thought I would have a problem with working with battered women due to my own experiences with that. But at the same time, I’ve thought about the possibility of being really good in that area due to my experiences and therefore, insight on how the women may be feeling. In either case, this client did not show. I reviewed his chart over and over and the more I read it, the more nervous I was becoming. So many things were running through my mind. The first thing I thought about was his age. Since I’m close to his age and I’m from a similar background than he is, I wonder how seriously he would take my as his counselor.

I also wonder if he would cross that boundary and flirt or anything of that nature considering that we are also close in age. I toiled over this and I came to the realization that I need to get over it. I noticed that I always have issues working with young males I think because in my younger years during my career as a Recreation Therapist, I worked at an inpatient unit where I was stalked by a patient when he was discharged. The person would call and call and wait for me in the parking lot and at one point threatened me if I didn’t go out with him. I guess my mind always goes back there and even now when I run my substance abuse groups on Wednesday nights, I feel a little uncomfortable if I notice one of the guys staring at me.

I think since that experience I’ve always had issues with working with men with whatever issue due to the fear that they will come on to me. In retrospect and in evaluating that list of client that I would have a challenge treating it basically would be men, not only because of that isolated incident I just discussed but because of my own experience with domestic violence and the underlying feeling of losing control and allow to be controlled of by a perpetrator.

Additionally, in reviewing the case about the guy who beat his one year old son, I wondered if I new him because he’s from my town and how I would handle that not only in session but also if I were to see him outside of session. I think it just all came down to the same thing, my feelings about my own experiences that were making me nervous about this one particular case. In any case, I have yet to see this client. There are some scheduling conflicts that have impeded his attendance to therapy, which is court mandated by the way, and at this point, I’ve thought of it so much that now I just want to meet him and move on.

In my experience so far, I have faced many challenges and insecurities, especially when I am to meet a client for the first time. At times, I wish there was a simple template to follow that would work for every client; however, I know this is not the case because every person and family is different. Perhaps this is when the theories come in to play where there is no specific format but a paradigm that I see now, is important and therefore, appreciated when working with a client.

In reflecting on the many trials that have been presented to me during this experience, I find myself thinking quite frequently on a male client I have been treating for the last six weeks. In analyzing and interpreting the reason why I think of him often, I was forced to bring into consciousness the countertransference that has surfaced in my mind but I chose not to dissect thoroughly for some time. I found myself many times immensely overwhelmed with thoughts about how the treatment can be truly therapeutic for him and even discussed different possible interventions with my fellow co-workers at my internship site.

So why does this client occur to me the most? The reason being is because he reminds me of my ex-fiancé. I sort of knew it from the beginning and in an effort to deal with this feeling I believe I in essence, fought against the possibility of terminating him when he failed to show for two consecutive sessions. I must share though, that since learning about the topic for this assignment, this client popped into my mind. Interestingly, I have not spoken about him in class and I minimally pursue a discussion about him during supervision at work. I must say, I believe I have not used the supervision time to discuss this case because of the differences in styles between my supervisor and me. With that said, I do realize I might just be rationalizing.

The way my supervision is structured is to discuss all new cases first. When I opened this particular case, I did inform my supervisor the presenting issue and the reason for seeking treatment now as was reflected on the initial contact form that this client filled out. As I was discussing the information that I learned from him during our first session, which was minimal due to his high resistance, my supervisor immediately asked me a question that seemed so abrupt and unrelated but was obvious to her. She asked, “So what annoys you about him?” As I maintained my composure from the shock I answered her, “He just does.” I knew at that point I was faced for some challenges but in spite of this, I didn’t close his case when I had the chance.

At this point, I feel I have dealt with these internal issues well enough to not let them interfere with my work with him. He still leaves a presence when our session has completed but I don’t feel the nervousness I felt during our first few sessions. In addition to that, his level of resistance has also decreased and I have been able to really understand what is going on with him because I just felt I couldn’t make progress with him in the beginning. I was also able to eventually discuss with my supervisor the possibility of a personality disorder but it was difficult to diagnose him because I wanted to make sure this was in fact what was being reflected and not my own biases. I am not a big fan of diagnosing anyway so the challenge was two-fold.

