CASE HISTORY TAKING INTERVIEW CONTENT

I. Identifying information

 Name: SS

 Age: 22 years

 Gender: Female

 Culture: Islam

 Languages: English, Hindi and Urdu

 Marital status: Unmarried

 Occupation: Student

 Education: Pursuing Graduation

Informant : Self

II. Presenting problems

Self doubt. Poor interpersonal relationship and social anxiety.

III. Brief history of the presenting problem

The client has been experiencing social isolation since last year when the lockdown
started, she was not even communicating with her friends and peers virtually and after
that she started to experience self confidence and esteem.

IV. Biological functioning (at present)

 Sleep: Unchanged

 Appetite: Decreased

 Energy: Decreased

V. Treatment history for the present illness

This was the first time she is taking counseling.

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 Psychosocial history

 Social and developmental history

The client is currently living in Hyderabad. She belongs to a muslim family. The
developmental milestones of the client were met at the right age. There were no
complications or any notable events during the growing years.

 Family History
She has family with two elder sisters and one elder brother and one younger brother. She
is very distant from other family members. Both the parents are working so they don’t
get time to interact much. They come from a middle socio economic background.

 Education History

The client has completed her schooling in 2017 and Intermediate in 2019. Currently she
is doing her graduation.

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 VERBATIM TRANSCRIPT

Client Name: SS Date: 11/03/2021 Session No.: 1

Time Started: 6:00 pm Time Ended: 7: 00 pm Time in mins: 60 minutes

Transcript Skills Used Process Comments

T1 Hi, SS. Welcome to the counselling Rapport The counselor welcomes the client in
session. I am your counselor Fiza building a friendly way.
Hussain.

C1 Hi. Thank you The client is looking around.

T1 Before we start today's session I would Information Before getting into the session,
giving.
like to tell you something important. the counselor discusses the terms of
Firstly, everything that we talk in our confidentiality and its limitations.
sessions will be kept confidential which
means it will be just between us. The
only exceptions to this is when I find
that there is a chance of self-harm or
harm to others. You can speak about
anything you want openly, I will not
judge you as being right or wrong.
C1 Okay. The client looks worried.

T2 Is there anything that you want to Immediacy. The counselor senses the client’s
share you look tensed. tense body language and asks the
client about it.
C2 Umm..Actually I don’t get along well with
people. And you are new so it’s a little
more uncomfortable. And this is the
main problem I want to talk about.

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T3 You don’t get along with people? Encourager. The counselor tries to get a clarity
from the client.

C3 It's like I don’t feel comfortable talking to

people. I feel my words are not making
sense and I start sweating. I feel I am
not good at explaining what I say.
T4 OK, but I see that you are fluent Positive asset To make the client comfortable, The
and your words did make sense. search. counselor points out that the client
You were clear has clarity of sentence she speaks.
C4 Thanks for that, actually not everyone Looks down.
feels that I am good for a
conversation except few and that is
why most of them don’t even talk
to me. Eventually I also started to
maintain distance from people.
T5 SS you mentioned that few people Open ended The counselor tries to get more personal
like to converse with you. Can you question information from the client.
talk about them?

C5 Ohh yess! That includes my senior with The client seems to be happy while
her I can share anything and everything talking about her friend.
infact I am more close to her than my
own sisters.

T6 Why do you feel so connected to her? Open ended The counselor tries to understand the
question. clients story better.

C6 Umm.. I don’t know I never thought Pauses to think.

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 about it. Maybe because we share the
friendship bond from that is pure or
maybe she understands me better also
because our interests are similar.
T7 That sounds fair. SS can you share what Open ended The counselor tries to understand the
interests you or more like what are your question clients better.
hobbies?
C7 I usually spend my day painting and the
senior I told about also is an amazing
painter. Our friendship actually started
from a painting competition when both
of us participated in that and she became
very fond of my work and I became
fond of hers and in no time we got very
close. It's only because she advised me
that I am seeing a counselor. Apart from
that these days I am painting a wall in
my room so I mostly spend time alone
and I like the time I spend alone maybe
that’s the reason I am not comfortable
with people.
T8 Yes, you told that you are not Close ended The counselor reflects the clients
comfortable talking to people. So is it question and words back to her.
because you like to spend time alone or Interpretation
that you feel anxious talking to them ?
C8 It's like I can talk to people but it take
some time for me to relax. I mean at
first I am little anxious but later I get
normal. But I prefer being alone.
T9 You have been telling that you like Open question The counselor picks up on the
being alone. Can you talk about it more. statement that the client keeps

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 making and inquires about it.
C9 I like being alone because that is The client looks away
peaceful you have no one to judge you
or comment on you.
T10 Judge you? Probe The counselor tries to gain more
clarity about the statement of
the client.
C10 My classmates, my family thinks that
what I do is not normal.
T11 Is there anything specific thing that they Open ended The counselor tries to gain more
point on? question clarity about the statement of the
client.
C11 I actually..I like making tunes and most
of the time I am humming those tunes. I
go slow to fast those are not actually
audile but there are change in my
expressions and this makes my
classmates laugh at me and my family
considers it inappropriate.
T12 Did your family tell you that it is Closed question The counselor tries to enquire more.
inappropriate?
C12 Actually I come from a very
conservative muslim family. They
believe that I should not do anything
that holds someone else's attention. And
they think I usually do this to grab
people's attention.
T13 No, I totally understand. Sometimes The counselor uses interpretation to
you’re thinking about something and let the client know that she
are in deep thoughts that you don’t understands what the client is feeling,
really are aware of your expressions and also to check if she has
Am I right?
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 understood it right.
C13 Exactly.. but they don’t understand. I am Breathes heavily
good at other things as well like I am
being appreciated by my teachers for my
presentation in class and also I am good
at cooking at home but they do not
acknowledge that. I make fun of my
classmates for their interest in K drama
actors who are not at all attractive but I
don’t do it. And just because I don’t like
K drama I can't go and fake my interset
just to talk to them.
T14 I see. So you don’t find the things they Paraphrase The counselor summarizes and
talk about interesting and you feel like paraphrases the client’s long
you cannot connect to them? statement into one short but
meaningful sentence.
C14 And they don’t like painting and music
so they don’t connect with me.
T15 Did you try to talk to them? Closed questionThe counselor tries to elicit more
information from the client.

