COUNSELLING PRACTICUM REPORT

BY

JANET NJERI WACHIRA

ADM 41482

DIPLOMA IN COUNSELLING PSYCHOLOGY

DECEMBER 2023
DECLARATION

I Janet Wachira declare that the presented report of the practicum prepared by me is my original work and not by a copywriter.
DEDICATION

I dedicate this work to my supervisors ,clients, my colleagues for their moral and my family for support, contribution and motivation and
motivation throughout my course work .God Bless you.
ACKNOWLEDGMENT

I thank my heavenly father for takin me through this far in my studies .It is by grace and favor that I have succeeded. I also thank Thika Technical Training Institute
fraternity for the great support during my course work. The trainers of TTTI, who inspired me through various courses, boosted my morale in pursuing my Diploma
counseling. I as well pass my gratitude to director of Mama Lucy Kibaki Hospital and the entire fraternity for fiving me the opportunity to exercise my practicum
skill and competence through evaluation and monitoring of the activities that I carried out during my practicum period.

God bless you all.

GENERAL OVERVIEW OF THE PRACTICUM REPORT.

As a counseling psychologist trainee, the field aims to help individuals at any stage in life. Overcome mental health challenges in order to improve the quality of life.
Being a counseling psychologist practioner is quite good but also it come with its challenges. Some of the challenges I underwent as a counselling psychologist
included; Having burnouts , ethical dilemmas and confidentiality
Client Code :FM/20/33

Age;20

Marital Status:Single

Venue: Mama Lucy Kibaki Hospital

Number of Session;3

Duration;3hrs

Date:19/09/23

BACK GROUND INFORMATION

Client FM/20/23 is a female who referred to mlkh due to GBV.She was beaten by her dad for being pregnant .The client is a high school dropout due to financial
reasons and she has been into sex working to be able to provide for her family. She has an alcoholic dad and her mother is a casual laborer who is abled differently.
She has eight siblings who are not going to school because of finances. The client is full of regrets and trauma ,she is suicidal and says she fells hopeless because she
is pregnant and doesn’t know the father and also doesn’t have finances for the expected child.

PRESENTING PROBLEM

Client Fm/20/23 is undergoing trauma and also fear of the unknown .She is hopeless and feels the only solution is to die .She is also lonely because shes underoing
through stigma because of her work and pregnancy.

EXPLORED PROBLEM/UNDERLYING PROBLEMS

Trauma

Suicidal

Identity crisis

Stress

Fear

Low self esteem

THERAPUTIC GOALS

Reaching to a state of self acceptance and healing from her past.

COUNSELING INTERVENTION

Paraphrasing

Unconditional positive regard

Geniuses

Active listening

Open ended questions

COUNSELING TECHNIQUES

Psychoeducation

This was meant to make the client understand more on sex education and self awareness.
Advantage

To help the client learn more on sexual health and help improve on self awareness.

Reframing

This was meant to be able to shift the clients negative and suicidal thoughts to a more positive way.

THEORIES USED

COGNITIVE BEHAVARIOL THEORY(CBT)

Aron Beck was the founder of cognitive behavioral theory.

Reasons for using the theory

The reason for using the theory is because it aims at reducing overwhelming problems in a more positive way . It also helps in developin coping skills ,whereby they
can be able to change their thoughts emotions and behavior.

Key Concept

Identifying and changing negative thoughts

Develop problem solving skills

Challenges encountered in CBT

The client would relapse at times.

It doesn’t take account into the clients emotions.

REALITY THERAPY

It was pioneered by William Glasser in 1965

This theory helps and focuses on improving present relationships and circumstances with less concerns and discussions of pasteevents.

Key concept

Emphasizing on the present situation

Teaches on how to control how we think and behave

Avoid criticizing and blaming

Challenges of reality therapy

Treatment may be limited

Potential to impose values

SUMMARY

At the end of the three sessions, the client was able to perceive themselves positively and was ready to work on themselves.
CASE TWO

BIORAPHIC DATA

Client code : MM/35/23

Age: 35

Marital status ; single

Venue : Mama Lucy Kibaki Hospital

Number of sessions :4

Duration ;4hrs

Date :27/09/23

BACKGROUND INFORMATION

Client MM/35/23 is a male who has been dealing with drug addiction (alcoholism and bhang ). He is a electrician and both parents are alive. He has three siblings
who are also in the field of business .the clients has been an alcoholic for almost six years. He was married for nine years having two kids ,and since the wife couldn’t
handle his drug addiction ,she left. He would be violent at times with wife. The client has been in psychiatric clinic and was reoffered to counselling and that’s where
we began the sessions.

Presenting problem

Client MM/35/23 has been a drug addict especially alcohol for almost six years He has been trying to stop then relapses .

Explored problems

Drug addiction (alcohol and bhang).

