Case Study Scenario - Jim.

You are employed in a counselling agency providing professional counselling services to people experiencing personal, relationship, or work-related issues. This counselling agency abides by the Australian Counselling Association code of ethics and practice (available on the website www.theaca.net.au).

Your client is an 80-year-old man. Jim has been referred by his GP for symptoms of depression. He has recently had heart surgery.

Jim is married to a 62-year-old woman, who is employed fulltime. This is Jim's second wife; they have been married for 10 years. They are comfortable financially. He has 5 children to his first wife - between the ages 35 - 50 years old, who are all living independently, with their own families, and he has reasonably good relationships with each. His first wife died 10 years ago.

Jim has led an active life, working in retail until retirement at 60. Prior to his heart problems (culminating in the surgery) he was very active physically and socially - used to play club tennis and golf, surf with his sons and go fishing. Related to these were also various social group outings. He is no longer able to perform these physical activities.

His symptoms include feeling low in mood and tired all the time, when his wife goes to work, he wants to just return to bed. Jim feels like he has no energy, and everything is an effort. He feels he is a burden to his wife, and she will tire of him. He is not sleeping well at night. He worries about everything - the car breaking down, getting to medical appointments, his children, his wife, managing the shopping. He worries the house is not clean enough yet cannot find the energy to do housework. When his wife does something around the house, he feels guilty as he should be doing it.

Your observations - At counselling sessions, Jim is very talkative, and has a vague, wandering style of communication, speaking quickly, and jumping from one subject to the next. It is difficult to get a word in. He has a serious, worried facial expression and a stooped posture, fidgeting often in the chair. He is very apologetic about taking up your time.

Task- provide a report using the questions as subheadings in your responses

Question 1.

What are Jim's issues that you have identified? List at least four (4).

Question 2.

(a) Outline how you will develop rapport and engage with Jim (describe the techniques you will apply)

(b) What might be barriers to developing this rapport?

Question 3.

What conclusions would you make from your observations of Jim - verbals and non-verbals?

Question 4.

Describe how you will use focusing skills while in the counselling session with Jim? Give two (2) examples of what you would say or do and why.

Question 5.

Describe how you will use challenging skills in counselling with Jim? Give two (2) examples of what you would say or do and why.

Question 6.

Describe how you will use reframing skills in counselling with Jim? Give two (2) examples of what you would say or do and why.

Question 7.

What other communication skills would you use in your counselling interview? Give two (2) specific examples of what you would say and why.

Question 8.

Keeping in mind your observations as listed in this scenario, outline how Jim's stress may have impacted on his concentration and attention, memory, verbal language and body language?

Question 9.

During your counselling session, Jim becomes very upset and breaks into a flood of tears. How will you respond to this strong emotional reaction?

Question 10.

How will you terminate the counselling interview? (please include the timeframe of your answer)