The sob story- What did I do wrong?

I think the fundamental thing that I did wrong on this assignment was that I had not done a thorough assessment and this affected the quality of my psychological formulation. A weak assessment does not provide a good background history for the marker/reader. In retrospect, this is perhaps my biggest struggle especially at the beginning of my counselling work. How much do we need to know about the client for therapy to work? Also, with a non-directive approach such as person centred, how do one then ‘question’ the client about their past? From a counselling perspective, if we are working on the current issues that clients bring, why do we need a detailed background history of the client? Why do we need to chart their childhood and adolescent relationships? Why are these relationships then used to produce a formulation of the client? Why doesn’t the formulation just describe how the client presented him/herself in therapy, what was worked on, what could be different and why.

In my defence, I had sought for these questions to be answered but perhaps due to my trainee status I was told that I was being too anxious (which I was, more so when I don’t know how to marry practice with professional requirements), uncomfortable with the non-directive nature of therapy, trying too hard, just need the therapy to be etc…  however I was also told that I should make my own assessments which was a very useful piece of advice. Now, why hadn’t I thought about this before? At the beginning of the year, I got a sense that one has to be qualified or experienced to make an assessment of the client after hearing from my colleagues how they shadow qualified practitioners while they make assessments or that they were simply provided with case notes that contain client background information. However, after recent discussions with my colleagues and reflection, I now know that being informed about their past allows for much greater depth in my understanding of the client. It puts the issues presented by clients into a wider social context where the interaction between the self and environment can be examined. This in turn allows for a more holistic therapeutic intervention and perhaps epitomise the idea of an idiosyncratic approach that prioritise subjective experience of individuals.

Having said all that, I think that there is another reason to the disappointing results I got – emotions or more accurately not communicating enough personal feelings about the client. A story for another time. :)

M.

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