C15 No I didn’t because I know the Looks down with a worried face.
consequences.
T16 What consequences ? Probe The counselor tries to get a meaning
of what client wants to say.
C16 Actually it's like whenever someone The client looks away with teary
laughs at me or put me down in a eyes.
conversation automatically my eyes get
teary and that gives them more reasons
to laugh at me.
T17 SS I understand some of us are sensitive Empathy Counselor empathizes with the client.

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 and we feel very bad when the other
person mocks us.
C17 Yeah
T18 So did you had any experience where Closed The counselor tries to elicit more
you were mocked by your classmates? questions information from the client.
C18 Not with the classmates but with a
neighbor once but the next day he came
to apologize me and from that day he is
good to me and I am also comfortable
with him. But I can't take a chance with
my classmates since a lot of they already
make fun of me I don’t want to give
them another reason.
T19 That’s good to hear! How did that Open question The counselor seeks clarification.
happen that you became friends with
your neighbor?
C19 He was good to me actually the thing is
I am a little nervous talking to people at
first but once I get comfortable it is
easy.
T20 And you get comfortable only when the The counselor seeks clarification so
other person responds positively. Am I that him and the client are on the
right? same page.
C20 Umm..Yes you are right. Actually I
myself realized this thing now.
T21 That’s good isn't. It's important for us to Positive asset Smiles at the client
be aware of thoughts and feelings.
C21 The counselling is already helping me. Smiles back

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T22 That’s good to know. Also you Probe The counselor moves forward to
mentioned a couple of times about your explore other areas of the client’s life
family. Let’s talk about your family. Is to get a more comprehensive picture.
that ok?
C22 Yes sure.
T23 How many members do you have in Close question The counselor begins with a relatively
your family? easy question.

C23 I have my parents, 2 sisters and 2

brothers.
T24 How would you define your relation Probe The counselor explores the client's
with them? relation with family.
C24 Like I told you my parents are very
strict they don’t like my actions and they
believe I am doing in wontedly to gain
attention. Which is nowhere true as I
said. My brothers never had time to talk
to me and my sisters are married they
have their own issues so I don’t feel like
sharing it with them.
It is so hurting at times when my own
family thinks that I am weird. Because
of that I started to develop a feeling that
maybe I am at fault.
T25 I can sense that and I can understand Summarizing The counselor uses empathy to
how difficult it must be for you… so and respectfully perceive client's frame.
far, you’ve told me that you get interpretation The summarizing skill to bring all
nervous when talking to new people parts of the client’s story together
and you prefer being alone. You also in a comprehensive whole. The
mentioned that you feel a lot of hurt counselor uses advanced empathy
from your family and you can’t talk to make an interpretation about the
to other girls in the class, because
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 they don’t share the same interests. It client’s thoughts and feeling
seems to me, that your issue with regarding her friends and family –
friends and family revolves around the counselor tries to make the
understanding… you feel like neither client aware of an emerging theme
of them understands you and your in her story.
interests. Did I get you right?
C25 Yes ma'am. You got me right.
T26 Do you want them to understand Closed question The counselor moves towards the
you better? client’s goals and expectations.
C26 I don’t think that’s possible ma'am
T27 We can make it possible by working out The counselor tries to see if the client
together. wants to change something about her
relationship with her parents.
C27 It doesn’t bother me anymore ma'am. I
think can deal with them.
T28 If that is what you believe we can work Focusing The client seems reluctant to work on
on the anxiety issues you told you have her family issues, thus the
when meeting new people. What do you counselor refrains from probing
think? further.Instead, the counselor
chooses to focus on her social
anxiety and intense feelings of
fear.
C28 Yes ma'am that is what I want.
T29 So we can schedule another session for
next week and take this forward.
C29 Okay ma'am. Looking forward to that.
T30 Thank you for sharing you issues.

PROGRESS NOTE ON COUNSELLING SESSION

Counselor’s name: Fiza Hussain

Clients’ first name: SS

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Date: 11/03/21

Session no: 1

Summary of the session: - (Objective)

The client’s presenting problem seemed to be her interpersonal relationships – both

with peers and family. She also told that she feel anxious while initiating a

conversation and hence usually stay away from talking to people. The session was

focused on letting the client tell her story. The major concern seemed to be that

the client felt like nobody understood her and this led to conflicts with other

people and to feelings of alienation and isolation in the client.

Hypothesis:

The client’s narrative style was negative and it seemed like she was focused on the

negative aspect of her life. She rarely spoke about strengths and even described

potential strength areas in a negative light. For example, she was extremely

observant and sensitive to other people’s feelings. She was also very intuitive.

These are traits that can be cultivated into strengths; however, the client spoke of

them with a negative connotation.

Interaction/ Skills/ Activity:

Since the client was very active in sharing her story, the counselor was focused on

providing an empathetic and warm environment in which the client can safely

share her story.

Future Course of action:

Future sessions must focus on positive asset search and addressing negative thoughts.

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 VERBATIM TRANSCRIPT

Client Name: SS Date: 19/03/2021 Session No.: 2

Time Started: 7:00 pm Time Ended: 8: 00 pm Total Time in mins: 60 minutes

Transcript Skills Used Process Comments
T1 Hi SS how are you doing? Rapport The counselor greets the client
warmly to make her feel comfortable.
C1 I am doing good how about you?
T2 I am doing great. Thanks for asking. Open question The counselor wants to check in with

Tell me how was your last week. the client to see if there has been some
change since they last met.

C2 It wasn’t that great ma'am. Actually the

next day after our session I called up
my senior to tell her about the session,
we were on a video call she asked me if
I was making any new tune so I was
humming one and there comes my dad
who saw me and started lecturing me it
was so embarrassing to hear all this
from him in front of my friend. He
scolded me for so long and then while
he was going he banged my door. It
made me really angry.

T3 Ok, so he got angry at you because you Paraphrase The counselor paraphrases what the

were humming? client said in order to communicate to

the client that she was listening.

C3 Yeah! Remember I told you in the last

session that they consider it
inappropriate, basically they believe
that a women should be hidden. She
should not raise her voice, she should
not do something that grabs others
attention and my family thinks change
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 my expressions while humming
because so that I can attract others.

T4 I see. It seems like there’s a Interpretation The counselor makes an interpretive

conflict of values. He believes that statement. This will help the client see a
this is inappropriate because his new perspective and understand the issue
cultural and moral values tell him better. However, the counselor ends it
that girls should be modest and with a check out to see if the client agrees
quiet. But you don’t seem to fit or has some other thoughts.
those criteria, so he feels like
something is wrong. Do

you agree with that?

