Clinical Experience Essay
Clinical Experience Essay
My clinical practicum for this semester has been at an outpatient mental health facility. The practicum took 60 hours, and I worked alongside a Licensed Master Social Worker (LMSW). The practicum experience revolved primarily around psychotherapy since I only engaged in counseling sessions. I observed and participated in psychotherapy sessions for pediatric and adult populations with various mental health and substance disorders. The most common disorders among children and adolescents were generalized anxiety disorder (GAD), Autism spectrum disorder, conduct disorder, attention deficit hyperactive disorder (ADHD), and depression. I observed that child psychotherapy is associated with several challenges for the counselor. Firstly, the counselor has to sort through to identify what is serious and enduring in the child’s history. Besides, the counselor must establish what requires more intensive psychotherapy and what is likely to be reactive, requiring more focus on supporting resilience.
Child psychotherapy needs grounding in both developmental and family theory as elements of the child’s life. The LMSW took the initiative to be grounded in the family in each child’s case. She engaged a child’s family by encouraging them to describe their worries and inviting them to participate in developing solutions for the child. In addition, the counselor utilized a developmental approach when counseling children and adolescents. The office was always adapted to be appealing to children and relaxing and interesting for adolescents. Furthermore, I observed that the counselor engaged the children in the psychotherapy sessions.
The counselor asked the children why their parents brought them to the office in the first session. This was followed by a conversation between the child and parents about what is going on, pressing issues, and what is working well. In subsequent sessions, the start of a session began with the counselor reviewing with the child about their accomplishments. She also asked about challenges and how the child performed with the homework that had been assigned. I learned that children know how to communicate, and their parents/caregivers should be encouraged to help the child express themselves (Bhide & Chakraborty, 2020). Besides, toys and play bring another discovery aspect to the sessions, and families should be encouraged to join the child in the play activity.
The common mental health conditions among adults on psychotherapy were major depression, GAD, Bipolar disorder, OCD, PTSD, personality disorders, and substance use disorder. The counselor employed various psychotherapeutic approaches, including cognitive-behavioral therapy (CBT), Dialectical Behavior Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR), motivational interviewing, interpersonal psychotherapy, social skills training, and mindfulness therapy. Individual, family, and group therapy were used depending on the patient’s diagnosis, and the level of social support needed to promote recovery. I learned that in adult psychotherapy, the counselor should seek to improve the patient’s capabilities and motivate the patient to utilize and expand their capabilities (David et al., 2018). Besides, the counselor should ensure that the client can generalize their abilities past the therapeutic relationship.
CBT was the most used psychotherapy approach and involved the counselor modifying a patient’s behavioral skills to help address common, uncommon, and crisis-associated challenges as they occur within a realistic period. During CBT, the counselor’s goal was to help clients observe, assess, monitor, and adapt their problematic views and behaviors toward a more optimistic, flexible, comprehensive, rational, and confident skillset (David et al., 2018). I learned that cognitive and behavioral skill training incorporating the client’s goals and abilities in a respectful, mutual, and structured approach is the cornerstone of CBT-based psychotherapy.
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Bhide, A., & Chakraborty, K. (2020). General Principles for Psychotherapeutic Interventions in Children and Adolescents. Indian journal of psychiatry, 62(Suppl 2), S299–S318. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_811_19
David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in psychiatry, 9, 4. https://doi.org/10.3389/fpsyt.2018.00004
This semester I did clinical hours at an outpatient mental health facility. I observed only counseling sessions with a License Master Social Worker ( LMSW). I have to tell about that experience. So imagine setting in 60 hours of counseling session.The clients was treated for different mental health and substance disorders. There was individual, family, and group therapy. Different counseling theories and techniques were utilized.( CBT, DBT, EMDR, etc.)