Therapeutic goals

The client to completely stop being addicted

Increase self awareness

Counselling interventions

Probing

Active listening

Unconditional positive regard

Empathy

Congruence

Techniques used

Assertion training

It was used to teach the client the virtue of assertiveness since he said most times his friend are the one who buy him drinks . it was to help him be more courteous,
calm and concise.
Cognitive restructuring

The client believed that drus was the only thing he could use to et rid of stress. This was used to teach the client that alcohol wasn’t the only solution to get rid off the
stress the had . it showed him other positive thins to do other than takin alcohol.

Advantage of the techniques

Taught the client virtue of assertiveness

It developed more rational thoughts to process

Challenges

Doesn’t take account into the clients emotions

Needed the client to commit himself to et the most from it

Theories used

Cognitive behavior theory

It founder was Aaron Beck in the 1960

Reason for using this theory

It was because the theory helps to develop coping skills whereby ,they can be abler to change their thinking and problematic emotions and behavior helps the client to
deal with overwhelming problems in more positive ways.

Key concepts

Engaging behavior experiments to test.

Developing problem solving skills.

Identifying and changing negative thoughts.

Challenges encountered using cognitive behavior therapy.

Behavioral theory

John b waston is referred to as the father of behavioral theory.

It states that every behavior is learnt and at the same time it can also be unlearnt .

The reason for using this theory it’s because it teaches the client on the virtue of being assertive by increasing the level of assertiveness there tend to be a reduction in
their drinking and a positive result on their personal functioning,

Key concepts

Learning occurs through the process of operant conditioning this involves reinforcing or punishing behaviors based on their outcomes.

It focuses on observable actions ,rather than thoughts and emotions.

Environmental stimuli shape behavior.

Challenges encountered with behavioral theory

It doesn’t take account into the clients emotion.

Summary of the case

At the end of the sessions the client had already stopped alcohol intake and he was doing good and improving.
CASE THREE

Client code; WO/26/23

Age:26

Marital status: married

Venue : Mama Lucy Kibaki Hospital

Duration:o

Number of sessions:3

Date :05/09/23

BACKROUND INFORMATION

Client WO/26/23 was a client undergoing loss and grief .she came to give birth at mlkh and her a delivery went well but two weeks, later her twin baby boys
succumbed because of various complications .she completed hihschool in form form and was btrouht up by a sinle mom .she has three siblins and she works at an
institution as a receptionist,she is married.the client came full of aner ,bitterness and hoplesness. She says blames the hospital for not takin proper care of her new
borns ,she also feels hoples and thinks shes cannot give birth to healthy kids beacasues she has had two previous miscareges and now the death of her twims .she was
reffered by the doctor for counselling sessions

Presenting problem

Client WO/26/23 is underoin loss and grief ,she is still in the denial stage because she hasn’t fully accepted the loss of her twins.

Underlying problems

Grief

Anxiety

Anger

Bitterness

Multiple losses

Stress

Therapeutic goals

To accept the reality of the loss and experiencing the pain of grief and all the emotions that follow up and adjusting to the new environment without the lost babies.

Counselling skills

Open ended questions -this was to make sure the client did not feel judged by the word used.

Probing -this was to makes sure that I drew more impontant information regarding the situation.

Techniques used

Empty chair technique

I used this technique so that the client could be able to express unresolved emotions and conflicts. She had to gain new insight and develop a sense of closure.

Advantages

Her and now- this meant to make sure that the client focuses on the present rather than blaming her self.
The techniques allowed to express and process unresolved emotions and conflicts.

Challenge’s encountered with the techniques

The client was very emotional when expressing her thoughts and feelings.

Theories used

Gestalt theory

The founder was Frederick peris in 1893

The reason for using gestalt theory with loss and grief client its because it encourages individuals to face reality and fiht rather than blaming herself.the client was
abled to express unresolved emotions and feelings promoting healing and full acceptances to the loses.

Key concepts of gestalt theory

Here and now whereby gestalt theory focus on the present moment rather than on the past experience. Focuses on closing the unfinished business and come into terms
with what happens

Aims in increasing a person’s awareness of themselves ,through this awareness personal growth becomes possible.

Challenges’ encountered using gestalt theory

It focuses on the present therefore leading to avoidance of important underlying issues

It does not help psychological thoughts are influenced by individual thoughts

Technique like empty chair may lead to intense emotional expression.

