Peer and self reflection critique assignment.

This assignment should only be completed after you have posted the video: SEE ATTACHED VIDEO LINK: Postpartum depression therapy video

VIDEO LINK: https://youtu.be/SkwuSJ8e5So

Your reflection should address all of the following questions between 750 to 950 words. Appropriate spelling, grammar, and punctuation required. Complete sentences are expected. All writing should be in your own words. Use APA references as needed to support your ideas; there is no requirement on number of references to include. Be sure to use APA format.

SEE VIDEO in order to complete this assignment, and also see the attached assignment example for references.

1. Which skills did you use in the session? How?
2. How did the assigned Corey readings, PowerPoints, Handouts, and videos inform your therapy session? Please explain in detail.
3. What were your strengths in the interview?
4. What were your weaknesses/areas in need of further development in the interview?
5. How could you improve your interviewing skills? Are there steps you plan on taking? What are those steps?
6. Was there any time when you felt stuck or uncertain how to respond? Describe what was happening then. Were there times you felt more confident in your responses with the client? Times you were less confident? How? Does this come through in the session?
7. How were you impacted by the client…your emotions, thoughts, physical reactions, transference, and countertransference, body language?
8. What was your overall response to the interview? Did you feel connected to the client? Distracted? Disengaged?
9. What was the quality of your engagement, your empathy?
10. If you were to continue seeing this particular client, what future directions would you take? How would you conceptualize the case and what would be some of your treatment goals? How would you pursue these goals?

In relation to your partner:

1. What were the partners strengths in the interview?
2. What were the partners weaknesses/areas in need of further development in the interview?
3. How could your partner improve his/her interviewing skills?

Please, see also the attached assignment example for references.

Background: I live in South Florida, I am currently enrolled in the Psych Mental Health Practitioner Program, I am a Registered Nurse, I work in a Psychiatric Hospital.

PEER AND SELF-REFLECTION 6

 

Peer and Self Reflection

NU-646-09: Theory and Practice of Contemporary Psychotherapies

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Peer and Self Reflection: Postpartum Depression

One of the leading factors in interviewing patients is first determining their tone and mood at the clinic during the interview. Secondly, the psychotherapist has to understand the ethical issues around the patient and how their discussion may trigger the patient’s cognitive and functional state. In the case of Jessica, she is experiencing symptoms of postpartum depression (PTSD). In PTSD mothers, the clinician has to balance the exploration of the triggers in the patient’s life alongside an understanding and assurance of the safety of the child (Corey, 2018). During the interview, the key skill that I and my partner utilized was the listening skill.

Listening implies allowing the patient to narrate their feelings and to openly discuss what they may assume could be the triggers in their life. Based on the course readings, such cases require active listening as a mechanism to build rapport with the patient. The patient must trust the therapist to ensure that the quality of communication is high and effective in acquiring the desired information that will guide the treatment and management (Amin et al., 2019). During the session, the two techniques I employed in building rapport with the patient were emotional mirroring and posture mirroring.

In emotional mirroring, I sought to identify the keywords that the patient used in demonstrating their emotion and using them towards the patient in continuing the discussion. In posture mirroring, I ensured that my tone and the responses were within the level and quality of the client. The idea was to ensure the patient feels that their narration and its emotions affect me not just as a therapist but as a human thus bringing the conversation to a person-person level (Jones-Smith, 2020). My biggest strength in the interview was the ability to remain objective over the entire interview. When the patient mentioned that she had concerns regarding the possibility of hurting her baby, I feel there was a likelihood that my attention could shift to judging the mother from a moral perspective. However, I stood my ground by showing the patient a sense of emotions and empathy but allowing them to recognize that such thoughts occur in a good number of women experiencing PTSD. I found that I had a notable weakness in pursuing the conversation on the patient’s decision to bear her last born. On two occasions I tried to understand the patient’s thoughts in the pre-conception phase and especially her relationship with the husband. I felt that I may have been eliciting a sense of guilt on the patient even after remaining objective for the better part.

