The raw score of negative self-image was 52 which were equal to the cut off scores and it depicted that the client had high negative self-image. The raw score of self-esteem was 87 demonstrated that the self-esteem of client was very low and it was matter of concern. These results are consistent with his background as the client was taken from the hospital with low self-esteem. The AARP is appropriate for use in clinical settings as both a screening measure for social maladjustment behaviors and as a measure of treatment affects. In school setting, the AAPR provides an efficient and economic screening, instrument for adolescents who demonstrate anger pattern that are potentially harmful to themselves or others Deanna, The adolescent anger rating scale AARS was administered on the client on Thursday, May 5, , in a well lit and ventilated room of the hospital.

The room was peaceful and noise free and there was no distraction. The client was made to sit comfortably in his bed. The instructions were given to him according to the manual. The test was orally administered to the client. The client was provided with a copy of the AARS , so that he could follow along. He took 20 minutes to complete the test. The client obtained the raw score of 90 which t score was 55 and percentile was The results of the test showed that client had average level of anger. According to the scores on self image profile for children showed that he had low positive self image, high negative self image and low self esteem.

The scores on adolescent anger scale showed that client had average level of anger. The client was taken from the Jinnah Hospital with complaints of sadness, anger, sleep disturbances, poor academics and low self esteem. The client had an accident eight months before as his left hand was seriously injured by chaff cutter machine. The client was taken from the hospital with the problem with his hand. His hand was completely damaged in that accident and doctors had to amputee his hand. The client worried and depress about his condition because he had to face difficulty in his daily life activities.

The psychological assessment was carried out on informal as well as formal level. The informal assessment included mental state examination and formal assessment included Child Depression Inventory CDI , The Self Image Profile SIP-C and The Adolescent Anger Rating Scale AARS. The results of the tests indicated that client had slightly above average depression, had low level of positive self image and high negative self image and average level of anger,. Amputation is the surgical removal of all or part of a limb or extremity such as an arm, leg, foot, hand, toe, or finger.

There are many reasons an amputation may be necessary. The most common is poor circulation because of damage or narrowing of the arteries, called peripheral arterial disease. Other causes for amputation may include: severe injury from a vehicle accident or serious burn, for example , cancerous tumor in the bone or muscle of the limb and serious infection that does not get better with antibiotics or other treatment etc McNaughty, In clients case he was seriously injured by the chaff cutter machine and when he was taken to hospital there was poor circulation of blood in hand and doctors had to amputee his hand. Most patients who lose a limb as a result of traumatic or surgical procedures encounter a series of complex psychological responses Cansever et al Many people successfully use these responses to adjust to amputation, but others develop psychiatric symptoms Frank et al The client was feeling depress on his condition because he had lost his body part and he was not able to perform his tasks easily by himself.

According to research by Kindon and Pearce , Kohl , and Cansever and colleagues , psychological reactions to amputation depend on a number of factors, which include age and sex, type and level of amputation, lifelong patterns of coping with stress, value placed on the lost limb, and expectations from the rehabilitation program. Kohl added that the individuals affected by the traumatic loss of a limb are required to face a redefined body and self as well as a new reality. The client had to face problem regarding his self image as the client was in the age of pre adolescence but children adapt well to the loss of function and manipulate prostheses and other limbs with great agility. They are particularly sensitive to peer acceptance and rejection.

The client was also worried that how he will participate in physical activities that required both hands as cricket etc. The loss of limb through accident is a tremendous shock. Unless your child is very young, they will feel the same emotions as adult amputees — grief, depression and anger. In addition, children often feel guilt for bringing pain and problems to their parents Ratto, Management plan is designed to help the client to resolve his problems and to return his back to the community sound and healthy. Several therapeutic interventions are designed for this purpose to be used with the client. Some of the therapies that can be used for the client who is suffering from depression, problems of anger and negative self-image are as follows. The client can be helped by using a number of therapeutic interventions, some of which are as follows:.

Supportive psychotherapy is the attempt by a therapist by any practical means whatever to help patients deal with their emotional distress and problems in living. It includes comforting, advising, encouraging, reassuring, and mostly listening, attentively and sympathetically. The therapist provides an emotional outlet, the chance for patients to express themselves and be themselves. Also the therapist may inform patients about their illness and about how to manage it and how to adjust to it. Psycho education refers to the education offered to people who live with a psychological disturbance.

