This course is based on the 90 day independent study model, and is primarily self-paced. Therefore, most of the work is done in assignments
Lecturer- Counseling Methods CHC
3102
In Christian Counseling the
Bible serves a continuing guide for all of our thinking
about counseling and it provides for us a worldview base
on the stability and trustworthiness of the Scriptures.
Cultivating relationships is a major task in the
counseling process.
The role of a counselor or helping person would need the
following strengths:
-
Empathy-
the ability to understand how another person feels
or perceives an experience.
-
Genuine-
the ability to be fully yourself and to express your
unique individual style and personality to another
.
-
Respect-the ability to communicate to another
person, both verbally and non-verbally, the belief
that he or she has inner strength and capacity to
make it in life
-
Self-disclosure- the ability to communicate personal
thoughts, feelings, attitudes, and beliefs to
another person in an appropriate manner when it is
in the benefit of the other person for you to do so.
-
Warmth-
is a nonverbal behavior that demonstrates positive
regard and makes another person psychologically
visible in positive way.
-
Immediacy-the ability to identify and clarify
specific problems and issues.
-
Concreteness-the ability to identify and clarify
specific problems and issues
.
-
Confrontation- the act of honestly communicating to
another person your perception of reality...
Listening attentively - to what the client says
is more than hearing, but focusing and concentrating on
what is said... Listen to what is implied, and. listen
to what the Spirit of God is saying to you. Question
wisely and watching body language is a part of attentive
listening. In developing a treatment plan, determine
what specific areas nee tobe changed and the level of
commitment to change. Then develop a treatment plan
goals based on accomplishing the changes.
The problem areas could fall into one of the following
categories:
1. Spiritual 6. Family
2. Legal, 7.
Relationships
3. Financial, 8. Addictions
4. Physical, 9. Sexuality
5. Employment 10. Other
Development of a Treatment Plan
Problem Area 1
Goals
Method of Treatment
Measurements
ULR-Unlimited learning Resources-Treatment Planner Software Modules
Example
Treatment Plan
Primary Problem:
Depression
Behavioral Definition
l Loss of
appetite.
l Diminished
interest in or enjoyment of activities.
l Poor
concentration and indecisiveness.
l Feelings of
hopelessness, worthlessness, or inappropriate guilt.
l Social
withdrawal.
l Depressed
affect.
l Low
self-esteem.
l
Sleeplessness or hypersomnia.
Long-term Goals
l Alleviate
depressed mood and return to previous level of effective
functioning.
l Develop the
ability to recognize, accept, and cope with feelings of
depression.
l Develop
healthy cognitive patterns and beliefs about self and
the world that lead to alleviation of
depression symptoms.
Short-Term Objectives/Therapeutic Interventions
l Describe
the signs and symptoms of depression that are
experienced.
Entry Date:
4/13/2001
Target Date:
4/30/2001
Projected Sessions:
2
Critical?:
Yes
Ø
Explore how depression is experienced in patient's
day-to-day living.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Encourage sharing feelings of depression in order to
clarify them and gain insight as to causes.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
l Verbally
express understanding of the relationship between
depressed mood and repression of
feelings-that is, anger, hurt, sadness, and so on.
Entry Date:
4/13/2001
Target Date:
5/3/2001
Projected Sessions:
4
Critical?:
No
Ø
Encourage patient to share feelings of anger regarding
pain inflicted on her in childhood that
contributes to current depressed state.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Explain a connection between previously unexpressed
(repressed) feelings of anger (and
helplessness) and current state of depression.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
l Identify
cognitive self-talk that is engaged in to support
depression.
Entry Date:
4/13/2001
Target Date:
5/28/2001
Projected Sessions:
6
Critical?:
Yes
Ø
Assist in developing awareness of cognitive messages
that reinforce hopelessness and
helplessness.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
l Replace
negative and self-defeating self-talk with verbalization
of realistic and positive cognitive
messages.
Entry Date:
4/13/2001
Target Date:
7/3/2001
Projected Sessions:
8
Critical?:
Yes
Ø
Help the patient keep a daily record that lists each
situation associated with the depressed feelings
and the dysfunctional thinking that triggered
the depression. Then use logic and reality to
challenge each dysfunctional thought for
accuracy, replacing it with a positive, accurate
thought.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Assign patient to keep a daily journal of experiences,
automatic negative thoughts associated with
experiences, and the depressive affect that
results from that distorted interpretation. Process
journal material to diffuse destructive
thinking patterns and replace with alternate, realistic,
positive thoughts.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Assigned homework for From Here to Where?
Entry Date:
4/13/2001
Provider:
l Make
positive statements regarding self and ability to cope
with stresses of life.
Entry Date:
4/13/2001
Target Date:
7/17/2001
Projected Sessions:
8
Critical?:
Yes
Ø
Reinforce positive, reality-based cognitive messages
that enhance self-confidence and increase
adaptive action.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Assign patient to write at least one positive
affirmation statement daily regarding himself/herself
and the future.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
l Decrease
frequency of negative self-descriptive statements and
increase frequency of positive
self-descriptive statements.
Entry Date:
4/13/2001
Target Date:
6/17/2001
Projected Sessions:
8
Critical?:
Yes
Ø
Assign exercise of patient talking positively about self
into a mirror once per day.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Reinforce patient's positive statements made about self.