My focus is to improve on the ability to pursue conversation beyond what the client states or narrates. Effective interviews are determined by the ability of the psychotherapist to acquire additional information in the grey areas. The challenge with the grey areas is that the patient may be seeking to hide some information from the therapist while such information could be the most important. I plan to identify any webinars by a reputable professional organization such as the American Psychotherapy Association. The idea is to provide me a platform where I can learn from the experiences of other psychotherapists on how they deal with situations at the clinical level. The advantage of webinars is that they are based on the most recent clinical guidelines in the assessment, interviewing, and management of patients. I plan to engage in at least two webinars every week over the next six months.

In the discussions on the decisions and relationships of the patient in pre-conception, I felt low on confidence especially due to my internally held assumption that I could be making the child a guilty party regarding the mother’s health. Admittedly, countertransference was evident, especially when responding to the mother’s concerns on the safety of her child and the likelihood of harm. I engaged the mother in a moral talk including citing religious quotes which I thought would have helped eliminate the mother’s negative feelings towards her child. In a similar scenario, I would have avoided the religious conversation especially because it is subjective and elicits an element of morality where the patient may feel that she lacks the appropriate morals. The interview with Jessica is one where I felt connected and involved. Even for a psychotherapist, when a child is an affected party in the case of PTSD, the level and empathy and the intention to seek solutions increase significantly. Importantly, the mother’s communication improved significantly in the later stages of the interview a phenomenon that indicated the commonality of goals for both the therapist and the patient.

If I continue seeing the patient in the future, I would wish to integrate the partner or a close family member in the management of the patient. However, in each of these possible scenarios, I would have to determine the causative factors to the client’s PTSD or the triggers. Family relations and social issues such as job loss may have influenced the PTSD manifestation in Jessica. Thus, the focus would be on helping the patient define a positive environment and avoid the scenario of necessitating the patient to adapt to a negative environment. The ideal situation in Jessica’s case is to enable the patient to find a resolution including identifying the triggers and working towards controlling those triggers (Corey, 2018). Secondly, the safety of the child will be a paramount consideration which justifies the need to integrate a reliable key person in the patient’s life. The treatment goals in this case include the improve symptoms and making Jessica develop a positive attitude towards motherhood. The patient will be placed on Zoloft (Sertraline) 50mg orally daily once. The medication will be sustained for four weeks during which a review will be conducted. Further, the patient will be placed on interpersonal therapy (IPT) for 12 weeks. The idea of IPT is to help Jessica find resolution with their relations and social environment. Once she has resolved the problematic aspects of her social environment, it will be possible to recover her function as a human and as a mother (Markowitz, 2016).

Peer Reflection

My partner’s key strength was being an active listener. The quality of a conversation between the therapist and the patient is dependent on the ability to ensure continuity of the discussions without making the client feel that so much is being demanded. My partner was balanced in ensuring that we acquired the most important information that would guide Jessica’s management. At the same time, my partner ensured that the inquiry did not make the patient uncomfortable by continually rephrasing or moving away from the questions that generate negativity in the patient (Sarı & Eryılmaz, 2020). The notable weakness in my partner was that he remained quiet when the issue of the child was mentioned. The silence was a typical case of countertransference and while silence may have been seemed logical for my partner, the patient may have felt judged. I believe that my partner can improve their interviewing skills by working with a preceptor or supervisor. This approach would be effective in introducing my partner to diverse patient situations and avoiding unlikely scenarios where silence is used to overcome difficult conversations.

References

Amin, P., Douaihy, A., & Prasad, R. (2019). Motivational interviewing processes and skills. Motivational Interviewing in HIV Care, 11-18. https://doi.org/10.1093/med/9780190619954.003.0002

Corey, G. (2018). Theory and practice of counseling and psychotherapy (10th ed.). cengage.

Jones-Smith, E. (2020). Theories of counseling and psychotherapy: An integrative approach. Sage Publications.

Markowitz, J. C. (2016). Adapting IPT for PTSD. Interpersonal Psychotherapy for Posttraumatic Stress Disorder, 47-55. https://doi.org/10.1093/med:psych/9780190465599.003.0004

Sarı, T., & Eryılmaz, A. (2020). Positive psychotherapy in PTSD and post-traumatic growth. Positive Psychiatry, Psychotherapy and Psychology, 153-163. https://doi.org/10.1007/978-3-030-33264-8_14