Learning Journal 27

This week was largely about a preparatory session for the case study. I think I had course fatigue throughout the day and this spread into my working week also, a general need for a break right now. But also the week has been about my development in my placement role at Chy, as well as thinking about how I could stretch myself with another placement as the possibility of one at the University does appeal. Now I have accumulated 30 hours it’s a possibility for September and would save me a lot of travel time. I definitely would struggle to do both placements. What I struggling with this week is drugs and alcohol clients. All day every day drugs and alcohol clients. On placement and in work. I have thought about when I can book a holiday next. In May.

7.2.2. & 7.2.3.

Supervision & Placement

Before the supervision session as ever I identify some key things that I want to talk about. They may be things that have come up about my responses, my feelings or just looking for advice. I make a note of them because it means I get the most out of the session. I enjoy just talking to my supervisor but it definitely helps to target the hour. I generally sit down on the way home after the sessions and make quick anon notes in MacDonalds.

I brought several core issues about my practice rather than individual incidents, which had figured largely in our previous encounters. I brought the general feeling that I hadn’t got a clue what I was doing. My self doubt. My lack of knowing if I was making a difference and my need to feel that at this stage at least I was doing something positive in my role in Chy. I am up to 30 hours in placement now and while in many ways I feel ever growing in confidence I also recognise that I am questioning the very thing that I am doing. I’m adding more measured and professional techniques such as the ways of responding or phrasing something that my supervisor might give me – I often write these down just so I remember the sentiment but ultimately I need to find my own voice - but sometimes I feel like I am just there, present and listening attentively and this causes some doubts. Is this it? Weeks and weeks of theory and I just listen?

The feedback from my supervisor on this was that he checked out what I was doing by way of checking out the core conditions plus the relationship I am forming and he was kinda satisfied that I was doing everything I needed to do. This made me feel better. What I went away with though was a way of actually measuring the client. He handed me a CORE OM or CORE 34 tool. This is to be used on clients at the start of treatment, like the TOPS form I’m used to in my drug work. In my field such forms are used as a means of quantifying data and success or lack thereof. As RISE are funded by PHE they need to see a return on their investment. It is down to funding implication and no doubt has been dreamt up by some media studies graduate in Whitehall. However, I doubt any clients ever answer the questions about shoplifting or theft accurately and I do not know why they are in there to be honest. Given that’s how I feel about TOPS, its refreshing to see that I find many more reasons to use CORE 34 with clients.

The CORE 34 measure things for many reasons, so a client and you can see progress or success, hopefully. The CORE 34 measures things like feelings of being overwhelmed or desperate, also it measures optimism and happiness. It divides them up into 5 distinct categories for analysis by the counsellor, and I hope for discussion with the client. The categories are risk (hugely important), wellbeing, problems, functioning and global distress. Now given they are all self-report this throws up understanding issues, mood issues and levels of states of being that may fluctuate and so needs to be delivered knowing that it is a snapshot only. It does also give a reading for how that person is doing in relationships through the functioning score and that could be really interesting to explore. Also to throw up measure of risk I feel is hugely important as it may reveal something that needs to be handed to supervision, it may mean a referral to a specialist worker or agency (I often make referrals to social services or community mental health team for example). Not only allowing you and the client to think about specifics that may have been hidden in the persons subconscious, it also enables you as a partnership to perhaps decide what would be most supportive to focus on.

I tried this in my session on Saturday. I asked my first client T if he would be happy to fill it out, after we’d settled and I had just reminded him of the session, the time and asked him if he was ready to begin. It was our 5^th session. T was very happy to fill it out. I knew he wouldn’t have any issues with the questions as he’s a graduate and likely familiar with the vocabulary. He flew through it. I told him I would look at it later so as not to take up any of his session and hopefully offer him one again nearer the end of our time together if he was ok with that. The rest of the session was very much his.

I found the process of handing it out quite easy. I think that I introduced it as a means of helping the client to get to know where they are really at by asking so many broad questions, but also so that he could bring things into his awareness perhaps. Either way, it was not a test and only for their benefit and would be entirely confidential as I made sure they only put their initial on it.

Looking at the data I collected from my clients that day I am both very aware that such tools are a momentary snapshot, people may be aiming to score on certain things or hide others, and they are quite blunt tools to dissect someone with (H. Lector), but it serves several functions. I can look at extremes and when appropriate ask the client about them, say if they score high on irritability for example. Or it can enable to them to rmember something that may be bothering them and they then feel able to bring it to the session. Further I can be aware of risk factors that may not have come out any other way. If someone feels more comfortable revealing something on a paper rather than actually say it for example.

I think that for now I am happy just to look at the collated numbers under the 5 headings and look at them again after several sessions. Then we could look at improvements or otherwise and get the client to acknowledge that they are doing some positive work, or perhaps it might expand the discussions into what’s really going on. Who knows? Its certainly added another dimension to my practice for sure.

I brought several other things but what stands out also in supervision was that I came with the concern that I wasn’t able to speak to a client, T about his intellectualisation. This was because I wasn’t sure how helpful it would be to even mention it in the first place, whether I was even accurate and then was I going to say it in a manner that was helpful? My supervisor fed back to me some ways of framing and handing back what the client has said. By doing this I am not interpreting what they have said, only handing it back to them.

Following supervision I was able to go into the session with T with a way of handing his own presentation back to him I suspected that would be supportive. I have always found him very ‘headspace’ and not feeling or focussing on his feelings. I totally get that and can relate to it and I know that may be why I have recognised it in him. Anyway, as usual T was thinking about thinking, using sometimes baffling levels of metacognition and leaving me wanting to know how he felt and wanting to help him make sense of that. By applying the confidence I had gained from learning ways of framing what I was feeling when listening to T I was able to use a phrase like “listening to you I am left wondering how you express what’s really you, what’s going on inside, something beyond all these goals and measure of success”. There, what a calm and thought-provoking way in to let T know that I was listening, caring and yet ‘wondering’ something. That is the key word. It’s not invasive and yet probing without probing. It asks the person to help me satisfy a thought that is incomplete. I found it was so gentle yet helpful. Now T did not actually say anything. That’s ok. He paused. He stopped talking for a little, which is not common. I felt uncertain afterwards and rescued him with a comment about it only being rhetorical if he wanted I just wanted to leave that with him.

During the conversations it came to light that I keep struggling with wanting to help a client make sense of their thoughts, as I do of my own. But my role as a counsellor or one of them is to help a client to make sense of their feelings, and that is very different. Armed with that notion, I went into the Saturday session much lighter. So much lighter. It seems easier to help a person to know their feelings, as feelings are so much easier to understand if you listen. I think. ;-)