|In the following pages this student will provide a process recording of interactions the student has had with clients which took place at his placement location. This student’s placement location is CRN Health which multiple locations, however the student is conducting his internship at the Dayton Ohio location. This process recording will capture client interaction details while working in the substance used disorders (SUD) outpatient clinic. This student will provide insight into content and topics of the student’s field education experience, details of the dialogue with clients, define where social work practices are utilized as they relate to cultural competence and diversity, detail interactions with clients, and provide details of where social work skills were practiced.
Field Experience Dialogue with Client – Presenting Problem
This student has had the opportunity to conduct one-on-one counseling sessions at CRN Health. The client interaction that this student will focus on is an interaction with a Black male client. The client is a thirty-eight-year-old single male who identifies as heterosexual. The client has a no children. The client completed a residential treatment program which consisted of 38 days total; 8 of which were for detoxification from methamphetamine and opiate intravenous use. The client is also utilizing mental health serves for anxiety and depression conditions.
Dialogue Interpretation and Social Work Theories
The student recognizes that several theories and models are presented when working with clients experiencing SUD and engaging in one-on-one counseling practice. The Student recognizes instances of the use of system theory and acceptance and commitment theory. System theory is one that concerns the interdependency of various systems, whether human-made or naturally occurring. Systems theory is an interdisciplinary approach to understanding how an event can have direct and rippling effects on other parts of a system (Kirst-Ashman & Zastrow, 2016). This student utilizes methods defined in cognitive behavior therapy and motivational interviewing during the one-on-one counseling sessions.
Diversity and Cultural Competence
By engaging clients initially in a way that fosters a helping relationship, we can start to build a trusting environment (Birkenmaier, & Berg-Weger2018). By recognizing and understanding the potential cultural differences, this student’s approach helps to close generational gaps, foster a safe atmosphere, and implement culturally appropriate helping strategies (Birkenmaier, & Berg-Weger2018).
Social Work Skills Displayed
At CRN Health, this student conducts one-on-one counseling sessions and facilitates support groups. This student leverages methods of the planned change model, uses empathy, trauma informed care, task centered practice, solution-focused therapy, and methods details in the generalist intervention model to conduct beneficial sessions.
Birkenmaier, J., & Berg-Weger, M. (2018). The practicum companion for social work: Integrating class and fieldwork (4th ed.). New York, NY: Pearson.
Kirst-Ashman, K. K., & Hull, G. H., Jr. (2018). Understanding generalist practice (8th ed.). Stamford, CT: Cengage Learning.
Zastrow, C. H., & Kirst-Ashman, K. K. (2016). Understanding human behavior and the social environment (10th ed.). Boston, MA: Cengage Learning.
Presenting Problem: The client is a thirty-eight-year-old single black male who identifies as heterosexual. The client does not have any children. The client is not currently working. However, the client desires to obtain work as soon as possible. The Client is currently staying with friends and family and does not report a permanent address. Client desires sober living and wants to stabilize recovery and employment before locating suitable housing. The client reports that he has a mental health diagnosis of Anxiety, Depression, and PTSD; all can be seen in the client’s chart and this student completed the assessment.
Please group dialogue together.
|Identify (for each section)
||Analysis/assessment of dialogue
What was going on? What were the patient’s reactions to your feedback? How did the client respond verbally (quality of voice, tone, did the respond better to closed or open-ended questions?) How did the client respond non-verbally (how did you know they were listening? were they distracted? Did they welcome your feedback?)
|Personal reactions and self-reflection to the interaction
What were you thinking? How do you feel the session went? What could you have done better? What will you do differently/the same next time?
|Me: Good morning, I wanted to follow up with you concerning the appointment we talked about with Five Rivers Clinic.||Facial expression, giving direct eye contact, warmth and empathy.
|I wanted to approach client with respect, displaying genuine concern. I wanted to maintain our rapport of trust we have built.
|He is anxious and not listening to what I am asking. I thought I would give him time to vent.|
|Client: Yell, I got a new phone and I need to give you my new number.
Me: I wanted to follow up, what day is your appointment?
You seem upset, is there anything you want to talk about?
|Attentive listening, using open-ended questions.
In hopes that he would discuss MH appointment that is needed.
|Interested to get a better idea of his need: MH referral, the cause of the frustration and follow up appointment. Presenting a calm demeanor.||Patient was angry during initial engagement
Client is frustrated with rapid speech patterns.
Patient has a sense of entitlement and feeling disrespected.
|Client: Why do y’all always tell us stuff at the last minute? I have things planned for tomorrow, now I have to be in group?
Me: What are you referring?”
|Using direct and indirect questions.
Using silence to allow him to speak.
|Compassion for his frustration.
I shared with him I understand he has been on his doing everything asked of him.
He is blaming others for his response to the request.
|He put himself as a victim.
Intense eye contact.
Speaking directly to SW Intern with exaggerated statements
|Client: I just found out if you have a medical marijuana card you have to do another group on Friday
Me: I repeated his understanding about a new group he is expected to attend tomorrow.
|Elicit clarity of situation for possible misinformation
Using reflective listening
|He seems anger and frustrated about the process.
Good eye contact, to maintain trust showing I am interested and want to help him.
|Venting about other issue he has experienced.
I am Empathetic, understanding he has a right to his feelings.
|Me: What do you want to do? How can I help you?
Client: I made plans for tomorrow that are important to me.
Me: Ok, Well I understand. How can I help you?
Client: I don’t mind going to the group next week but not this week.
Me: Can we talk about the date of your appointment date?
Client: I have not made one yet.
Me: Would it be alright for you to make it now and let me know when it is?
|Silence to allow him time to process.
Conducting needs assessment. I understand the client has an anxiety disorder and has been managing without medication.
I want to empower him to know he can make decisions
Summarizing all the information that has been shared.
|I felt client was not being honest acknowledging the need for the appointment.
Problem solving. I am thinking what approach is needed without him being honest about his mental health due to other files stated he has a history of mental health diagnosis and medications.
|He moved away while ranting.
Down case eyes he looks away when apologizing.
Client displays a sense of trusting what he is saying is being heard
Showing interest in finding comfortability.
He wants a solution.
Client is evaluating his options.
Thankful for the assistance.
|Client: Yes. I need to get medication for my blood pressure too.
Me: Make a reference to his history of MH/substance use. I want to help you avoid any setbacks.
|Solution focus/ empowerment technique.||
However, focusing on what is to him important at this time.
He knows he has been doing well in the program and he does need the medication.
|Client is speaking clearly with a lot of verbal interaction with me|