C4 Yes I think that’s what the problem is.
Basically there is a generation gap
between us also all my siblings are very
obedient as my parents label them and I
was sent to the hostel for my studies
and they believe my unusual behaviour
comes from there.

T5 Unusual behaviour ? Probe The counselor picks out the key

words and restates it, encouraging the

client to elaborate on it.

C5 Okay so basically we had dance and

singing classes in our boarding school
and it is from that time that I developed
interest in making tunes so they blame
my school for that. My parents changed
my school just after they got to know
about this. I personally feel that the
tunes I make are wonderful and a lot of
people have also appreciated me for
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 that but I don’t think I can continue this
for long..My parents will throw me out
for being immoral.

T6 Did you ever try talking about this Open question The counselor wishes to gain more

interest with your parents and did you information.

ever made them listen those tunes?

C6 I think that is a total waste of time since The client breathes heavily and looks
they do not appreciate it. away

I think we are just wasting time talking

about this issue I feel there is more in
my life to sort out.

T7 If you think so we can talk about

something that seems important to you.

C7 Ma'am I want to share something with

you. It's about my school friend HK.
She is in the same college in which I
am. We were very good friends in
school but when she joined my college
she started to behave in a very unusual
way.

T8 Unusual way? Probe To understand the situation better.

C8 She has not been talking to me at first

and then she made her own different
group of friends and started to mock
me .

T9 Can you share an incident when Open question The counselor realizes that the client

something like this happened? is speaking in vague and abstract

C9 So since everything is happening online

these days we had a seminar where I
was asked to give the welcome speech.
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 I messed up big time I read the whole
speech without even realizing that my
mike was muted. Everyone made fun of
me but I didn’t expect HK will do the
same in fact she also made a video of
the same and sent it to my other school
friends. It was really embarrassing. I
got really angry and sent her a text
message saying what she did was
wrong.We had an argument and I
accept I was rude. I don’t know what
happened after that but she blocked me
from instagram. And I am not happy
about that.

T10 Ok, so you had an argument with Summarising The counselor summarizes the issue,
your friend a few days ago because while also using some reflection of
she recorded a video of you and sent meaning to bring out some implied
it on the group. And because of this meanings in the client’s statements.
you got angry at her. And now she
blocked you from instagram which
is troubling you correct?

C10 Yes ma'am it is bothering.

T11 Okay tell me the ideal situation you Open question The counselor enquires about the
want to be in. relationship she wants with her friend.

C11 I don’t think I understood what you

mean

T12 Ok, let me simplify that to you, I mean

to ask if not this way how would you
want the situation to be with your
friend.

C12 I want everything to be normal. I want

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 our bond to be strong.

T13 Ok, you want to get your relationship Paraphrase, The counselor wants to understand the
to be normal with her. First, let me ask open question dynamics between her friend and the
you, what is normal for you in this client.
relationship?

C13 I think, normal would be, talking to

her like we used to talk in school,
sharing secrets and also supporting
each other.

T14 What do you think is the reason behind Open question The counselor tries to take information
she acting out in the unusual way you from the client regarding her friend's
said? behaviour.
C14 Umm.. Pauses for a some time Looks at the counselor being confused.
T15 You can take your time and think.
C15 I think it's because she doesn’t like me
anymore. I mean I have got pimples
and I am not that attractive to be friends
with.
T16 So you’re saying that it’s because Reflection of The counselor reflects the implied
you’re meaning meaning behind the client’s words.
not ‘good enough’?
C16 Well I don’t know but this can be one
of the reason. I am not like other
college girls my interests are different,
I look different and not attractive at all.
I feel whenever people are talking to
me they get annoyed by my talking
style and my appearance.
T17 Annoyed? Probe The counselor wants to understand the
clients thoughts and feelings more
deeply.

C17 It's just that when I try to build a

converstaion or want to keep the
conversation going I usually put myself
down so that others be interested. I
share jokes and I think that is boring for
them and when things I share are not
funny it makes me feel embarrassing.
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T18 Ok I understood your point SS. We Summarising The counselor uses summarizing to
had talk about so many things in this organize all the information that the
client has divulged so far in the
session, let’s just go over them once. conversation. This also helps pull
You told me about your conflict with together and connect important pieces of
information, give the conversation a
your parents, and we spoke at length direction and help the client gain some
about your relationship with them. insight.

You also told me about your conflict

with your friend, and we also spoke
about your relationship with her.
Another important thing that came
up was your relationship with
yourself. You told me that you feel
like people find you annoying. You
had also mentioned in the last
session that you get anxious while
talking to new people and in this
session we’ve discussed that it could
be because you think people will find
you annoying. You mentioned two
important things – number 1, that
they will find what you say to be
boring. Number 2 that you will end
up being embarrassed. Is that right
so far?

C18 Yes ma'am

T19 Now, broadly speaking, there are Closed The counselor tries to move the client
three main concerns you have question towards an action plan by asking the
client which issue she would like to deal
brought up so far – number 1, your with first.
relationship with your parents,
number 2, your relationship with
your friend and number 3, your
negative thoughts about yourself. At
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 the present, according to you, which
one is the most pressing? What
would you like to deal with first?

C19 I want to talk to my friend ma’am. I

want to resolve this issue with her.
T20 Okay, so tell me how do you think you Open question The counselor wants to know what
can do that? the client is willing to try.
C20 I guess I will have to talk to her about it
but she blocked me from instagram.
T21 Yes you told me that she blocked Influencing The counselor gives some advice to the
you from instagram. How about client using mild influencing skills, as the
client has to realize that she is the one has
giving her a call and sorting things to take action.
out? I understand how you feel. But
since you are the one who wants to
make amends, you will also be the
one who has to take action, because
we cannot force her to come and
say sorry to you. Does that make
sense?

C21 Yes ma'am. I totally understand

T22 I would suggest you to go and talk to Influencing The counselor invites the client to carry
her, tell her how you feel being distant out some actions necessary for her to
from her and share your feeling for her. reach the goal she has set.
C22 I shall try that ma'am
T23 Do you think it will make a difference? Close question The counselor wants the client to
know that the choice is hers and the
counselor does not mean to impose
her advice on the client.

C23 I will try ma'am.

