Amanda Geriak

CSP 512: Advanced Counseling and Mental Health Intervention

Professor Olaya and Professor Maupin
March 13, 2023

Individual Counseling Reflection #2

During this session, my agenda consisted of clarifying beliefs, automatic thoughts, feelings and
behaviors. I also wanted to assign some homework for my client to partake in. Throughout our review, I
would ask for confirmation or collaboration. Because of these questions, my client was able to add more
detailed information about herself and her experiences. For example, I was previously unaware that her
sleep issues relate to past diagnoses of sleep paralysis and night terrors. Currently, my client experiences
mild insomnia and low energy in her daily routines. Because of her medical history, I can infer that her
lack of sleep may also stem from a fear of anxiety-inducing occurrences during sleep. This is definitely an
important early experience that has translated into her present behavior. I also learned more about the
history of her family dynamic. Her personal relationships within this dynamic have been affected by the
pandemic, loss of her grandfather, and other circumstantial contexts. It seems that this occasionally
weighs on my client and is a source of some stress and sadness. My client is a very socially oriented
person where her relationships with family and friends are extremely important to her. However, it seems
that she has a tendency for the ‘unlovability’ core belief discussed in our textbook. I inferred this from her
preoccupation with concern that loved ones are angry with her. My client internalizes this and has a
tendency to self-blame for her friends’, parents’, and boyfriend’s moods. I attempted to use guided
discovery to catch some of my client’s self-deprecating thoughts through many open questions and trying
to focus on my client’s feelings rather than others’. My client seems to be hyper aware and very involved
with her social relationships to the extent where it’s hard to participate in true self-reflection. This relates
to some of her automatic thoughts about friends and family being mad at her, having difficulty separating
her own thoughts from others, and thinking her problems burden those she loves.
Fortunately, I believe I made serious progress with guided discovery by playing on her strength of
empathy. My client responded really well to my questions of “What would you say to a friend who’s
going through this?”. She would reply with compassion and strategies that work for her, which increased
her self-awareness with her own situation. Therefore, because this worked so well, I applied this to the
areas that contribute to the problem including: academic stress, work stress, friendship stress, and lack of
self-care. These allowed us to catch some of her unhelpful automatic thoughts that keep her from enjoying
her day and hinder her motivation. This also helped us collaborate on some homework which we ended
up calling ‘funwork’ instead because it is self-care and school ‘homework’ causes her anxiety. For my
client’s fun work, we decided to designate a reward for the end of the week in order to motivate her to
devote effort towards her responsibilities during the week. We also plan to utilize her planner not only for
mindfulness of school work but also self-care activities. This went really well, and I believe I am building
a strong rapport with my client.
In terms of difficulty, my client had some trouble thinking of core beliefs that are separate from
social relationships. I had some trouble coming up with strategic questions that are more centered around
herself without trying to pry it out, or seem unnatural. I want to improve on anchoring our counseling
sessions to the problem. I found that I enjoy my client dominating the conversation and divulging more
information about herself. However, it can be hard to naturally redirect the conversation to our main
problem. Therefore, I want to be more mindful of anchoring the conversation to focus on my client’s own
thoughts and feelings that feed into her problem. In the future, I plan on introducing the concept of
‘cognitive dissonance’ because her responses in this session seem to contradict some of the statements
from her first session about self-confidence. I also think that introducing ‘thinking traps’ would be helpful
in catching more automatic thoughts that negatively affect my client. For example, some of my client’s
thoughts involve repetition, jumping to conclusions, reading her friends’ and family members’ minds. I
plan on doing so in the next session, and hope that it is received well.

Case Conceptualization

Early Experiences

- During childhood, client excelled in academics and was a “Straight A student”

- During childhood, client was very close with older brother and mother
- During childhood, client “took [her] grandma for granted”
- When client’s grandfather died, client felt backlash from family (to her, it seemed like they
thought less of her because of her avoidance of the tragedy)
- During childhood, client experienced sleep paralysis and night terrors
- Saw sleep specialist for night terrors

Underlying Beliefs

- Good grades equate to good student, good person, and good daughter
- Tendency for ‘Unlovability’ core belief(pg. 34)
- Client believes she must get good grades to receive praise/validation from parents
- Client believes her brother does not care to be in her life because of how she is (still
vague)
- Client believes friends are often mad at her because of something she did, but can’t
name specifics
- Client believes in healthy social skills and supportive friendships
- Client believes in importance of family and family history

Thinking and Feeling Patterns

- “God, I don’t want to be here. There are so many other things I need and/or want to do”
- Feeling = overwhelmed, anxious, lack of motivation, lethargic
- “I’m not good/smart enough to get into nursing programs”
- Feeling = lack of confidence , lack of self-esteem, lack of faith in self and future
- “My friends must be mad at me. What did I do? I hope I can cheer them up”
- Feeling = unsure of self, worry, concern
- “Mom’s not happy with me. Why do I even talk to her?”
- Feeling = sadness, aggravation, lack of self-esteem
- “Why do I feel so strongly about this?”
- Feeling = unsure of self, ashamed, confused
- “I don’t know my own thoughts. I don’t know what I should think instead of what others are
thinking about me”
- Feeling = uncomfortability with self-reflection, concern about others
- “I messed up. I need to make up for it”
- Feeling = guilt, ashamed, concern for others
- “I should distance myself because I don’t want to burden others”
- Feeling = undeserving of emotional support, ashamed
- “Other people at school look so much better than me. I mean, look at my clothes!”
- Feeling = lack of self-confidence, lack of self-esteem

Behavior Patterns
- Poor sleeping behaviors
- Past history of sleep diagnoses (paralysis and night terrors)
- Still has lucid dreams that cause fear in client
- Poor eating habits
- Skip meals
- Occasionally over-eats to the point of physical uncomfortability
- Prioritizes relationships over school responsibilities and personal self-care
- Does not often complete assignments on time
- Often takes care of friends by planning activities to spend quality time and
communicating regularly
- Seems to neglect personal mental and physical health
- Does not take time to self and maintain well-being
- Busy doing something with or for friends/family
- Tendency to self-blame
- Reads into social interactions and
- Cries and isolates when feeling distressed
- Pushes people away
- Cries on weekly basis