In analyzing the movie Ordinary People, the first thing that struck me was how dull the environment looked. All I kept thinking was that if I was that client, it could have added on to the suicidal thoughts. It was just plain depressing. However, the psychiatrist greeted him in a welcoming way, I thought. He started off with universalizing the fact that all the people who go there seem to try the wrong door. I believe that although the psychiatrist was not too warm in his presence, at least that comment could have been an ice breaker that may have eased the initial anxiety he may have been experiencing.

One of the things that struck me was how this psychiatrist had the presence of an “ordinary person.” I think that many people seem to expect this perfect being and here was this psychiatrist that may have been seen by Conrad as just as “crazy” or not, as the rest of us. He smokes too which makes him again just “normal.” However, what was not normal for me was the fact that this therapist smoked in front of Conrad during session. What if Conrad was allergic to smoke or didn’t care to be around second hand smoke. In essence, this therapist may have also been placing Conrad’s health at jeopardy. It was kind of like a double standard.

The session started off somewhat judgmental and non empathic. One of the first questions the therapist asked was if Conrad had money. That question alone may make a client feel that what is of importance is the money and I would think that it would be difficult to influence someone in a positive way if they think is that getting paid takes precedence; even though, I know it is important for the therapist. I think he could have somehow asked him differently. Perhaps something like, “I know therapy can get be expensive and I’m wondering if you have given that some thought.” This may have prompted the client to give information about his means for payment and perhaps some insight into the socioeconomic status of the client.

In thinking about the psychiatrist’s approach I thought that perhaps he was confrontational and didn’t leave Conrad with much room to analyze things at first. For example, he told the client that he likes to be in control and that he, the therapist, was not big on that. This statement could have been misconstrued as placing the therapist in the driver seat. Conrad already told him he was not feeling like he was in control and if the therapist is going to take charge and not allow the client to experience some level of control then that could have ruined the relationship; although, I think that in this particular case, this approach may have been implemented in an effort to get Conrad to react since he wasn’t allowing himself to feel. Perhaps the therapist continued to strip him off his power to get him to realize that he needs to really face what is going on which was that he was his worse critique. The problem wasn’t what happened; the problem was the thoughts of guilt he was experiencing. He was experiencing these irrational thoughts.

Additionally, I noticed that the therapist asked too many “Why” questions. That could have been a roadblock to communication between the two of them. Conrad was already feeling guilty and this form of probing and questioning could have made Conrad feel more defensive or labeled. However, as the session progressed I saw more empathy from the therapist. He began to use more reflecting methods such as empathic echoing and supporting sounds. He started to allow Conrad to take a little more control of the sessions and therefore, it looked like he was utilizing a mixture of confrontation and person centered approaches. I think that when he noticed that Conrad was beginning to show some emotion he stopped telling him what was wrong and started listening to what Conrad felt because at that point he was ready to open up.

I saw mixture of confrontation, rational emotive, gestalt, and person centered approaches during the sessions. I think this psychiatrist was echoing some of the things Conrad was saying to make him realize what he was saying and therefore, thinking about himself. He even asked Conrad the question “How long are you going to punish yourself?” I think this statement put everything into perspective for Conrad because the thoughts he was having were how he was punishing himself. The thoughts were making him feel suicidal. He also mirrored Conrad a lot and this made him come out of this passive world he was living in. Conrad actually began to confront people about things particularly his mother which he never did before.

In analyzing the multicultural sensitivity however, I believe this psychiatrist was not sensitive to Conrad’s age. He kept calling him “Kido” almost implying that he is superior and perhaps older and wiser. I don’t think this was a good tactic. This is a power approach and it doesn’t always work well. I think maybe because Conrad was so used to sitting back and watching things happen it didn’t affect the therapeutic relationship. Perhaps there was some transference in that Conrad’s mother seemed to treat him as if he was inferior. But, whatever the case was, this psychiatrist and Conrad bonded and they even disclosed this bonding to each other when they both said they were each other’s friend. I think this was important for Conrad to hear since he was lacking support systems.

The following is a practice 30-minute counseling session with a client. The session is audio taped and 8 minutes of the interview is transcribed. This paper includes a description of the client including the history and presenting problem. Additionally, the session will be described and analyzed in terms of the techniques and interventions utilized and how the client responded.

Section I: Description of Client

            Jackie is a 30-year-old Latina female who is currently in a Graduate School. She currently lives alone. She came dressed casually and is appropriately groomed in no apparent distress. She appears to be her stated age and is of average height and weight. During the interview, this client appeared slightly anxious but composed.

Jackie sought out counseling because she experienced the loss of her live-in boyfriend whom she resided with for four years. She has no past psychiatric or medical conditions but stated that she has family members who are diagnosed with schizophrenia and depression. According to the client, she believes her father is suffering from depression and has been for many years but he is not receptive to treatment. Additionally, he abuses alcohol but she doesn’t feel he is currently dependent on it. Jackie’s mother divorced her father approximately four years ago. This is when she and her now ex-boyfriend decided to move in together.

