Termination summary
Termination summary
Name: Mr. Pablo Peterson Age: 37 years Residence: California
Date of Termination Summary: 23rd April, 2018 Date of First Consultation 20th Nov, 2017
Date of Last Consultation: 22nd April, 2018 Duration of the Treatment: Six Months
Total Number of Sessions: Twelve Missed Sessions: One
Termination type: Planned
Presenting Complaints
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The client is a 37-year-old man of American origin who at the time of consultation, had recently planned to move in with his girlfriend. The client sought counseling for feelings of discomfort and fear that he could not manage to stay with his girlfriend. He explained that the previous week, his girlfriend had asked if he was ready to move in as a preparation for their marriage. The client had reported this was interfering with his work and it could hinder his performance and advancement as a civil engineering consultant. He described periods of intense anxiety and panic attacks since the idea of moving in came up. The patient was having difficulty sleeping, sweating intensely and hot flushes. The client explained that he was not ready to move in with his girlfriend, but he couldn’t express the feelings to his partner because they had waited long enough. He grew up with his family in California and expressed that he was determined to accomplish his goals before marriage. This was the first consultation with a psychotherapist, having no previous experiences in counseling.
Major Psychosocial issues
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The client is employed and works as a civil engineering consultant in California. He has a family that stays in California, and he is the only son in a family of four. The client expressed that he was tied to his career because of the family expectations. His father was an engineer that worked for big companies in the US before he retired. The expectations from the family and the dreams of the client are associated with the delay in marriage. The patient spends more than ten hours at work, and he is always busy with his clients. He associates less with friends and according to the patient; most of his friends are men. Apart from his girlfriend and the family members, he does not associate much with ladies. It was observed that the patient is conservative and talks less with people. The patient also expressed that he does not discuss his affairs with friends because he believes in solving his problems alone.
Types of Services Rendered
The primary counseling service rendered was individual therapy. Individual therapy is a counseling approach through which clients work one on one with a qualified therapist to solve mental problems. The therapy is conducted in a safe, quite and caring environment to explore the feelings of the client and work through the challenges. Individual therapy is best achieved through setting goals and objectives of the counseling process to aid in the evaluation of the effectiveness of the therapy sessions. The counseling of the patient was initially done individually, and after four months of good progress, group therapy sessions were introduced. Group therapy was conducted together with other patients experiencing anxiety and panic disorders to maximize exposure and to gain the confidence of the problem by the patient.
Overview of the Treatment Process
The counseling sessions were done once after every two weeks with each session taking one hour. Incorporation of cognitive behavioral therapy techniques was used to manage the anxiety and panic attacks observed to be the threat to the patient’s psychological well being. Informed consent and assurance for confidentiality were done during the initial phase as a preparation for the therapy sessions. A good therapeutic relationship was established and maintained throughout the counseling process.
Goal Status
Treatment Limitations
Cognitive behavioral therapy focuses on the current problems facing the individual forgetting that current problems are attached to past experiences (Hayes, 2016). Remaining Difficulties/ Concerns
Nature of the Termination
Recommendations
The client made tremendous progress during the counseling sessions, and all the goals were met. Though the progress was satisfactory, the client may benefit from exploratory psychodynamic therapy in the future.
Follow-up
Due to the nature of the termination, a monthly follow-up plan is indicated. The programme will ensure that the attacks are over and that the patient returns to his premorbid personality.
Instructions for Future Contact
The client was informed that he was free to contact me in the future if needed. The client was also advised to continue with the relaxation techniques and to seek healthcare treatment if the attacks re-occurred.
Signatures
Student’s Name
Psychiatric Nurse
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Barlow, D. H., Allen, L. B., & Choate, M. L. (2016). Toward a Unified Treatment for Emotional Disorders–Republished Article. Behavior therapy, 47(6), 838-853.
Dobson, D., & Dobson, K. S. (2016). Evidence-based practice of cognitive-behavioral therapy. Guilford Publications.
Hayes, S. C. (2016). Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies–Republished Article. Behavior therapy, 47(6), 869-885.
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive therapy and research, 36(5), 427-440.
Hunsley, J., Aubry, T. D., Verstervelt, C. M., & Vito, D. (2013). Comparing therapist and client perspectives on reasons for psychotherapy termination. Psychotherapy: Theory, Research, Practice, Training, 36(4), 380.
Knox, S., Adrians, N., Everson, E., Hess, S., Hill, C., & Crook-Lyon, R. (2011). Clients’ perspectives on therapy termination. Psychotherapy Research, 21(2), 154-167.
McGuire, J. (2009). Ethical considerations when working with older adults in psychology. Ethics & Behavior, 19(2), 112–128. doi:10.1080/10508420902772702
Swift, J. K., & Greenberg, R. P. (2015). What is premature termination, and why does it occur? In Premature termination in psychotherapy: Strategies for engaging clients and improving outcomes (pp. 11–31). Washington, DC: American Psychological Association. doi:10.1037/14469-002
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