T24 Ok so how will you go about it? Open question The counselor asks the client for her plan
C24 Maybe I will go and call her.
T25 Okay, good But remember that way Information The counselor advices the client to be
you talk or express your thoughts are giving calm
also important. You have to be really
calm and composed.
C25 Yes I will try.
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T26 Try to be assertive. The 3 C's of Information
assertiveness are Confidence, clear and giving
controlled.
C26 I will keep in mind these 3 points.
T27 Excellent. You can talk to her and we
will meet in the next session and one
thing I tell you it is very important the
way you consider yourself and talk to
yourself so make sure to have a
positive self talk with yourself.
Whenever you get a negative thought
about yourself, that says that I’m not
good enough, or I’m boring, tell
yourself, ok, I’m getting this thought
right now. What is triggering this
thought, what am I feeling right now.
Just do a little bit of mindful tracking,
and in the next session, we’ll talk a bit
more about it.

C27 Sure ma'am

T28 See you in the next session
C28 Yes ma'am

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 PROGRESS NOTE ON COUNSELLING SESSION

Counselor’s name: Fiza Hussain

Clients’ first name: SS

Date: 19/03/21

Session no: 2

Summary of the session: - (Objective)

The client came in for the next session. She had an argument with her parents that

morning. The client also had some disagreements with her friend. The friend had

made a video of her which she didn’t like and in response to that she has an

argument with her . The friend has blocked her on instagram This disturbs the

client and she wished to sort things out between her friend. The told her to use the

assertive style of communication to talk to her friend and also introduced the

negative tracker exercise to track her negative thoughts.

Hypothesis:

The client has many negative thoughts around the theme that people don’t like

her and find her annoying, which is affecting her interactions with other people,

including her family.

Interaction/ Skills/ Activity:

The client was made aware of her negative thoughts using Socratic dialogue and

psycho education. The client was also given an activity to track her negative

thoughts. The client was given brief assertiveness training to talk to her friend.

Future Course of action

Future sessions must focus on the clients negative thoughts. Another area to explore was

her interpersonal relationship. 20

 VERBATIM TRANSCRIPT

Client Name: SS Date: 27/12/2019 Session No.: 3

Time Started: 5:00 pm Time Ended: 6: 00 pm Total Time in mins: 60 minutes

Transcript Skills used Process Comments
T1 Hi, how are you? Rapport The counselor greets the client

warmly to make her feel at ease.

C1 Hello ma’am, I’m good. How are
you?
T2 I’m good, thank you. How has Open question The counselor begins by checking in
the past week been for you? with the client.
C2 It’s been good ma’am.
T3 Ok, were you able to speak to your Closed The counselor wants to check if the

friend? Question client put her plan to action.

C3 Yes, ma’am. Just after your
session I did spoke to her, we got
on a long call we could talk for an
hour.
T4 Excellent. So it worked out well Closed
for
Question
you?
C4 Yes, ma’am

T5 So how does it feel talking to her Open question The counselor wants to focus on the

after so long. client’s positive feelings.

C5 There were still some differences

that I could sense but overall I felt
good that I didn’t sit back but did
something to strengthen our bond.
We also got on another call after
that one. Maybe eventually things
will get better.
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T6 That’s good to know. Yes things Reflection The counselor gives the client some

will take time. Hopefully positive feedback about her strengths

everything will get better. I am and directs the conversation towards

happy that you took a step. the client’s assets.

C6 Hoping for the best ma'am.

T7 You were able to go speak to her Open question

without any hesitation how does
that feel to you about yourself.

C7 I was hesitating in the beginning but

then I felt it's better to be strong
take a step rather than being
troubled by these thoughts every
day.

T8 That’s amazing isn't, you could Positive asset The counselor emphasizes on the victory
break the thoughts you had and win of the client, so that the client feels as if
the race. You should be proud. she has made progress and increases her
motivation and positive affect.

C8 Yes ma'am. It feels so much better

when you point these things out to
me. Generally I am not able to think
this way.

T9 It's important for you to be mindful Information The counselor tries to tell the client about
of what your thoughts and feelings giving. the importance of being mindful.
are that will help you to deal with
your problems effectively.

C9 Yes ma'am. I will do that from now

on.

Also in the last session you told me

about an exercise to track negative
thoughts I tried it and it was really
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 helpful.

T10 That’s good to know. How did you Open question The counselor enquires about the exercise
go about it? the client did.

C10 So basically I had another argument

with my parents. My mother told
me that I am good for nothing and
then I was zoned out and felt that
maybe she she is true. I have not
done anything that I should be
proud.

I thought I will bring up this issue

today and then got recalled about
the negative tracking exercise you
introduced me to. I gave it a deep
thought and then I realised that I
may be not good in one task but
there are many things I can be
proud of.

T11 I am glad that it helped you. Tell Positive asset

me what did you list down when search
you were listing the things you are
proud of.

C11 My painting, my trophies also that I

am an achiever. Also today after
this session I will proud that I could
talk to my friend.

T12 Wow that's amazing isn't. Also you Open question The counselor is trying to know about the
told that there was something that relationship client has with parents.
happened with your parents would
you like to talk about it?

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C12 Ahh.. Not really ma'am. That’s just
the same story that I have been
telling you.

I have learnt to live with it now. I

am trying to live with it now.

T13 Does it not bother you anymore? Closed question

C13 It does ma'am but I can't do

anything about it.

T14 Did you ever try sorting it out? Closed question The counselor tries to get more insight
from the client.

C14 How do I do it ma'am? Looks down

T15 Maybe you can get into a healthy

conversation with them.

C15 Healthy conversation ma'am?

T16 How things got easy when you used Influencing The counselor is directing the client
assertiveness to talk to your friend skills towards formulating an action plan.
you can use the same style with
your parents.

C16 Do you think it will work with

them?

T17 It worked with your friends so it Open question

should work with your parents as
well. What do you think about it?

C17 May be I can give it a try. But I

don’t know if that works with my
parents.

T18 Have a positive outlook. It may be a Influencing

little difficult but I know you will
be able to do it.
24
C18 Okay ma'am I will do it.

T19 Is there anything you want to talk

about SS?

C19 Nothing for now ma'am. I think I

will go and talk to my parents first
and if that helps I will be really
grateful.

T20 Stay calm and positive. You will be

able to do it.

C20 Yes ma'am. I will see you next

week ma'am.

T21 Yes. Take Care.

25
 PROGRESS NOTE ON COUNSELLING SESSION

Counselor’s name: Fiza Hussain

Clients’ first name: SS

Date: 27/03/19

Session no: 3

Summary of the session: - (Objective)

The counselor started the third session with a review of the past week. The client

reported some improvement in her interactions with her friend, but there were still

some negative thoughts. The client shared how the negative thought tracker was

helpful for her and how she applied that to be get aware of her strengths. The

client also opened up and agreed to work towards strengthening her relationship

with her parents. The counselor suggested the client to use the same

communication style she used to talk to her friends.