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Assign patient to write at least one positive
affirmation statement daily regarding himself/herself
and the future.
Entry Date:
4/16/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Assigned homework for Define Failure/What Kept You From
It?
Entry Date:
4/13/2001
Provider:
Arthur E. Jongsma, PhD
l Implement a
regular exercise regimen as a depression reduction
technique.
Entry Date:
4/23/2001
Target Date:
Projected Sessions:
10
Critical?:
No
Ø
Develop and reinforce a routine of physical exercise to
stimulate depression-reducing hormones.
Entry Date:
4/23/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Recommend that the patient read and implement programs
from Exercising Your Way to Better
Mental Health (Leith).
Entry Date:
4/23/2001
Provider:
Arthur E. Jongsma, PhD
Secondary Problem:
Financial Stress
Behavioral Definition
l
Indebtedness and overdue bills that exceed the ability
to meet monthly payments.
l A feeling
of low self-esteem and hopelessness that is associated
with the lack of sufficient income to
cover cost of living.
l A long-term
lack of discipline in money management has led to
excessive indebtedness.
Long-term Goals
l Establish a
clear income and expense budget that will meet bill
payment demands.
l Contact
creditors to develop a revised repayment plan for
outstanding bills.
l Achieve an
inner strength to say no to one's personal impulses,
cravings, and desires which directly or
indirectly increase debt irresponsibly.
Short-Term Objectives/Therapeutic Interventions
l Describe
the details of the current financial situation.
Entry Date:
4/17/2001
Target Date:
4/24/2001
Projected Sessions:
Critical?:
No
Ø
Provide a supportive, comforting environment by being
empathetic, warm, and sensitive to the
fact that the topic may elicit guilt, shame,
and embarrassment.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Explore the patient's current financial situation.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Assist patient in compiling a complete list of financial
obligations.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
l Reconstruct
the history of the problem in an attempt to isolate the
sources and causes of the
excessive indebtedness.
Entry Date:
4/17/2001
Target Date:
4/30/2001
Projected Sessions:
Critical?:
Yes
Ø
Assist patient in compiling a complete list of financial
obligations.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Assist in identifying, without projection of blame or
holding to excuses, the causes for the
financial crisis.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
l Verbalize
feelings of depression, hopelessness, and/or shame that
are related to financial status.
Entry Date:
4/17/2001
Target Date:
4/24/2001
Projected Sessions:
Critical?:
Yes
Ø
Probe feelings of hopelessness or helplessness that may
be associated with the financial crisis.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
l Identify
priorities that should control how money is spent.
Entry Date:
4/17/2001
Target Date:
6/1/2001
Projected Sessions:
Critical?:
Yes
Ø Ask
patient to list priorities that she believes should give
direction to how money is spent. Process
those priorities.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Assigned homework for Where Does It Go?
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
l Write a
budget that balances income with expenses.
Entry Date:
4/17/2001
Target Date:
6/18/2001
Projected Sessions:
Critical?:
Yes
Ø If
financial planning is needed, refer to a professional
planner or ask partners to write a current
budget and long-range savings and investment
plan.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
Ø
Review budget as to reasonableness and completeness.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
l Identify
personal traits that make undisciplined spending
possible.
Entry Date:
4/17/2001
Target Date:
5/15/2001
Projected Sessions:
Critical?:
Yes
Ø
Probe for evidence of low self-esteem, need to impress
others, loneliness, or depression that may
accelerate unnecessary, unwarranted spending.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
l Acknowledge
impulsive spending as part of a general pattern of
impulsivity that is based on mood
swings.
Entry Date:
4/17/2001
Target Date:
Projected Sessions:
Critical?:
No
Ø
Assess for mood swings that are characteristic of
bipolar disorder and could be responsible for
careless spending due to impaired judgment of
manic phase.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
l Keep weekly
and monthly records of financial income and expenses.
Entry Date:
4/17/2001
Target Date:
5/7/2001
Projected Sessions:
Critical?:
Yes
Ø
Encourage patient to keep weekly and monthly record of
income and outflow. Review records
weekly and reinforce responsible financial
decision making.
Entry Date:
4/17/2001
Provider:
Arthur E. Jongsma, PhD
Response to Plan
Response to treatment plan presentation:
Judy is
accepting of the treatment plan.
Significant Other response to treatment plan
presentation:
Jack is
supportive of the treatment plan.
I, Judy Young, have reviewed this treatment plan.
x. _______________________________________________
Date: ______________________________
Progress Notes
Session
1
Date:
4/13/2001
Time:
2:00 PM to 3:00 PM (60 min)
Progress Rating:
No
Change
Modality:
Individual
Therapy
CPT Code:
Problem Addressed:
Depression
Patient Presentation (Signs and Symptoms):
l
The
patient reported that she has not had a normal and
consistent appetite.
l
The
patient reported a diminished interest in or enjoyment
of activities that were previously found pleasurable.
l
The
patient has withdrawn from social relationships that
were important to her.
Interventions Implemented:
l
The
patient was asked to describe her experience of
depression for the signs and symptoms that are present
in her daily
living.
l
The
patient was encouraged to share her feelings of
depression in order to clarify them and gain insight
into their causes.
Narrative Progress Note:
Judy has
described her depression symptoms including social
withdrawal, sad affect, low energy and lack of
appetite. I urged her to begin a journal of her
thoughts and feelings.
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