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?