Process recording assignment.
Running head: PROCESS RECORDING 1
Process Recording
Insert Student Name
Walden University
SOCW 6500
Dr. Felicia Tuggle
Date
PROCESS RECORDING 2
PROCESS RECORDING
Student’s Name: Client’s Name: BB
Interview Date: 11/7/2018 at 4:15 pm Session #: 3
I. PURPOSE OF THE SESSION: To identify and discuss potential stressors in the home that could
negatively impact client’s newborn child and increase client’s anxiety. SW intern will provide client with
coping strategies to assist in managing stressful situations and explain how client’s decisions will affect
her child’s growth and development.
II. OBSERVATION: Client is 37 weeks pregnant and is preparing for the birth of her child. In
previous sessions, client has discussed having “anger issues” with SW intern. Client was not alone during
this session and has never visited the SW intern facilitated maternal clinic independently. Client arrived
with her boyfriend, the child’s father, and her mother, who join her at every visit. SW intern voiced
concern for client’s history of impulsive and explosive behaviors, and relationship dynamics amongst
those in her household. Client was talkative, energetic, and open to discussing anxiety.
III. CONTENT: This content is from the most relevant part of the session.
INTERVIEW
CONTENT/INTERACTION
(SW intern said, Client
said)
SKILLS USED
YOUR THOUGHTS/
FEELINGS/REACTIONS
CLIENT’S
FEELINGS/AFFECT
Field
Instructor
Comments
SW intern said: “The
past few sessions I’ve
gained a better
understanding of your
home environment from
things you’ve told me. I
know we’ve discussed
your anxiety and anger.
You could deliver any
day now. What makes
you worry most about
bringing baby home?
Client said: (adjusts in
Open ended
questioning,
active
listening
I want client to have
an awareness of her
own feelings, the
sources, and be
present in the
moment.
It’s not surprising that
Engaged,
attentive, eye
contact.
Flushed face, lots
The student is
developing
excellent
observations
of behavior
and thoughts
and feelings
of clients and
others
involved in
meeting
interaction.
She displays
PROCESS RECORDING 3
her chair, raises the
volume of her voice)
“My brother better be
quiet because if he
wakes my baby up, I am
going to have to go off
on him. You don’t
understand, the walls in
my house are paper thin
and I just know he is
going to be loud event
though I already told
him he can’t be like that.
He gets on my nerves.”
SW intern said: “So
when you ‘go off’ on
your brother, or anyone
else, what does it look
like? What are some of
the things that you do?”
Client said: “I just get
annoyed and go off.
Like… I just start yelling.”
(Looks at boyfriend)
Boyfriend said: “You
start cussing and yelling
and screaming and
throwing things and
making noises.” (Client
looks at mother, who
gives a nonverbal “he’s
right” facial gesture)
Client said: “Well if
everyone would stop
being so annoying and
making me go off, I
wouldn’t have to”
SW Intern said: “So
Discovery
oriented
questioning
BB is wound up and
tense all the time
because there are so
many people living in
such a small space.
She tries to control
everything. It’s toxic
and not good for
baby.
I want the client to see herself objectively and look at her behaviors. I want to ultimately have a better understanding of client’s role in the household. I wish I could speak to client without her mother and boyfriend then there. Client needs a better understanding of her individual needs and a better sense of self. Codependency in the family for sure. Definite boundary issues. I want client to
of hand
movements,
aggressive tone
Client no longer
making eye
contact, looking
at the table, less
aggressive tone
Client sounded
almost
remorseful at
first, but became
defensive after
her boyfriend
stepped in.
Client tilted her
knowledge
and
understanding
of different
questioning
methods to
make the
client feel
comfortable
and open to
receiving
information.
Her insight is
logical and
illuminative
and she
continues to
seek and work
on areas of
improvement.
PROCESS RECORDING 4
when everyone is
getting on your nerves
and you ‘go off’, what
happens? Does it help
the situation? Do you
get what you want?
Client said: (paused a
moment) “Well… no. It
just makes everything
worse and everybody
gets mad and I get mad
and everyone is mad.”
SW Intern said: “The
cycle sounds exhausting.
Bringing your baby into
an environment where
everyone is mad and
yelling and things are
chaotic all the time, isn’t
good. Babies need peace
and security and
comfort. Your mood is
going to directly affect
your baby.
Client said: (grabbing
both sides of her head
and running her fingers
through her hair) “I
know. I know. I just
don’t know what to do.”
SW Intern said: “It’s
okay. You’re smart and
you can learn. This is
going to be a huge
adjustment and it’s
going to take a lot of
work. But you have a
Direct
questioning,
leading
question
(appropriate
in this
context)
Empathy, Education Empathy, mirroring, educating,
understand that her reaction is illogical and impractical because it accomplishes nothing, therefore unnecessary. Client is intelligent. If I can lead her there, she can see. I think it’s working. I think she recognizes the contradictions in her behavior. I need to bring the focus back to the client and her baby, not the family. I wonder if she’s ever had any medication for anxiety. I can’t tell yet if she’s going to take her role as a mother seriously. I want her to eventually surrender and let go of trying to control everything. The anxiety is coming from trying to force external factors,
head and looked
up to the ceiling
as if she were
thinking.
Client stated this
while smiling and
laughed a little
bit.
Client made eye contact, nodded her head. Client sighed heavily, seemed to be in thought, internal conflict Client made intermittent eye contact with SW intern, mother, and boyfriend. Played with her
PROCESS RECORDING 5
good support system. I
want you to understand
that nobody can make
you do anything. You
said earlier that the
people in your family
“make you go off”. They
don’t make you go off,
you choose to go off.