Hypothesis:

The client has interpersonal issues with her parents.

Interaction/ Skills/ Activity:

The counselor engaged in some information giving with the client and asked her

to engage in an assertive communication style with her parents that will help her

to strengthen her relationship with them.

Future Course of action:

Future session must focus on exploring her feelings of isolation and her

relationship with family.

26
 PROGRESS NOTE ON COUNSELLING SESSION

Counselor’s name: Fiza Hussain

Clients’ first name: SS

Date: 1/04/21

Session no: 4

Summary of the session: - (Objective)

For the next session, the counselor began by asking about developments in the

relationship with her friend. The client mentioned that even though she had the

opportunity to talk to her friend, she chose not to because she didn’t want to

become friends with her again. She felt that their friendship was getting to negative

and toxic, and she felt better with the way things were. She wanted to break her

friendship and create some distance from that friend.

Next the counselor asked the client about the negative thoughts about self. She

mentioned that she did have many negative thoughts about herself. She recounted an

incident where she was talking to her friend and she tried to make a joke, but she was

afraid that the person will think she’s stupid and will dislike what she’s saying. But she

noticed this thought and tried to replace it. She said the joke anyway and felt like it was

a small victory for her. The client also spoke at length about what happened when she

tried talking to her parents. She said that her anger took over the conversation and she

couldn't follow what was instructed to her. She said that she will try again to have a

healthy conversation with her parents.

Hypothesis:

The client feels ‘unworthy’ and ‘disliked’ because she experienced isolation from her friends in
27
the lockdown, none of her friends contacted her or tried to keep in touch with her, and she felt

unimportant. The client’s low self-esteem were also influenced by these.

Interaction/ Skills/ Activity:

The counselor engaged in empathetic listening and presence with the client. She also did a

positive asset search where the client and counselor spoke about the good friends that client has

now. The client came to a realization that she is not as isolated or misunderstood as she initially

presented herself to be, and there are in fact people around her who she likes spending time with.

Future Course of action:

Negative thoughts about family need to be addressed.

28
 PROGRESS NOTE ON COUNSELLING SESSION

Counselor’s name: Fiza Hussain

Clients’ first name: SS

Date: 08/04/21

Session no: 5

Summary of the session: - (Objective)

The counselor started the next session by inquiring about the things that went well for the client

since they last met. The client mentioned that she had a talk with her senior. And she was so

happy to share that she could have a decent and a healthy conversation with her mother. She was

in tears stating how good she felt having a 5 minute talk with her mother where she was not

taunted by her mother. She said that this conversation happened after completing the work which

her mother asked her to do. She said that if she be a little more obedient she may fix up her

relationship with her whole family.

Hypothesis:

The client feels happy and accepted talking to her mother and she wants to develop the same

relation with her other family members too.

Interaction/ Skills/ Activity:

Through Socratic dialogue and counselor’s self-disclosure, the client and counselor discuss how

the client can see things from her parents’ perspective. The client and counselor discuss how her

parents are also humans with flaws and we sometimes expect our parents to be perfect and make

no mistakes at all. The client realized that she must improve her communication with her parents

and sometimes forgive them for the mistakes they make

Future Course of action: Follow ups must focus on how well the new learning are being

implemented
29
 Mental Status Examination

Characteristics Normal Abnormal

Appearance and Behavior
Posture Normal Limp, ill-at-ease, bizarre
Gestures Appropriate Hyperactive, agitated, fidgeting, hand-
writing, picking, touching, effeminate,
violent, purposeless, tics, twitches,
clumsy, bizarre.

Grooming (hair, nails) Neat Slovenly, meticulously clean.

Dress Appropriate, casual Careless, slovenly, seductive,

inappropriate, bizarre, dirty.
Facial Expression Appropriate Dazed, perplexed, grimacing, poor
eye contact, staring, lip-smacking.
Speech

A. Pace Normal Pressured, retarded, halting, blocking,

stuttering, mute.
B. Volume Normal Very loud, very soft, monotonous.

C. Form Logical, coherent Illogical, rambling, tangential,

circumstantial, incoherent

D. Clarity Clear Slurred, garbled

E. Content Normal Flight of (poverty of) ideas, loose

associations, rhyming, punning,
echolalia, perseveration, obscene,
neologisms, word salad.
Attitude and Sensorium
Attention Normal span, alert Short span, hyper alert,
drowsy, fluctuating, easily,
distracted.

Mood Happy, friendly, Elated, euphoric, agitated, fearful,

cheerful anxious, panicky, hostile, apathetic,
sad

30
Characteristics Normal Abnormal
Affect Appropriate Inappropriate, intense, shallow, flat,
blunted, labile, indifferent.

Perception and Thought

Content
Hallucinations
A. Auditory Absent Own voice, another’s , many; talking
to/about patient; flattering, accusatory,
directive
B. Visual Absent Shadows, lights, halos, forms, figures.
C. Tactile/Somatesthetic Absent
D. Gustatory Absent
E. Olfactory Absent
Delusions Absent Paranoid/persecutory;
grandeur; reference; alien; control;
guilt; nihilism; thought;
insertion/broadcast/withdrawal

Illusions Absent Visual; auditory

Other Absent Derealization; austistic; thinking;

phobias; ambivalence; obsessions;
compulsions; ruminations; suicidal/
homicidal ideation or plans

Orientation Oriented X 3 Disoriented to: time , place and person

(others, familiar others, self)

Judgment Intact Impaired

Cognition
Memory
1. short-term Intact Impaired

2. Immediate recall Good Poor (digit span of 5 or less)

3. Reversals Good Poor (digits backward of 4 or less)

31
Characteristics Normal Abnormal
Concentration Good Poor
Calculations Good Poor
Abstraction
Similarities Handled well Poor, bizarre responses

Absurdities Recognized Not recognized, poorly handled

Proverb interpretation Good Literal, semi concrete, concrete,

bizarre
Insight Good Fair, poor, absent

32
 TERMINATION

Reasons for Termination:

The client reported improved functioning in her interpersonal relationships.

Total No. of Sessions: 5

Follow up if any:

Follow up session can focus on client’s eating habits and checking whether the positive

thoughts are sustained.

33
 CASE CONCEPTUALIZATION

Background Information:

SS is a 21 year old Muslim girl, pursuing her graduation.