Frequently Psycho educational training involves clients with complaints of depression, anxiety, hopelessness, loneliness, eating problems, and sleep problems etc. The main purpose of psycho education is to educate the client about his condition and also its management to help the client to deal with the problem by himself. The client needs to be educated about his problems and what factors are affecting on it and how he can control it. The client should be educated about the importance of self-management and how he can cooperate with his psychologist to make him better.

Amputation is a triple threat. It involves loss of function, loss of sensation and loss of self-image so it is very important to deal with it. First of all the client will gain insight about the aspects of his problem then he will be able to easily deal with it. The theory is, with better knowledge the client has of her illness, the better the client can live with her condition. Contingency Contracting is a type of intervention that is used to increase desirable behaviors or decrease undesirable ones. A contingency contract may be entered into by a teacher and student, a parent and child, or a therapist and client.

It specifies the target behavior, the conditions under which the behavior will occur, and the benefits or consequences that come with meeting or failing to meet the target. This technique will be used to change the behavior of client during studies to motivate him to work hard. This technique will also be used to decrease the anger level in client. Go to sleep at about the same time each night, and awaken at the same time each morning. Wide fluctuations between workdays and days off can further impair your sleep. Try not to nap. If you do, restrict this to about an hour per day, and do it relatively early before about 4 in the afternoon. Do quiet, relaxing activities until you feel sleep, then return to bed.

Avoid doing stimulating, frustrating, or anxiety provoking activities in the bed or in the bedroom watching television, studying, balancing the checkbook, etc. Try to reserve the bedroom and especially the bed, for sleep. Exercise, particularly aerobic exercise, is good for both sleep and overall health and should be encouraged. Avoid stimulating exercise in the evening do this at least 5 hours before bedtime. Perform relaxing activities in the hour before bedtime. Make sure your sleeping environment is as comfortable as possible, paying attention to temperature, noise, and light.

Do not eat a heavy meal just before bedtime, although a light snack might help induce drowsiness. It is sometimes helpful to place paper and pen by the bedside. If you find yourself worrying about completing or remembering a task the next day, write it down and let it go. Then return to bed. Place clocks so that the time is not visible from the bed Bazil, Cognitive behavioral therapy CBT is the most widely-used therapy for anxiety disorders. Cognitive behavioral therapy addresses negative patterns and distortions in the way we look at the world and ourselves. CBT is one of the most effective treatments for depression, and has been found to be useful for a wide range of people, including children, adolescents, adults and older people.

As a treatment for depression and other mood disorders, behavioral activation is based on the theory that, as individuals become depressed, they tend to engage in increasing avoidance and isolation, which serves to maintain or worsen their symptoms. The theory holds that not enough environmental reinforcement or too much environmental punishment can contribute to depression. So, the treatment tends to increase environmental reinforcement and reduce punishment. The goal of treatment, therefore, is to work with depressed individuals to gradually decrease their avoidance and isolation and increase their engagement in activities that have been shown to improve mood.

Many times, this includes activities that they enjoyed before becoming depressed, activities related to their values or even everyday items that get pushed aside such as:. Exercising, going out to dinner, improving relationships with their family members, working toward specific work-related goals, learning new skills and activities, Showering regularly and completing household chores etc. this technique will be used for client to decrease his depression level by involving him in different activities Leahey, The client and therapist schedule activities for most hours of each day and often incorporates those activities too which the client finds pleasurable.

The activity schedule provides clients a sense of direction and control Leahey, It will enhance the memory, attention, concentration, problem solving skills and executive functions of the client. Rational Emotive Behavior Therapy REBT is both a psycho therapeutic system of theory and practices and a school of thought established by Albert Ellis. This is an active approach for helping clients evaluate the helpfulness and efficacy of elements of their belief systems. The philosophical approach addresses a life satisfaction issue. Often the client will have been too focused on the identified problem that he has lost perspective on the other areas of his life.

Rational coping statements are self statements which usually are implemented after disputing has been accomplished, but they can also be used when the client is in the process of exploring her beliefs. These factual, encouraging phrases are consistent with social reality and client can be encouraged to repeat them consistently to reinforce the ideas for her. Assigning helpful audio cassette, videos, pamphlets, books, lectures, workshops and topic specific group can all contribute to client understanding of his problem and progress in changing inappropriate and unhelpful reactions.

This meditation teaches people to focus on the very present moment, just noticing whatever they are experiencing, be it pleasant or unpleasant, without trying to change it. At first, this approach is used to focus on physical sensations like breathing , but later it is used to focus on feelings and thoughts. MBCT helps client to stop their mind wandering off into thoughts about the future or the past, or trying to avoid unpleasant thoughts and feelings. Building your self-esteem and creating a positive self-awareness comes from taking an inventory of your own strengths and abilities as a human being. Low self-esteem is often linked to depression or anxiety. If your emotions feel overpowering or out of control, one way to build self-esteem around this issue is to learn to manage your mood and gain control over your feelings.

