Hi Randall. How are you today? Um, I'm doing okay.

What brings what brings us together today? Um, it's kind of embarrassing my supervisor.

Asked me to give you guys a call because like I'm just kind of coming on glued.

I haven't been sleeping haven't really been eating for the past like week.

I lost my house to a house fire.

I'm something stupid my roommates did.

Cause me to lose like everything.

Okay, so is this a recent event? Did happen last week? Week. Okay. Yeah.

You Randall since we are on Telehealth. Um, I need to ask a couple questions. What is your actual physical address in case I would need to send help to you. I need to know what your actual physical address is for this session. So like where I am right now right now right? I'm at work, which is at 265 Cardinal Street to some Street. Okay. It's in downtown Phoenix. Okay.

Okay, and are you in an office suite or are you in an apartment? I am in an office suite.

It's on the third floor room 316.

Okay. Thank you.

And for from my office, I don't have anyone around me. This is soundproof and HIPAA compliant, but from what? Okay, are you are is there anywhere in who is an earshot that you are uncomfortable hearing any conversations that we may be having? No my boss. Let me use his office so I could have total privacy.

So no one else is in here.

Okay, perfect.

With counseling. Have you been in counseling before? No, so this is like totally weird for me.

Okay. Well, I'm going to make this as comfortable as possible. Right? I do want you to know that everything we'd say is confidential with the exception that if you you tell me that you are suicidal or homicidal or that there's some significant event of abuse in your life that's happening. We I would have to break that confidentiality. Do you understand that? Okay.

Yeah, yeah understand wonderful. Okay with that being said.

You have disclosed that you had a house fire a week ago. Yeah, it's glazed and that now at work. You're really experiencing a lot of Nervousness anxiety depression. What's what's the yeah. I'm I mean I'm sad I'm anxious.

Like I really haven't slept because every time I close my eyes I smell smoke.

Because the fire like the smell of the Smoke Gets what woke me up. So By going to sleep is just terrifying for me because I feel like it's just a nightmare that I keep reliving, right? so, um As far as sleep, have you spoken to a medical professional? Have they talked to you about anything to help with um in the moment? I talked to my doctor to my doctor still out of state so he couldn't prescribe me anything but he suggested I take melatonin so I'm gonna get some today to try to see if that helps. Okay.

You have any kind of past history of emotional disorders of depression anxiety any previous PTSD Tremont trauma? Any previous post-traumatic episodes? Um, not that I've been diagnosed with like I I'm a pretty anxious person anyway, but you know, it's something that I'm able to usually have a really good handle on, okay.

So you have hoping techniques that you use for your anxiety to keep it in check.

Yeah. Yeah, I usually like exercise and stuff but like all of my stuff kind of went up in smoke.

for a lack of better words Yeah, no pun intended.

Yeah, sounds like oh a little bit of humor.

Yeah, that kind of helps me cope too because I mean It's nothing I can do about it. Luckily. No one was hurt. Like all the stuff can be replaced because it's stuff but Um, I moved out here like a month ago.

To take this new job. So like I'm here and like my support systems aren't so it's just really really hard because like I have like even this shirt that I have on it's not mine. Like the only thing that I have is the pajamas that I was wearing when I ran out the house and the jewelry that I have on like that's pretty much it. So I'm having to get like new ID cards and just like everything so it's just really stressful.

And trying to be at a new job where I don't have time to take off because I just started right? So safety factors, do you have a plate a safe place to stay? I'm right now the homeowners insurance put me in a temporary living situation and so like the investigation and all that stuff is done. So I'm I mean I have somewhere I'm somewhere safe. Yeah more safe. Okay. Yeah someone that is helping you from the insurance end of things to acquire.

Yeah, you necessary items for living. Yes. So we are free to focus on just your emotional well-being and how you are coping through this crisis in your life.

Yeah.

Yeah, everything else is like kind of on it's underway the process for like claims and everything has started.

So just like helping me hold it out together. I guess it's what I'm looking for.

Yeah. What emotions are you experiencing the most right now? oh like anger because like I feel like it's my roommate's fault because they were shooting fireworks and then just kind of after they finished cleaning everything up put in the trash can and that caught fires. So like, okay.

Hey, if you guys think a little bit this we could have probably avoided it. So I'm like really really angry with them for for that piece and like I'm sad because like all my stuff is gone stuff that I worked really hard for.

And I don't know is this so many different emotions right now. I don't.

Like I'm overwhelmed I'm stressed. I'm anxious. This is so many different things running through me. So everything is just kind of combined and it's it's yeah and yeah to manage that and still go to work and yeah, I have this job that's brand new for you. And now I'm still learning. Where am I going to live? And how am I going to yeah.

Yeah, exactly.

All right.

Coping skills. You said in the past you've used things like humor. You do some deep breathing you use maybe it's sounded to me like maybe you know how to meditate a little bit in the in the moment. What other coping skills.

Do you have that you've used in the past? when you are around Working out helps. So I mean since now I don't have access. I've just been trying to take some walks, but then and doing that I'm getting inside my head and just like getting more Angry that's like some of the things that I did before are not working like meditating in a moment when I'm close to my eyes. It's like reliving everything all over again smelling the smoke and you know running out of the house and seeing the flame.

So all of that is just keeps coming back so I can't even Focus to meditate right So you're going to have to learn some new coping skills, but also we really have to just process through all these emotions and the event that happened itself the losses. Yeah felt.

And yeah change in your life.

Absolutely.

Okay, do you feel like this Telehealth? Modality works okay for you? Yeah, I'm because during my lunch I get an hour for lunch, but it doesn't give me enough time to like go anywhere and see someone and so my boss said that I could use his office. So this is perfect. Okay.

Well, I don't have like the computer or right any of that stuff at home. So being able to do it here. It's great.

Excellent. Okay. Well, let's go ahead and plan on doing some regular sessions. We'll come up with a treatment plan and and really just focus on how to can debrief and get through all of this crisis and and all these emotions that you're dealing with now is that sound like a good plan.

That sounds good. Yeah

What are some considerations that a counselor must make when conducting a telehealth session? Is there anything that concerns you about observing or interpreting a client's mood, affect, vocal tone, or body language using telehealth? What are some goals that you might include in this client's safety plan? What resources local to your area might you offer this client.