Overview of the sessions:

The client’s presenting problem seemed to be her interpersonal relationships with

her friends and parents. The major concern seemed to be that the client felt like

nobody understood her and this led to conflicts with other people and to feelings

of alienation and isolation in the client. She also spoke about the nervousness she

feels while initiating a conversation. Since the client was very active in sharing

her story, the counselor was focused on providing an empathetic and warm

environment in which the client can safely share her story.

In the next session the client spoke about an argument with her parents, but she

didn't to work on it to make things better instead she presented another problem

about a dispute with her friend which disturbed the client and she wanted to make

things better between them. The counselor helps the client by educating her about

the assertive style of communication and encouraging her to use it and also

introduced the negative tracker exercise to track her thoughts.

In the third session the client reported some improvement in her interactions with

her friend. The client also shared how the negative thought tracker was helpful for

her. The client also opened up and agreed to work towards strengthening her

relationship with her parents. The counselor suggested the client to use the same

communication style she used to talk to her friends.

In the fourth session the client reported that she was maintaining distance from her

friend as that was getting toxic. She also told that she couldn't talk to her parents
34
as there was another argument that took place.

In the fifth session the client reported that she could talk to her mother using the

assertive communication style and that made her feel happy. She further wished to

use the same style to fix her relationship with her dad.

Dominant Issues:

 Negative beliefs about self

 Poor Interpersonal relationship with friends and parents.

Observations and assessments:

SS is friendly and intuitive girl. She has trouble initiating a conversation with

people. She has self esteem issues. However, she is open to learning and has good

insight.

Common Themes:

The common theme emerging in client’s conversations was that she tended to

avoid conversation with people fearing that they may get bored or may disconnect

with her as she believes that she has poor communication style. She thinks that she

is not attractive and hence people ignore her. The client also thinks that her family

wants to get rid of her and hence they treat her bad.

Client’s barriers to growth and coping skills:

There was no serious barrier to client’s growth except for her capacity to doubt

her own abilities. Otherwise, the client was open to suggestions and willing to

learn and implement behaviors that would help her.

The etiology of the client’s present psychological capacity or incapacity:

The client’s negative belief about self stems from her poor interpersonal relations

with her friends. She believes that she has been ignored and avoided because she
35
is not attractive and her interests in different from that of others. Her interpersonal

relations with her parents are poor because she spent her childhood in her

boarding school where she learnt dance and singing which was against their

culture.

Counseling Goals:

The goal of counseling was to teach and enable the client to use assertive

communication skills and to change the core beliefs of the client to more

positive beliefs . Another major goal was to help hestrengthen her relationship

with her parents and friends.

Therapy used for the client:

A treatment module for this client would include cognitive therapy to address her

negative thoughts as well as her anxieties . Socratic questioning and cognitive

disputation, as well as tracking and replacing negative thoughts may help her

address her negative view of self and the world. This, along with training in

assertive conversation skills, will greatly improve her interpersonal as well as

intrapersonal relationship. Addressing her negative thoughts about self, and

increasing positive affect may also help her self-esteem issues.

Observation about self:

I observed that using immediacy with the client, and being genuine, helped the

therapeutic relationship. The client showed resistance at the beginning and giving

information to the client about why certain things are done in therapy will help her

participate more fully in the sessions.

Experience:

It was good talking to her. I was able to equip her to help her through her issues.
36
Her openness showed that I was able to make the environment open and trust

worthy where she can talk about anything.

37
 CASE HISTORY TAKING INTERVIEW
CONTENT

I. Identifying information

 Name: Lalitha

 Age: 22 years

 Gender: Female

 Culture: Hindu

 Languages: Telugu and English

 Marital status: Unmarried

 Occupation: Student

 Education: Pursuing Post Graduation

Informant : self

II. Presenting problems

Interpersonal conflict with boyfriend and parents.

III. Brief history of the presenting problem

The client has been in several conflicts with her boyfriend and also has a hostile
relationship with her parents. She is also scared to open her relation with her
boyfriend to her parents as he is from another community.

IV. Biological functioning (at present)

 Sleep: Decreased

 Appetite: Decreased

 Energy: Decreased
38
V. Treatment history for the present illness

The client is seeking counselling for the first time.

Psychosocial history

 Social and developmental history

The client is currently living in Hyderabad. She belongs to a Hindu family. The
developmental milestones of the client were met at the right age. There were no
complications or any notable events during the growing years.

 Family History
The client is the only child to her parents. She has a hostile relationship with her parents.
The client's parents are very orthodox and they have been controlling the client. They
come from a middle socio economic background.

 Education History

The client is currently pursuing her post graduation.

PROGRESS NOTE ON COUNSELLING SESSION

39
Counselor’s name: Fiza Hussain

Clients’ first name: Lalitha

Date: 12/03/21

Session no: 1

Summary of the session: - (Objective)

The client’s presenting problem is an interpersonal conflict with her boyfriend.

The client states that the relationship has not been a healthy one, and there have

been frequent conflicts with her boyfriend. The client also talks briefly about her

family and states that her parents are strict orthodox Hindus and she fears that her

parents would reject the boy he chose. The client also opened up about her

experience with sexual abuse as a child. The client seemed to be coping well with

it and did not seem to have any severe trauma. The session was mainly focused on

exploring the client’s story, however, a considerable part of it was also

solution-focused, since the client was in a crisis situation – a conflict with her boy

friend, and she wanted a solution.

Hypothesis:

The client has interpersonal conflicts with her boyfriend due to lack of setting

clear boundaries and assertive communication.

Interaction/ Skills/ Activity:

The client was taught assertive communication skills.

Future Course of action:

The next session can focus on assessing the success of the intervention. An

important area to explore could be her relationship with her parents

40
 PROGRESS NOTE ON COUNSELLING SESSION

Counselor’s name: Fiza Hussain

Clients’ first name: Lalita

Date: 19/03/21

Session no: 2

Summary of the session: - (Objective)

In the second session, the client informed the counselor that she had been able

to talk to her boy friend and they had come to a mutual understanding. The client

reveals that they spoke for a long time and the issues got resolved. They decided

to maintain a healthy communication and set some ground rules that any of them

gets upset in the future, instead of ignoring each other, they will talk and try to

resolve the matter. The client was happy with the results. The counselor then

ventured into the topic of her parents, and explored the client’s relationship with

them. The client states that she feels pressurized by her parents’ to get married but

she doesn't have guts to talk about his boyfriend since he is from another

community and she is scared that her parents would reject him. The client narrated

several incidents that indicated that her mother was extremely controlling. and

strict. There also seems to be a lack of communication between the client and her

parents. The counselor suggested to develop the communication with her parents

before bringing up the proposal. Ways in which the client’s communication with

her parents can be improved were discussed.