Some people are able to do this with the help of friends and family. Others need to work with a mental health professional to manage the problems that may lie beneath the surface of low self-esteem Ponton, Psychologists then ask patients to spend a minute or two thinking intensely about a situation that makes them excessively angry, such as other drivers going too slow. Psychologists then help patients relax. Psychologists and patients practice this sequence over and over again. Listing of advantages and disadvantages of anger, distraction from negative thoughts, identifying bodily symptoms associated with anger, using positive statements and identifying positive solutions etc will also be used to treat anger.

When teaching anger management to client, a traffic light is effective at encouraging the identification of angry emotions. The color red represents stopping, and is useful when client begin to lose control of their emotions. Yellow offers client an opportunity to think and find an appropriate solution to their problem, and green lets them know they can move forward in a responsible way. Just as a driver who runs a traffic light risks getting a ticket or causing an accident, a client risks punishment, personal injury, or inflicting injury on someone else by running an anger traffic light. The three colors on a traffic light can represent the three stages of emotion a client passes through when becoming angry.

Green represents calm and relaxation, or the state before anger begins to develop. Yellow symbolizes the build-up of angry emotion that typically occurs when the client first encounters a stressor. Once the client learn to recognize what stage of anger they are in, they can utilize coping strategies learned in anger management programs to stop the progression of their emotions before they reach red. Anger is a complicated and overwhelming emotion, but using a traffic light for anger management allows client to visualize their anger and the steps necessary for controlling their reaction to angry emotions Ketcham, All human beings require a support system throughout life in order to maintain emotional health.

However, not all are so blessed, and many find themselves transiently or permanently in state of isolation. Single and widowed individuals suffer more psychological distress and difficulty in adapting to amputation than do those who are married and have a family. Parents are the major source for children and adolescent amputees but peer acceptance beyond the family is critical in the successful adaptation of all amputees and especially children and adolescents Racy, Also Study: Psychological Assessment Example. I need some sample cases, with the diagnosis of the problem, assessment of the client, formulation of counselling goals, interventions, and assignment gaven.

Clients' lives are currently unbearable as they are being lived What is the current status of DBT? Empirical research has shown signs of progress with treatment Strengths Well received by clients Production of Outcomes and treatment Effects continue after treatment termination Easily combined with other treatment methods Acceptance and Commitment Therapy How was ACT developed? Stephen Hayes Common philosophical roots Constructivism Narrative Psychology Feminist Psychology Some elements of traditional behavior therapy Additional Eastern-influenced mindfulness What are the theories and strategies of ACT? Relational Frame Theory Use of metaphor, paradox, and experiential exercises What are the goals of ACT? Application to a wide variety of problems and disorders Easily tailored to the need of the client Suited well for: Anxiety.

This may also depend on what requirements or tasks you do to. Field work The Main Four 1 2 3 4 This career is focused on designing and decorating work spaces, homes, ect. Here you have the creativity of choosing how to display the room in different aesthetics. Being a fashion designer gives the freedom of creating a new fashion piece, or creating a new clothes line. Merchandise focuses more on marketing new clothes lines or art products. More focused on promoting products. Being an editor focuses on representing and editing the visual representation of the film or video. Such as the lighting and colors. They can have a high salary or a low one depending on the amount of work put into the growth of this career.

Transcript: Often took turn twice, out-of-order Crying, whining, laughing in peers faces, pointing, leaving game social story Evidence-based! When I wait patiently, I watch my friends take their turns. My friends like to have their turns be first too. Now you can be first. I only take one turn. When my turn is done, I let my friends take their turn. Some progress! That is not using good manners. It's polite to take turns. When I take turns, I am using good manners. Friends like when I use good manners. When playing a game with peers, Chris will respond inappropriately to winning or losing. Direct instruction of social skills 2. social story 3. psycho-education 4. relaxation techniques 5.

power cards Coping Strategies improving social skills, enhancing perspective-taking, increasing self-monitoring Counseling Model Taking Turns CBT Adaptions Agendas First experience working with a student with ASD! Goal 3 Emotional Regulation Last Session Tomorrow GAS completed by teacher Coping strategy "quiz" Classroom observation "Chris" 10 year old, 4th grader Currently in self-contained classroom Diagnosis of ASD Also very low cognitive and academic Counseling minutes on his IEP Supportive family Low attention span, active, limited social skills, eye contact, etc. Goal 2 Baseline- Takes appropriate turns approx. Also come to the School Psychers End-of-Quarter Social tonight after class at Rhein House!! Taking turns Operational Definition After 6 weeks of attending weekly counseling sessions, Chris will respond appropriately to winning and losing.

