This is the final written assignment in this course. Throughout the course, you should work to infuse information about your couple and identified patient (Jasmine) in each section. This template is
Assessment Selection
I met with Dilan and Jasmine to administer the formal assessment. The assessment that I chose to administer was the Gottman 19 Area Checklist for Solvable and Perpetual Problems along with the Cross Cutting System Checklist: Level 2-Anger-Adult & Level 2-Anxiety-Adult because during the initial assessment problems and or needs identified were needing friendship, conflict management, mental health and shared meaning
What appeared to be easy during this process was the Gottman instrument because it was in direct correlation to why my clients issues that was identified during the initial assessment.
There are two limitations that Gottman talks about and that is relapse and limited population studies. Relapse- people not doing what is beneficial to them and slipping back into old habits and patterns of behavior. Limited population studies- the research does not reflect individuals seen in the clinic. In clinics couples typically seen with relationship satisfaction scores 5 or 6 standard deviations below the mean. The research literature has primarily served couples with relationship satisfaction scores within one standard deviation from the mean and generally screens out couples with co-morbidities (Relationship Institute, 2016).
Process of Administration
I chose option number #1 simply because I had already set up scheduled appointments to meet with both Dilan and Jasmine. The purpose is to get Dilan and Jasmine to learn skills to replace negative conflict patterns with positive interactions and to repair past hurts, which will allow for increase closeness and intimacy that can be utilized to improve friendships, deepen emotional connection, develop coping skills for dealing with individualized problems and create changes which will enhance their shared goals.
Assessment Scores
Dilan was given the 19 areas checklist for solvable and perpetual problems questionnaire about 4:30 pm and completed about 5:00 pm. So it took roughly about 30 minutes to complete the assessment. Dilan reports that his experience was eye-opening and shocking. Dilan stated that he had anxieties completing the assessment fearing that Jasmine would take some of his responses the wrong way and blow-up in the session. Dilan stated that he felt like at times on certain questions just lying about them for fear of an argument with Jasmine.
The interpretation and guidelines for scoring were: 0 to 20% = Area of strength; 21 to 40% = Marginal; and 41 to 100% = Needs Improvement.
The results of Dilan assessment were as follows: Emotional distance problems – He scored 23% marginal; Handling stress problems 100% needing improvement; handling disagreements 17% area of strength; Romance and passion problems 23% marginal; Sex problems 0% area of strength; Handling major external events 100% needs improvements; Problems w/ children 20% area of strength; Problems w/ in-laws or other relatives 17% area of strength; Flirtation, attracted to others & jealously 100% needs improvement; Recent affair problems 100% needs improvement; Unpleasant fight problems 0% area of strength; Problems with hard life events 0% area of strength; Basic values and lifestyle problems 0% areas of improvement; Working as a team 0% areas of strength; Coping w/ issues of power, handling finances, having fun together, building community together, and Spiritual connection were all 0% areas of strength.
Jasmine was also given the 19 areas checklist for solvable and perpetual problems questionnaire same time as Dilan and it took roughly about 45 minutes to complete the assessment. However, I decided to add two additional short assessment questionnaires with Jasmine to target her self-reported anger and anxiety issues during the initial assessment. The two additional questionnaires were as follows: Cross Cutting System Checklist: Level 2-Anger-Adult & Level 2-Anxiety-Adult
The results of Jasmines anxiety assessment were the raw score was 27 and her T-scores were 68.9, which put her at moderate level of anxiety. Jasmine’s anger assessment raw score was 19 and her T-score was 67.2, which put her at a moderate level of anger. When I discussed these results with her she stated “Oh I thought it would’ve been higher” I than explained to Jasmine that sometimes we may think our problem is more severe and may begin to use an excuse to not address sighting “this is just who I am” (being careful not to attack her character or blame) but trying to get her see that we can sometimes exaggerate our problems in order to avoid dealing with them head on. She responded by saying “I did not realize it and I want to fix it”.
The results of the 19 area checklist were as follows: Handling stresses, handling disagreements, romance and passion, unpleasant fights, and working as a team were 17% areas of strength; Sex problems, handling major external events, and problems w/ children were 23% marginal; Problems w/ in-laws and other relatives, flirtation, attracted to others & jealously were 100% needs improvement; Emotional distance, basic values and lifestyle, problems w/ hard life events, handling of finances, having fun together, building community, and spirituality connection were 0% areas of strength.