Hypothesis:

The client’s family is strict and has high expectations from the client, both

culturally and morally. This makes the client feel stifled and negatively affects her
41
relationship with her parents.

Interaction/ Skills/ Activity:

The counselor allowed the client to share her story and engaged in active listening

and empathetic responding. The counselor suggested that the client also use the

assertive conversation skills she learnt with her mother. The counselor and client

spoke at length about ways in which the client can improve her relationship with

her mother; for example, doing some hobby together, or discussing religious

matters, as a way of bonding, since the client’s mother was a preacher.

Future Course of action:

The client’s relationship with her parents can be further explored by talking about

the client’s childhood and her parents' childhood as well. Another area to focus on

could be the client’s academic difficulties.

42
 PROGRESS NOTE ON COUNSELLING
SESSION

Counselor’s name: Fiza Hussain

Clients’ first name: Lalita

Date: 26/03/21

Session no: 3

Summary of the session: - (Objective)

In the next session, The client discusses that she is extremely distressed because

she has her exams coming up and cannot seem to focus on her studies. She

discusses how she is always troubled by the thoughts of losing his boyfriend

because her family doesn't accept it. The counselor helps the client understand the

importance of exams and also helps her with study tips. The counselor and the

client discussed how the client can increase her motivation and what techniques

can be used to help her study for her exams.

Hypothesis:

The client is not able to concentrate in her studies as she is disturbed by the

thoughts of losing her boyfriend. The problem is aggravated because her parents

have started to look for proposals for her.

Interaction/ Skills/ Activity:

Through motivational interviewing and cognitive techniques, the counselor helped

the client to understand the importance of exams. The client was also encouraged

to focus on her exams for the moment. The counselor and the client also discussed

ways in which the client can increase her focus and concentration, such as

assigning a particular place in her house for studying and only studying in that

43
place, using the pomodoro technique of time management, using mind maps and

mnemonics. The counselor also asked the client to write down the thoughts which

she experience while studying and keep it for discussing in the next session.

Future Course of action:

The next session could focus on assessing the success of the techniques talked

about in this session. Furthermore, in this session, it had not been possible to

review about the relationship of the client with her parents, which was talked

about in the second session. This can also be focused on in the fourth session.

44
 PROGRESS NOTE ON COUNSELLING
SESSION

Counselor’s name: Fiza Hussain

Clients’ first name: Lalita

Date: 08/04/21

Session no: 4

Summary of the session: - (Objective)

The client got infected with covid- 19 and could not attend the sessions regularly.

In the fourth session the client narrated how her parents got worried seeing her in

pain and she also believed that she would hurt her parents if she brings in the

proposal of her boyfriend. The client seemed to be very worried. She didn’t

wanted to let her parents down and on the other hand she also believed that she

couldn't live without her boyfriend. The client's health was deteriorating due to the

stress. The counselor asked the client about her action plan so the client said that

she would like to talk about her relationship to her parents instead of worrying

every day. But at the same time she was worried of their reaction. She was advised

to use the same communication style she used before to talk to her parents.

Hypothesis:

The client is in a dilemma, whether to choose her parents or her boyfriend as she

feels that choosing one over the other would hurt the other person.

Interaction/ Skills/ Activity:

The counselor used empathetic listening and responding to draw out the client’s

story and her emotions around the events. Through Socratic dialogue, the

counselor allows the client to speak about her action plan. The client agrees to

45
take a step towards solving her issues. The client and counselor then came up with

a step by step plan on how the client will talk to her parents about her boyfriend

and express her desires to them.

46
Future Course of action:

The future sessions must focus on reviewing the success of the conversation

between the client and the parent.

47
 PROGRESS NOTE ON COUNSELLING
SESSION

Counselor’s name: Fiza Hussain

Clients’ first name: Lalita

Date: 14/04/21

Session no: 5

Summary of the session: - (Objective)

The client approaches the counselor for a fifth session to discuss how the

conversation went. She looks very low and weak. She shared that before having a

conversation with her parents the client had a talk with her boyfriend. The client's

boyfriend asked her to not take a step so soon as he was not very sure if he will be

able to marry her. He also told that his family may not accept the girl. Following

which the client became very worried and she asked his boyfriend to talk to her

parents. The client's boyfriend asked for a two day time but he didn’t get back to

her and is neither taking her calls. The client had a talk with her parents regarding

the proposal of his boyfriend following which there was a big mess. She got into

a big argument with her parents which lasted for 2-3 days. She expressed that she

wanted to talk to the counselor but couldn't as she was physically feeling very low.

She didn't eat for 3 days and got unconscious and was admitted in the hospital. He

texted his boyfriend and told him the whole incident but he didn't answer her calls

or messages. The client's parents were very stressed seeing her in pain and agreed

to meet her boyfriend. The client is in a crisis situation as her boyfriend is not

available for her and it been more than a week and he has also blocked her from

the social media applications and at the same time her parents have agreed to

48
meet him. The client feels guilty for hurting her parents and want to fill in the

cracks that were created in her relationship with her parents. The counselor

empathizes with the client, helps her build her strengths and also suggest ways to

strengthen her relationship with her parents.

Hypothesis:

The client is confused because of her boyfriend’s behaviour, despite his actions

which claim that he does not want to have a relationship with her ; the client has

some hopes that he might reciprocate his feelings. The client’s parents have

agreed to meet the client's boyfriend but he is not responding to client's calls and

texts. The client feels stifled – there is a need for clear communication and

understanding between the client and her boyfriend.

Interaction/ Skills/ Activity:

Through Socratic dialogue and cognitive restructuring, the client is made to see

how the boy could be ignoring the relationship with her. The counselor and client

discuss that he might not be doing this intentionally but under his family pressure.

The client decides to talk to his boyfriend with the help of his friend and clear

things out, She says that she has no interest to marry her boyfriend but just want a

closure. She also says that she would not hurt her parents any more. The counselor

and the client discuss how the client can communicate with her mother in a

healthier manner. The client understands that the change will not happen

overnight, and commits to trying to fill in the breaks that were created in their

relationship.

49
Future Course of action:

Any development in the communication with the boyfriend and the steps she has

taken towards improving her communication with her parents needs to be

reviewed.