When friends are together, they take turns. Feelings Felix is a star baseball player for the Seattle Mariners. He must patiently wait his turn to go to bat. Felix likes to win, but sometimes he loses. Games should be fun for everyone! Classroom observation After 6 weeks of attending weekly sessions, Chris will take appropriate turns when playing games with peers initiating a turn, taking only one turn, waiting for next turn, relinquishing turn when necessary. My friends will be happy when I use good manners and take turns.

They will want to play with me again. Session 3: Coping strategies to deal with frustration cognitive behavior therapy CBT When playing a game with peers, Chris is unable to identify coping strategies to deal with his emotions. Because of limited attention and engagement, I had to supplement CBT with behavioral interventions. Baseline- Can't identify any reasons he should take turns After 6 weeks of attending weekly counseling sessions, Chris will be able to identify at least one reason why he should take turns when playing with peers. Transcript: Cultural Considerations Qualitative Fill-in Responses Learned how to connect with D. cross-culturally Differently Myself 1. People can have many kinds of feelings, how many different feelings can you think about? Life isn't how you want it.

sometimes you might feel sad, and humble and fall and maybe cry. And you don't want to trip" AngrySadSilly Scared HappyDizzyGiggle Silent 3. Breathing Exercise Green Cupcake, Gum Toppings, Blowing candles. Feeling thermometer Events that have made us feel in the different zones e. You can learn to let anger out in different ways, which are some ways to let anger out? After suffering with trichotillomania for 15 years, I felt trapped by my constant urges to pull my hair. By using the tools I learned in therapy, I can go several days at a time without pulling and am continually improving. Not long ago a client Alan came in seeking help for drug and alcohol abuse.

He started drinking alcohol before he was a teenager. Alan finished high school and began working in retail. He changed jobs or was fired every couple years but was able to work his way up into a manager position. He was married and had three children. His drinking had a negative impact on his family and occasionally he yelled at his wife and kids. Often he spent time by himself at home watching T. or surfing on the Internet. During therapy, it became evident that Alan used drugs and alcohol to cover up his feelings of anger, frustration and at times low self-esteem. He was able to learn new coping skills and reduce his use of drugs and alcohol.

His marriage improved and he enjoyed his kids more. Even his relationship with his assistant manager improved. Cathy had been married for 14 years to her high school sweetheart. Things started out good but as their family grew to four children the first five years, their marital relationship gradually deteriorated. Her husband, a sales manager traveled almost every week. When he was home, he tended to ignore her and the kids. Cathy would occupy herself with housework, church duties and helping neighbors and other relatives. Most people thought Cathy had a good marriage, but inside she felt empty and trapped. Feelings of frustration and anger would occasionally rise to the surface, but most of the time she just kept it all inside.

When Cathy started therapy, she had just discovered her husband had an addiction to pornography. She was concerned about the kids. The therapy focused on a pattern of behavior called co-dependency. Cathy discovered that her husband was in many ways like her father, who was an alcoholic. She tried to control her family growing up and now she was trying to control her husband. Gradually Cathy developed a healthy mental separation from her husband and as she began to get healthy, her husband admitted he had a problem with pornography and decided to get help himself.

I would not exchange or trade the honor and privilege I have had helping individuals, couples and families since Along this journey, I experienced many situations of success and seeing people grow and share their positive outcomes. Below you will find a sample of cases where a client has given me permission to share their experience. Identifying information has been changed to protect confidentiality. Chen is a good therapist. He has helped me clarify perceptions that have blocked my growth and development. I have been able to resolve the feelings that have grown from the misperceptions. In counseling, I have learned new attitudes and language to help improve my marriage and family relationships.

The barriers I have built up over the years are being removed. This process takes a long time, but I think it has moved at an appropriate pace. Other counselors have taken much longer to help me even begin the healing process. I have made great progress while working with Dr. As with any parent, we were concerned for our child and feared for the worst. Your extensive knowledge and expertise helped us understand what was going on and provided comfort and reassurance. Your expertise and ability to relate to our situation helped us get through a very difficult time. Thank you for the competence and calm demeanor you displayed as you helped reassure us during this critical time.