Jackie experienced this loss approximately five months ago and she decided to seek out counseling because she was feeling increasingly sad and was unable to remain focused at work and in school.

Section II: Description of the Session

The session took place in Jackie’s home in her kitchen. Her home appeared to be cluttered and when I arrived and I wasn’t sure where we would meet for session. Jackie eventually moved her piles from her kitchen table and made room for us to meet. At first, it seemed a bit uncomfortable because I felt the messy surroundings were distracting and making me scattered. Jackie was friendly to me but initially was unable to focus on our meeting. She consistently tried to engage me in small talk, which I attributed to her anxiety. I politely asked her if we would please begin and she agreed.

As I had suspected, something was on Jackie’s mind. She informed me she saw her ex-boyfriend at the ski slopes this past weekend. She had not seen him since he “walked out” on her. This is a place they frequented together and I had a hunch that perhaps she purposely went there to see him. To her surprise, she saw her ex-boyfriend speaking to another girl and this made her emotional perhaps shooting down the idea that they might attempt to rekindle their romance.

I believe the approach I used was more of a person-centered approach by attempting to guide her to always be the “driver.” I think she responded well. For example, one of her strengths is that she was insightful enough to realize she does not cope well with stress and that she allows her frustrations to dictate her behaviors. She independently decided to make a change realizing that she needed to “find herself again.” This is referring to the idea that she had given up her control to this person in her life so deeply that she was not able to recognize herself any more.

I utilized a lot of empathy during our session and I believe this worked for her because part of her problem is her feeling of inferiority and not being respected or wanted. I think I allowed for an atmosphere of understanding and she appreciated it to the point where she began to realize certain things about herself on her own. She was able to experience a sense of control.

Because she made reference to her father and ex-boyfriend ignoring her I thought the utilization of empathic echoing was allowing her to experience acceptance because she was listened to and remained an important person in this process. This is something she lacked in her previous relationships. I also utilized a lot of affect by asking her consistently about her previous feelings and current ones, including how she felt about our relationship.

The parallel she was making between her ex-boyfriend and her father is something that she concluded. She knew that the old issues with her father’s neglect surfaced; however, when I approached her about her father, she resisted. I thought I might lose her and I did want to explore the issue with her father a little more. However, I respected that she was not ready to go there and allowed her to continue in the driver’s seat.

I don’t know that silence worked well for her. A lot of times it took a while to figure out what I was going to say or ask; therefore, there were many periods of silence. I noticed this made her uneasy and at times I would find myself asking the same questions in different ways because I needed to buy more time. I did not want her to feel like I was inadequate or that she had to fill in the moments of silence. She had already started the session with some anxiety about seeing her ex-boyfriend with another girl so I believe that based on my observations, this made her uncomfortable.

I implemented many techniques of exploration and elaboration. For example, I utilized a lot of questions in my session. Most of our dialogue consisted of open-ended questions. She responded well to the questions and didn’t seem to want me to give her all the answers. I attended both physically and psychologically which I thought was well appreciated since her issue was feeling ignored and rejected. I think the bulk of my approach consisted of reflection, prompts, and empathy. This empowered her to maintain the position to recognize things in herself. Additionally, the use of validation was implemented to motivate her to accept change.

I believe it was easy for me to be culturally sensitive because the client and I shared similar demographics in terms of ethnic background, age, and education level. At times, I feel working with a client who is extremely different than me will put me at less ease because part of my session will require a conscious effort to be cultural sensitivity.

Click Here for the transcript of the session

Section IV: Overall Evaluation and Comments

I enjoyed meeting with Jackie. I feel comfortable with people who allow me to guide them as opposed to clients who want me to give them the answers. She was extremely accepting of taking the lead, which goes well with my style of counseling. I think in the future I would explore her relationship with her father and perhaps recognize how it may all tie into her current use of coping mechanisms. The most difficult thing for me right now is implementing a non-repetitive flow of questions. I was not sure if my client was aware but when I listened to the tape, I noticed I asked a lot of the same questions, which she had already given me answers to. This could be misconstrued as me being a poor listener or non- accepting and/or needing to test. I think in order to meet those challenges I would need to be more genuine with my client and just let the client know when I’m stuck. I think that my fear of inadequacy places me in a situation where I need to carry-on the front of just flowing according to plan. I definitely need a lot more practice. When I decided to major in this field I had no idea how difficult it really is to “get paid just to talk to people.” It is a lot more complicated than I had anticipated but I am finding that I am also learning about myself in the process. I assume this is the “awareness” as a starting point that I keep hearing in my counseling classes.