50
 Mental Status Examination

Characteristics Normal Abnormal

Appearance and Behavior
Posture Normal Rigid, limp, ill-at-ease, bizarre
Gestures Appropriate Hyperactive, agitated, fidgeting,
hand-writing, picking, touching,
effeminate, violent, purposeless, tics,
twitches, clumsy, bizarre.

Grooming (hair, nails) Neat Slovenly, meticulously clean.

Dress Appropriate, casual Careless, slovenly, seductive,

inappropriate, bizarre, dirty.
Facial Expression Appropriate Dazed, perplexed, grimacing, poor
eye contact, staring, lip-smacking.
Speech

A. Pace Normal Pressured, retarded, halting, blocking,

stuttering, mute.
B. Volume Normal Very loud, very soft, monotonous.

C. Form Logical, coherent Illogical, rambling, tangential,

circumstantial, incoherent

D. Clarity Clear Slurred, garbled

E. Content Normal Flight of (poverty of) ideas, loose

associations, rhyming, punning,
echolalia, perseveration, obscene,
neologisms, word salad.
Attitude and Sensorium
Attention Normal span, alert Short span, hyper alert,
drowsy, fluctuating, easily,
distracted.

Mood Happy, friendly, cheerful Elated, euphoric, agitated, fearful,

anxious, panicky, hostile, apathetic,
sad

51
Characteristics Normal Abnormal
Affect Appropriate Inappropriate, intense, shallow, flat,
blunted, labile, indifferent.

Perception and Thought

Content
Hallucinations
A. Auditory Absent Own voice, another’s , many; talking
to/about patient; flattering, accusatory,
directive
B. Visual Absent Shadows, lights, halos, forms, figures.
C. Tactile/Somatesthetic Absent
D. Gustatory Absent
E. Olfactory Absent
Delusions Absent Paranoid/persecutory;
grandeur; reference; alien; control;
guilt; nihilism; thought;
insertion/broadcast/withdrawal

Illusions Absent Visual; auditory

Other Absent Derealization; austistic; thinking;

phobias; ambivalence; obsessions;
compulsions; ruminations; suicidal/
homicidal ideation or plans

Orientation Oriented X 3 Disoriented to: time , place and person

(others, familiar others, self)

Judgment Intact Impaired

Cognition
Memory
1. short-term Intact Impaired

2. Immediate recall Good Poor (digit span of 5 or less)

3. Reversals Good Poor (digits backward of 4 or less)

52
 CASE CONCEPTUALIZATION

Background Information:

Lalita is a 22 year old Hindu girl, in post graduation final year.

Overview of the sessions:

In the first session, Lalita’s presenting problem was a conflict with her boyfriend.

Lalita was taught assertive communication skills to resolve the conflict. In the

second session, Lalita reported success in resolving the conflict. She opened up

about her strict family, and her hostile relationship with her family and the fear of

her relationship with her boyfriend being rejected as he belonged to another

community. She was suggested to strengthen her relationship with her family with

the assertive communication style. In the subsequent sessions the client reported

that the assertive way of communication helped her to communicated with her

parents effectively but she also discussed that the fear of losing her boyfriend is

leading to trouble in concentrating on her studies. The counselor helped the client

to deal with her issue by providing her with study tips.

In the fourth session, the client reported that she was tested positive for Covid-19

and in that course of time she saw her parents worried for her and she was in a

dilemma whether to bring up the proposal to her parents or not. On beig asked by

the counselor about her action plan The client said that she want to talk to her

parents about the proposal as the client's health was being affected due to the

stress.

In the fifth session the client reported that post a conversation with her parents

there was a huge argument between Lalita and her parents and her health started

deteriorating again. She also stated that her parents got worried for her and agreed
53
to meet her boyfriend, but on the other hand her boyfriend had cut his relationship

with her. The client also mentioned that she doesn't want to hurt her parents

anymore and want to fill the breaks in her relationship with her parents. The

counselor helped the client in positive asset search and to strengthen her bond with

her parents.

Dominant Issues:

 Relationship Issues with Boyfriend

 Interpersonal conflicts with Parents

Observations and assessments:

Lalita is an intuitive, outgoing and friendly girl. She has trouble setting boundaries

and using assertive communication in her interpersonal relationships, which often

leads to conflicts. However, she is open to learning and has good insight.

Common Themes:

The common theme emerging in client’s conversations was that she tended to

avoid confrontation and conflicts, even when some action was required. She

looked at confrontation as a negative way of interacting and tried to avoid it in all

her interpersonal relationships.

Client’s barriers to growth and coping skills:

There was no serious barrier to client’s growth except for her inexperience.

Otherwise, the client was open to suggestions and willing to learn and implement

behaviors that would help her.

The etiology of the client’s present psychological capacity or incapacity:

The client’s tendency to avoid conflicts seems to stem from early maladaptive

schemas developed from her early interactions with her parents, especially her
54
mother. The client’s mother is controlling and strict, and does not seem to allow

the client to oppose her or express her views. She placed strict rules and

restrictions on the client that did not allow her to explore her socio-emotional

functions, needs and desires. It also taught the client that it was best not to

confront anyone about anything and to give in and behave in a passive manner, to

maintain peace.

Counseling Goals:

The goal of counseling was to teach and enable the client to use assertive

communication skills more often. Another major goal was to help her increase

focus on her studies.

Therapy used for the client:

Person-centered therapy, as well as CBT was used with the client. Person

centrered approach helped the client to facilitate the relationships of the client

with her boyfriend and then with her parents. It also helped her in searching her

own strengths and utilising them in best possible way.

The Cognitive Behavioral Therapy helped the client to identify and change the

underlying thought patterns that contributed to her distress.

Observation about self:

When the client told that she cannot live without her boyfriend, I found myself

being judgmental towards my client, I thought how a person can get so

attached to another person just by knowing him for 5 months.

However, I spoke to my supervisor about this and tried to see things from my

client’s perspective. I realized that different people have different ways of getting

55
attached to others and only because I don’t think of it as a problem does not make

it less distressing for the client. It is important to make the client realize if she is

magnifying the severity of the problem, but writing a client’s distress off as trivial

is not acceptable as a counselor.

Experience :

It was a good experience with the client and there was many things to learn from this case,

but since the time was limited I couldn’t complete the whole case by myself.

56
 TERMINATION

Reasons for Termination:

The client reported some improvement.

Total No. of

Sessions: 5

Follow up, if required:

Follow up must focus on development in the communication with her boyfriend and
reviewing her relationship with her parents

57