Prebriefing & Debriefing
Prebriefing - clients to the assessment process I feel decreases anxieties of the unknown and allows for clients to make a decision rather they would be willingly to participate. It is also an opportunity to inform them of what type of assessment and its purposes, and lastly to assist in building rapport with the client and getting the comfortable to the process.
Debriefing- clients after the assessment is just as important as prebriefing. This process allows the counselor to share the results of the assessment and discuss further testing if needed and to answer any questions and/or concerns the client may have. This process also allows the client to resolve any tensions felt during the interview process.
Practitioner/Clinician Reflection
My experience administering the informal and formal assessment was definitely an eye opener and when I say that I mean this was different from the assessments I normally administer at work. Completing this assessment with my couple was interesting because I learned about them as individuals and as a couple. There is a famous saying and book I do believe that “Men are from Venus and Women are from Mars” this case is a classic example of that. It is amazing how you may think your partner is on the same planet as you and come to find out that that is the farthest from the truth. For example, their results from section “Emotional distance problems” Jasmine scored 0% thinking everything was good in that dept. and Dilan scored a 23% which is marginal. So Dilan obviously feels like there is trouble in that dept. I do believe I was organized and mentally prepared. I was fairly comfortable with my couple being that I have met with them on previous occasions. I still don’t think conducting both informal and formal assessment challenged my own personal belief system, however I am curious how me and my husband would score after being married for the past 12 years.
One thing I did find interesting was how these stories are different and more detailed in the formal assessment process understandable so because during initial we were just getting to know each and there was rapport building.
What I found to be challenging is the complexity of the results from Jasmin’s assessment and staying on target with initial problems and reasons for therapy due to Jasmine having complex issues that stem from outside of the relationship such as anxiety and anger, which she was administered additional testing.
I feel more extensive testing is needed for Jasmine such as the Beck Anxiety Index (BAI) to determine more deeply about her moderate anxiety that was scored on the Level 2 Anxiety-Adult Short form I used.
I feel Jasmine will benefit more from a more extensive test with her outburst and self-reported anger issues. So the Clinical Anger Scale assessment may be beneficial in determining if trait anger, state anger, anger-in, anger-out, anger-control were factors into her constant uncontrollable outburst.
According to Caldwell & Stone (2016), it reports that therapist often struggle with the complexities of ethical decision making when treating couples and families. It goes on to say that as therapist we are expected to balance these complex issues of the client and their subsystems within the family while making sure we are following ethical codes, standards and boundaries. We must be responsive to our client’s cultural needs and ethical decision making being more involved (Caldwell & Stone, 2016).
Faculty Videos
I learned a lot from the faculty videos. However, the ones that stood out to me the most was the Psychodynamic Theories and CBT Couples & Family. I love psychodynamic and psychanalytic therapy and when I was in school to become a Licensed Chemical Dependency Counselor I did a research paper on Sigmund Freud and I love his approach as creepy as it may seem, but loved looking at the root of problems and going back to unresolved issues as a child and how it affects your adult life. It was here recently when I was obtaining my Bachelor’s degree that I learned I could not use this approach with every client.
That brings me to CBT and Family I felt CBT in my opinion was closely related to psychodynamic or definitely could be used in conjunction with. Counselors are directives, teachers, and experts, look at schemas with family and couples, and how one family member may reinforce behaviors of other family members.
In my couples case I feel attributions and expectations is what is going on with both of the as well as lack of proper communication beginning with positive first, specific behaviors, and not disallowing verbal abuse.
References:
Scher, S., & Kozlowska, K. (2012). Thinking, Doing, and the Ethics of Family Therapy. American Journal of
Family Therapy, 40(2), 97–114. https://doi-
org.libproxy.lamar.edu/10.1080/01926187.2011.633851
Snell, W. E., Jr., Gum, S., Shuck, R. L., Mosley, J. A., & Hite, T. L... (2013) . The Clinical Anger Scale (CAS) .
Measurement Instrument Database for the Social Science. Retrieved from www.midss.ie
Wines, Lisa & Nelson, Judith & Watts, Richard. (2015). African American School Counselors in
Predominantly White-Culture School Districts: A Phenomenological Study From a Humanistic
Perspective. Journal of Humanistic Counseling. 54. 59-80. 10.1002/j.2161-1939.2015.00064.x.
