Case Specification worksheet: [Basic information to be shared with your professor and role play partner]
1. Identifying information (name, age, gender race/ethnicity):
- Client Name: Abby Yip
- 25 years old, Malaysian-Chinese American, and she identified herself as a woman.
- She is single and has no children.
- Currently a graduate student
2. Brief description of the presenting problem, including its behavioral description, onset, severity, and frequency:
Abby is feeling depressed and anxious due to the pressure of not meeting others’ expectations, especially those who are important to her (family and close friends). She has reported that she is in her mid-twenties, and most of her friends now are ‘pretty stable’ with their life, such as having a stable job, relationship, or family. But Abby says that she does not. She is uncertain of her future career, and people are starting to pressure her about her relationship and marriage life. Abby has expressed that she wants to continue school after her Master degree. However, she thinks that people will not be happy about her decision. She does not want to upset them, but at the same time, she wants to live for herself. She claims that she does not know what to do. Lately, she has been feeling confused, sad, and frustrated. She has been convinced that this is happening because of her incapability. She feels like she just failed into a black hole and cannot get herself out. She only tells her current situation and incident to her best friend, Sophie. Abby claims that she has not been sleeping well for a period of 6 months. She reports that her average time of sleeping is about 1-3 hours. The lack of sleep causes her not able to“function well,” such as in school, work, and personal life. Lately, she does not want to leave her room and her house. She does not want anyone to visit her except Sophie. Abby denies any suicide ideation and plans to hurt herself or others.
3. Brief description of the treatment setting
Client received services from the Counseling and Psychological Services located on client’s campus, Columbia University.
4. Treatment mandates or pressures.
Abby came for services because her best friend Sophie wanted her to see someone professional. Even though Abby did not believe that they could help her and solve her problem. Since Sophie had reached out and made the appointment for her, she’s willing to give it a try.
This is my STEP 2 Video as the social worker
Skill assessment II
This assignment assesses your competency with essential cognitive therapy skills. You will participate in two 20-minute interviews. In one interview, you will reprise the client vignette you developed for skill assessment I. In the second, you will enact the role of clinical social worker. Rubrics used in grading the assignments are presented at the end of this document.
The assignment assesses the following specific competencies:
- Utilize Socratic questioning to examine the usefulness, accuracy, and assumptions underlying the cognitive conceptualization.
- Utilize reframing in conjunction with Socratic questioning to explore alternative thoughts, beliefs, and understandings.
- Utilize other cognitive therapy techniques discussed in readings and in class
- Implementation of a collaborative style (i.e., MI spirit, collaborative empiricism, cultural humility)
Note that the assignment will not be graded based on the success of any cognitive change effort. Rather, it will be graded based on technical proficiency and style. The client need not adopt new ways of thinking during the session.
The assignment will be completed in three steps:
1. Watch the case conceptualization interview for your assigned client in skill assessment I. Write a brief cognitive conceptualization, and identify additional information needed to complete the conceptualization. Outline a tentative agenda for the clinical interview.
2. Conduct a recorded interview. Demonstrate skills for each competency.
3. Write a self-evaluation.
Step 1: Write a brief cognitive conceptualization, and identify additional information needed to complete the conceptualization. Outline a tentative agenda for the clinical interview. Five points.
Watch the interview conducted with your client for skill assessment I. Using information presented during the interview, complete a case conceptualization using any of the models presented in class. Because the case conceptualization may be incomplete, identify questions that you would like to further explore with the client. Finally, outline a tentative agenda for your clinical interview using the five competencies of the assignment as a guide. Your outline may include:
· The structure of the meeting.
· Possible issues you would like to address with the client using Socratic questioning.
· Possible reframing interventions you would like to consider with the client.
· Possible additional interventions you would like to consider with the client.
· Alternatives for tasks that the client may choose to complete after the session has been completed.
Step 2: Conduct a recorded interview
Instructions for the client:
When playing the part of the client, your role is to provide the social worker with the opportunity to utilize cognitive therapy techniques. Therefore, neither be too difficult nor too easy. This means that you should generally be willing to provide information requested by the social worker even if you are mandated to treatment. It also means that you should not volunteer too much; let the social worker work for their information!
1. Re-watch the interview in which you role played a client in skill assessment I. Reprise this role.
2. During the interview, be responsive to the specific information that the social worker seeks to elicit from you.
3. Once the interview begins, your client vignette may change from your original plan. That is OK. Allow your client’s story to emerge organically during the course of the interview.
Instructions for the social worker:
Your job is to conduct a set of cognitive interventions with your client and to establish one or more tasks that the client may choose to complete after your session is over. The assignment assumes that you have established a therapeutic alliance and that you have an agreement to work on aspects of the case conceptualization as described in skill assessment I.
1. Open by briefly reviewing elements of the case conceptualization as you understand it. To warm up the conversation, ask if the client has any changes to report since the first meeting.
2. Transition to intervention by asking for further information about an aspect of the case conceptualization that may be a target for change. For example, “it would help me to learn more about how these automatic thoughts are linked to the ways that you feel and respond to the stressor,” or “we’ve talked about the links between your automatic thoughts and your feelings and reactions, and we’ve also talked about what your automatic thoughts suggest about your beliefs about yourself. Which would you like to talk about in more detail?”
3. Use Socratic questioning, reframing, and any other cognitive intervention described in class or in your reading to explore possible changes you and the client hypothesize to relate to the presenting problem. NOTE THAT YOUR SUCCESS DOES NOT DEPEND ON CHANGING HOW THE CLIENT THINKS OR RELATES TO THE PROBLEM. YOU WILL BE ASSESSED ON YOUR TECHNICAL PROFICIENCY WITH THE INTERVENTION STRATEGIES.
4. Close the interview with one or more steps of the task-centered sequence.
Step 3: Write a self-evaluation
Write a brief assessment of your interview using the five competencies of this assignment as an outline. Describe your thought process underlying which interventions you chose to utilize during the interview, as well as strengths of the interview and the ways you would like to strengthen an interview like this in the future. Maximum 4 pages, single spaced.
Step 1 case conceptualization and clinical agenda rubric
|Case conceptualization||0= mostly incomplete 1= behavioral chain mostly specified 2= behavioral chain mostly specified plus reasonable hypotheses presented for gaps or missing information.|
|Tentative agenda||0= mostly incomplete 1= few of the proposed interventions and tasks are accurately described and justified by the case conceptualization. 2= Most proposed interventions and tasks are accurately described and justified by the case conceptualization. 3= All proposed interventions and tasks are accurately described and justified by the case conceptualization.|
Rubric for the self-evaluation
|Student identifies specific strengths and areas for work in:||1 point each|
|1. Socratic questioning|
|3. Other cognitive techniques|
|4. MI spirit/ collaborative empiricism/ cultural humility|
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