Ultimately, I did not have to diagnose him because I realized he was self-pay but I do appreciate now the learning experience and how real it can be to experience strong feelings for a client I never met just because he reminded me of somebody else. In summing it all up, I am glad to say that the counseling sessions must be working for him because he referred someone else to me for treatment.

I am completely in disbelief that more that half of the semester is gone by. I must say, I am feeling a little bit more like a counselor as the weeks go by. I find myself becoming more confident as I go into session. I still get somewhat nervous when I know I’m going to meet with a new client. This is especially this week. I was told last week that I will see a new client who is a 16 year old male whose mother was just diagnosed with stage four colon cancer.

To be honest, I have never experienced having a close family member with cancer or any terminal illness for that matter, but I felt overwhelmed with when I was given the initial contact information. I have no clue how I was going to help this client and neither did I think I would be working with a teenage kid with those circumstances. In any case, the day arrived to see this client. As if anxiety wasn’t killing me enough, my car broke down literally in the parking lot of the agency I work for. I thought how true is the old cliché, “when it rains it pours.” I was so shaken up but needless to say, think I handled things well. I met my client with his mother.

I realized I have preconceived expectations about the mother before I met her. I imagined a frail lady with perhaps a wig due to chemo or someone who was perhaps grief stricken who would probably be sobbing about her fate. However, that was far from the truth. My client’s mother appeared as healthy as any women and mother would be. I couldn’t tell she was ill if I hadn’t known ahead of time. She seemed so well put together and so healthy.

My client however, it was obvious something was going on with him. His affect appeared somewhat depressed, understandably so. When I initiated the psychosocial assessment and asked him about his presenting problem, he verbalized that he and his girlfriend broke up.

During the entire initial first meeting we spoke about the girlfriend. I’m starting to learn how these emotional symptoms are manifested. I remember from my presentation in class, with my female client who is going through relationship issues that we as counselors need to be open and creative enough to understand the deeper real issue without making judgmental assumptions.

It is quite tough though. In this particular situation, because I had read the intake ahead of time, I was prepared to work on issues of grief and loss with the dying mother. I even did research on how to work better with him. I was so ready to go there and I guess this was yet another learning experience. He was not ready to go there and preferred to talk about the girlfriend.

In fact, I think I may have even made a mistake by asking him about how he was dealing with his mother’s illness and he said the two situations are “completely separate and one has nothing to do with the other.” Needless to say, on one hand I was “checking in” which a technique we learned in our Counseling Techniques is” class but I’m not sure if I should had checked in about that since he didn’t bring up the issue. I mean, this was our first session, so perhaps I could have waited and did the same thing I did with my female client who is struggling with her loss of her ex but had underlying issues with her dad.

I’m not sure. I kept thing that I will continue to see this kid and that what if his mother dies while he is in treatment? I guess this is what I was thinking, basically going in with my own agenda as opposed to meeting the client where he is. It is quite challenging because it is so easy to slip if you’re not careful. Since I know as a human being I go in there with my own set of issues but I keep wondering if it is actually possible to always separate yourself completely without letting your own agenda somewhat sneak up every now and then.

I feel a little stuck. I have this client whom I have been seeing since the beginning of my internship and I feel like we have hit a plateau in our sessions. I don’t know if to take is as if she has gotten better and is coping better now with the breakup of her relationship but I feel almost robotic when I speak to her. I feel like I am struggling to prompt her and she is just there answering questions and not really deeply getting into things. I mean, I think that she has definitely progressed. When she first came in she came in with this attitude like she came to therapy because it was an option that was there and that her insurance covered. She did get to a point when she was able to express her grief and show that she is not as well put together as she comes across.

I don’t think this is a bad thing. I think she is now well aware that her feeling of loss and the way she is coping is related to her relationship with her father. She has made a few comments surrounding this issue but will not stay there long enough to really explore what’s going on with her and her dad. I don’t know, although I feel like this is the underlying issue with her, sometimes I think that maybe its just me trying to make sense of it all. I mean, what else could it be, I think.