I firmly believe that others facing similar problems would greatly benefit from your services. After suffering with trichotillomania for 15 years, I felt trapped by my constant urges to pull my hair. By using the tools I learned in therapy, I can go several days at a time without pulling and am continually improving. Not long ago a client Alan came in seeking help for drug and alcohol abuse. He started drinking alcohol before he was a teenager. Alan finished high school and began working in retail. He changed jobs or was fired every couple years but was able to work his way up into a manager position.

He was married and had three children. His drinking had a negative impact on his family and occasionally he yelled at his wife and kids. Often he spent time by himself at home watching T. or surfing on the Internet. During therapy, it became evident that Alan used drugs and alcohol to cover up his feelings of anger, frustration and at times low self-esteem. He was able to learn new coping skills and reduce his use of drugs and alcohol. His marriage improved and he enjoyed his kids more. Even his relationship with his assistant manager improved.

Cathy had been married for 14 years to her high school sweetheart. Things started out good but as their family grew to four children the first five years, their marital relationship gradually deteriorated. Her husband, a sales manager traveled almost every week. When he was home, he tended to ignore her and the kids. Cathy would occupy herself with housework, church duties and helping neighbors and other relatives. Most people thought Cathy had a good marriage, but inside she felt empty and trapped. Feelings of frustration and anger would occasionally rise to the surface, but most of the time she just kept it all inside.

When Cathy started therapy, she had just discovered her husband had an addiction to pornography. She was concerned about the kids. The therapy focused on a pattern of behavior called co-dependency. Cathy discovered that her husband was in many ways like her father, who was an alcoholic. She tried to control her family growing up and now she was trying to control her husband. Gradually Cathy developed a healthy mental separation from her husband and as she began to get healthy, her husband admitted he had a problem with pornography and decided to get help himself. She was nervous and anxious most of the time. She rarely dated but desperately wanted to get married. However, Ann was afraid to socialize and had few friends.

Most evenings she would read a book at home or talk on the phone to her parents or other relatives. By the time Ann came to therapy, she had begun to have panic attacks and at times she thought she might die. Therapy began by exploring why Ann was not dating. It was discovered that she had been sexually abused by a baby sitter when she was 7 years old. This abuse continued over a two year period. She had never told her parents. Later she was also sexually abused by an uncle. Ann had strong feelings of anger toward men but also wanted to develop a relationship with a man and eventually get married. Her feelings of ambivalence had developed into anxiety which lead her to isolate and avoid men.

During therapy Ann was able to work through the trauma of the two different periods of sexual abuse. Her anxiety disappeared and then therapy focused on helping her develop appropriate social skills. Ann began dating and recently became engaged. She had her first depression with the birth of her first child, and her family doctor prescribed an anti-depressant. Her husband was supportive and made a decent income, yet money always seemed tight. It was a challenge taking each of the four children to music lessons, dance, football practice and the like, not to mention all the church activities. Donna never felt like there was any time for herself. In fact, if she did take time to do something she enjoyed, she felt guilty. She knew there were other women who were depressed and taking medication, but she still felt like no one understood what she was going through.

When she finally came to therapy, she felt hopeless but wanted to change her life. In therapy, she learned to develop some positive thinking skills, not just think happy thoughts, but really challenge some of her long held beliefs that kept her from finding the peace and happiness she knew she had always sought. She began to enjoy life more and her husband even commented how much happier she seemed. Donna almost cried. He had worked in the computer industry for over 20 years and was recently let go from one of the major computer companies.

He first got into the computer industry because it was exciting and new developments were happening all the time. But over the years he became upset by the lack of loyalty that large companies showed their employees. The more he explored, the more interested he became in fixing scientific devices. He enrolled in a course designed to help technicians fix medical devices. During this course he met another entrepreneur and together they developed a business plan. Tom had found a new challenge and was ready to move forward. Toggle navigation. Dear Dr. Thanks again, Bruce L. Chen, After suffering with trichotillomania for 15 years, I felt trapped by my constant urges to pull my hair.

Thank you! Kelsey Alcoholic Alan Not long ago a client Alan came in seeking help for drug and alcohol abuse. Co-dependent Cathy Cathy had been married for 14 years to her high school sweetheart.

Counseling Presentation Transcript: Bertucci's 1 Whole grains for quick energy Breadwinners Here are some tips to keep you healthy on the run The home environment of client was very good all the problems were solved by mutual discussions. He was having an excellent auditory perception. Anger 8 9 8. l also need some sample cases with the diagnosis of the problems, assessment of the client and interventions. Toll Free

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