You cannot control what
other people do and you
will exhaust yourself
trying. Get to know
yourself, B, and make
the best decisions for
baby.
Client said: “I really do
want to do what’s best
for the baby. I swear to
god if anyone hurts my
baby, I’ll be like mama
bear.”
SW Intern said: “I have
an assignment for you.
Whenever you
encounter a situation
that makes your ears
burn, remove yourself
from the situation and
write down what you’re
feeling. Remember,
“going off” accomplishes
nothing and is bad for
baby.
Summarizing
including people, into her ideal of how things should be. When she can’t- anxiety and anger. She needs to learn accountability. She’s used to bullying everyone around her. Mama bear? She means it. So aggressive, this one! If she can get used to identifying triggers, maybe she can learn to control herself before she crosses the threshold.
fingers in her lap, nodded her head. Engaged, assertive tone, eye contact
IV. IMPRESSIONS/ASSESSMENT: 1) What did you observe throughout the session -- behavior and
affect; 2) was the behavior/affect appropriate, explain; 3) how does this behavior/affect fit with what
you know about the client’s past behavior/affect; and 4) identify the major themes/issues that emerged.
• Client stated at the beginning of the session that she had not been sleeping well. She expressed
that she feels very energized and can’t sit still long enough to get some rest. It is apparent that
the impending birth of her child has increased the severity of her generalized anxiety. It is
PROCESS RECORDING 6
unknown if the client has been official diagnosed with a disorder, but presents markers and
likely meets criteria for diagnosis. Throughout the session, client was fidgety, adjusting in her
chair, fixing her hair, and playing with her fingers. Client often spoke in dramatic tones and
emphasized hand gestures to accompany her message.
• I think a spike in client’s underlying anxiety is warranted in this context. Client is a teenager and
preparing to give birth. Going through the natal process is taxing and it is my understanding that
client has had many difficulties during pregnancy. Client has cited in the past that the experience
of being pregnant has been “miserable and uncomfortable.”
• Each session I have had with this client has been saturated with attempts for the client to
control the conversation. I think the client uses aggressive tones and dramatic movements to
manipulate conversations and these tactics work with more submissive personalities, especially
those within her household. Client has never been directly aggressive toward me and is typically
receptive to information and discussions.
• The biggest issue that arose during this session, as with every other session, is the presence of
her boyfriend and her mother. I think this client really needs to work on establishing a sense of
self and individuating herself from her familial unit to decrease codependent behaviors. I think
the client does not have the opportunity to be completely honest and the presence of her
boyfriend and mother reduce the authenticity of the client’s affects and behaviors.
V. USE OF PROFESSIONAL SELF: Choose two significant interventions you made: 1) identify/describe;
2) what was your impression of your effectiveness; and 3) what would you change.
• I used the cognitive behavioral focused interventions of structure, direction and education. Due
to the time frame and in hopes of catalyzing a change in environment before baby arrives home,
my interventions were from a solution-focused perspective. It is my impression that the client
often feels unheard and misunderstood, so I wanted to utilize strengths perspectives and
empower her to solve her own problems. I guided her through understanding her behaviors,
what triggers them, the effects of the behavior, and offered management solutions that can
implemented immediately.
• Unfortunately, I will not know how effective they are until I see her again at our next session. By
the time this happens, baby will be in the home, and I will be able to grasp the client’s
perspective on her role as a mother by asking discovery questions. During the session, the client
offered nonverbal indicators that she was understanding the messages I was trying to convey.
When I asked her if she got what she wanted by “going off”, the look on her face made me think
that she had never thought of it like that and understood the point I was trying to make.
• If I could change anything, I would have instructed the client to bring the therapeutic homework
assignment back to me, so we could talk about it. My intuition tells me that she will not
complete it, but I do think she will attempt to be more mindful of her actions when her baby is
there. I could have used the threat of home visits as incentive for homework completion.
VI. PLANS: (Brief statement of your plans for the next session, long range goals, short range goals that
are relevant for this client.)
• The next session will likely take place at the clients first visit after giving birth. My plan is to
discuss how she is feeling, what are her stressors, what is she worried about, what is going well.
I want to get a generalized understanding of where she is in the present moment and the
PROCESS RECORDING 7
environment that her child is in. My plan with this client at each session is to bring her to the
present moment, slow down her thought process, and facilitate a verbalization of what is going
on inside her head. In the long term, teaching the client these cognitive will translate into her
life outside of our sessions and she can utilize the tool to increase her own well-being.
Technically, her child will be my client, too, so I will be assessing the child to ensure its well-
being and educate on any deficits I observe. The health of the child is my primary concern.
VII. ISSUES, QUESTIONS OR PROBLEMS: (To explore in supervisory sessions.) Areas to explore in your
supervisory conference: include issues of diversity, value dilemmas, counter-transference etc.
• I am concerned with the family dynamics in the client’s household; Boundaries are lacking. I
would like to explore the opportunity that my conclusion could be the product of a personal bias
or a deficit in my personal competence. Am I rejecting this because the family practices are
different from my own perspective and understanding? Or is this truly dysfunctional?
• I would like to explore the opportunity of creating a space that I can speak to the client alone,
especially after baby is born. I am going to want to know how other family members are
responding the presence of the baby, and I want the client to have the opportunity to be honest
about those matters. Is there a way we can separate the client from the boyfriend and mother
for a session?