To me it is somewhat obvious that she is having all of these same pattern intense relationships and she is only 23 years old. What is she looking for in these men and why does it seem like she is just never always happy. She has even admitted to always having something to complain about in all of her relationships. Her relationships with her boyfriends are all she really likes to talk about. She does make reference to her school and her work and feeling stressed out about the amount of work she has and the amount of tests she has to study for, but at the end of the day, its seems like she is in this quest to find approval in all these guys. I think it is almost like the approval she is looking for in her father since she did make a comment about never hearing from her father that he is proud of her.

On a similar yet different level, when I asked her if anyone’s has ever treated her nice she said yes but she doesn’t seem to stick with those guys. It almost seems like she wants to be the guys who may not necessarily be so nice, but will one day change and treat her good. I know it sounds cliché but this is really real. Another thing that I have noticed about her is that she constantly complains that this guy stares at other girls and that he “makes” her feeling ugly but he has complemented her in the past and she has been unable to tolerate his complements. I guess this is typical when a person is not used to hearing praise. It is almost like its undeserved and something that needs to be worked on hard enough before you get it. I think this is why she works so hard and why she is a perfectionist, although she has realized that perfectionism is not necessary and has reflected on it long enough to accept that she may make mistakes every once in a while.

I don’t know, my supervisor says this is normal sometimes in therapeutic relationships. She said perhaps she’s had a slight relapse and feels like she’s above it all and doesn’t really need “therapy” because she is “smart” enough to handle it. She keeps coming though. I figured that since she is still participating, something has got to be working for her. Besides, it’s almost a good thing if it is true what my supervisor says because that way I know that I haven’t eased a dependency in her.

In reflecting on my easiest client, I found one particular case to stand out. Usually, I’m nervous every time I go into session with clients; particularly those I feel are the most challenging. However, with this specific case, I do remember feeling nervous when I was going to meet with her for the first time after reading the initial contact form with the presenting issue, but I then found out after meeting with her that she turned out to be my favorite client. The client I am referring about is a 24-year-old Hispanic female who was having difficulties getting over her 3 year relationship after the break up. This woman had broken up with this man a year prior to coming to treatment and was still finding herself preoccupied with the situation to the point where it was not only affecting her self esteem, but also her work and motivation in school.

What I think made this case easy for me initially was the idea that I could relate on many different levels, particularly in that I have been broken hearted before, as most of us have been. The problem was that I thought at that time that this was why I enjoyed working with her, because it was something that I was familiar with personally and felt fairly competent in the matter. In contrast, my other cases were drug related and I guess, I felt somewhat inadequate and inexperienced. As I continued the journey of personal reflection, I later came to realize and more now that I am rethinking that experience that yes, perhaps I felt like I could be of more assistance because I felt more knowledgeable about situations like those but more importantly, I discovered that she reminded me a whole lot of my sister who was also experiencing a similar situation at that time.

Don’t get me wrong, I definitely became aware that perhaps some counter- transference issues where transpiring and I believe my awareness and professionalism was what kept me from telling her to “screw him” in regards to the guy she was talking about, but had I explored it a little more, I would have realized that I was spending way too much time talking about “him” and his issues and background than focusing on my client’s personal healing. As I continue to reflect, I come more into the realization that subconsciously, I think I was comparing situations and I’m wondering if some of what we talked about was biased from my part.

In pondering the use of basic techniques of reflection and prompting for deeper exploration of the matter, I think that my way of asking questions, not so much the questions I asked, was enough to send my client the message that I did not like this guy she was talking about. In my head, I think I thought the idea of having someone side with her was healing enough, but as I think about it more and more, it really didn’t all have to do with her situation.

I don’t know, sometimes I feel that the more I look for flaws in my style and how I handle particular cases, the more I find and granted, there is always room for improvement. However, even though I had thought about this case frequently, revisiting that time is making me think I did this woman less justice than I had originally thought. Unfortunately or fortunately, depending on how one looks at it, I don’t see her any longer because her insurance only covered a few sessions, but I’m thinking that probably the reason why I never really thought about it on this realm was perhaps my own fear of discovering that my favorite client, whom I thought was “easy” to work with, turns out to be the most challenging case I have had thus far and there is nothing I can do about it now, except learn from it.