Cognitive behavioral theory

Aaron beck was the founder of the theory in the 1960s

The reason for using this theory its because it aims at reducing overwhelming problems in a more positive way and also help in developing coping skills whereby,
they can be able to change their thinking and problematic conditions

Key concept of CBT

Identifying and changing negative thoughts

Developing problem solving skills

Engaging behavioral experiments to test

Challenge’s encountered using CBT

Attending regular CBT sessions and doing extra works sessions was time consuming

Summary of the case

At the end of the sessions the client was able to come into terms with the losses and the bitterness and feelins of hopelessness had faded away .
CASE FOUR

BIORAPHIC DATA

CLIENT CODE: PK/17/23

AGE:17

MARITAL STATUS : single

VENUE: Mama Lucy Kibaki Hospital

NUMBER OF SESSIONS:3

DURATION:3hrs

DATE:12/09/23

Background information

Client PK/17/23 was referred by the school to mlkh because he was suspended from school because he was found usin drugs in school (bhang and tobacco). He stated
that he does this because he has bad peer company back in school but he was willing to change . he is in form three and has botyh parents . He has two other siblings
an elder sister and a small brother.

Presenting issues

Client PK/17/23 who was suspended from school because he was found usin bhang

underlying issues

self awareness

identity crisis

stress

peer pressure

Theraputic goals

The client to be more self aware and assertive

To stop takin drus (bhang and tobacco)

Counseling skills

Reframing

Empathy

Active listening

Paraphrasing

Techniques used

Counselor self disclosure

Self disclosure was used the counsellor disclosed their bbpersonal information on how to maneuver through highschool and how to avoid neagative peer pressure.
This idea was to be able to let the client gain insiht on how he could overcome bad peers.

Advantage of the technique

It made the client build trust

It strenthenes the therapeutic alliance

It helped build rapport with the client

Challenges

It needed the client to commit himself to chane

Theories used

Cognitive behavioral theory

Aaron beck was the one who introduced cbt

Reasons for using the theory

CBT helps the client to deal with problem in more manageable ways

CBT helps the client change their negative thoughts pattern and imorove the way they feel

Key concept

Identify and changing negatuive thought pattern

To develop problem solvim skills

Summary of the case

At the end of the sessions the clint was ready to change and leave negative peer groups and focus on his study.
GROUP THERAPY

CASE FIVE

BIORAPHIC DATA

CLIENT CODES:GC/10/23

AGE:25-35

NUMBER OF SESSIONS:1

VENUE:Mama Lucy Kibaki Hospital

DATE:4/12/23

BACKROUND INFORMATION

The group comprised of twelve members ae between 25-30 years . Some of them where born piostive and other acquired HIV virus in their life time .these youths
heve different issues like stimitization,pill burden,lack of self acceptance,low selfesteem and it is diificult fot them to disclose their status in their relationships.

Presenting problem

Clients C/10/23 Who are HIV positive and are oin through stimatiztion,poor slef image and lowself esteem

Therapeutic ogoals

Raise self esteem ,self accesptance and a;so self confidence

Increase awareness and also self knowledge about the virus

To prevent relapse

Underlying problem

Stigmatization

HIV &AIDS

Neative perception

Counselin skills

UPR

Empathy

Probing

Active listening

Techniques used

Psychoeducation

This was meant to provide the clients with knowledge about various facts of the virus and its treatment for a better overall outcome

Advantaes of using the technique

To provide insiht into the visrus

Engagin in crisis management

Tp promote relapse prevenetion

Challenges

Less confidentiality thus makin it difficult for some clients to open up

Theories used

Psychosocial theory

Thefounder of this theory is Erick Erickson on 15th June 1902

It focuses on stress manament ,coping,selfefficacy on peoples mental health and adherence

Key concepts pf psychosocial theory

Social interaction and relationship played a role in the development and rowth of hu,man beins

Developing through unfolding of our personalities in predetermuind staes and that the environment and surrounding culture influences how we proress throyuh these
stages
SELF EVALUATION

SWOT ANALYSIS

STRENGTHS

I was able to maintain confidentiality and keep my clients information confidential

I had good interpersonal skills

I was able to create a safe environment where my clients could express themselves freely without being judged

WEAKNESS

Lack of confidence

Experiencing burnouts

Lack of multicultural competence

Anxiety while carrying out certain activities

THINGS TO IMPROVE ON

I would most likey want to improve on my self confidence

GENERAL CONCUSIONS AND RECOMMENDATIONS

The practicum was a useful experience am greatfull to mama lucy kibaki hospital for ivin me the chance to do my poracticum. I have ain insight on what my strengths
and weaknesses are an I ought to improve

I got different ideas from different people at the hopitslnthrough interacting with other students who were also on practicum

I gained new knowledge and skill and got achance to intercat with new people

I benefited a lot in my practicum filed in a way that I managed to apply my theoretical knowledge to practice.
REFRENCES

DSM(V) diagnostic and statistical manual of mental disorders 5th edition Washington

DC London, England American psychiatric publishing

Rodgers HB (2013) adverse outcomes in group psychotherapy

Power J (2012) PERSON CENTERD THERAPY WITH ADULTS SEXUALLY ABUSED AS CHILDREN

Warden Jowl (2014) grief counselling and grief therapy(4th edition)

Barath LG Huber (1995)counselling and psychotherapy (6th edition)