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A counseling case study adopting a client-centered approach

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Paul B.
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  1. Introduction.
  2. Rationale.
  3. What is a client centred approach?
  4. Congruency.
  5. Empathic understanding.
  6. Unconditional positive regard.
    1. Questions.
    2. Reflection/selective reflection.
    3. Empathy building.
    4. Checking for understanding.
  7. Conclusion.
  8. Appendix.
  9. References & further reading.

The following intervention analysis will utilize a planned verbal interaction, which occurred as part of ongoing care, during a 15-week placement on a Psychiatric Acute ward catering for people aged 18-65. The client's informed consent was gained verbally, to use this conversation within my assignment. The client will be referred to as Carol. These measures are in accordance with the UKCC (1998) guidelines regarding consent and confidentiality. A client centered approach is to be employed as an aid to critical analysis of the intervention. It will firstly give a rationale for why this particular intervention was chosen and for the theoretical approach utilized. Biographical details of the client including events leading up to this point, previous conversations and incidents which are relevant to the chosen intervention, can be found in Appendix A. It will outline what a client centered approach involves. Firstly by defining its beliefs and essential core conditions, then by calling on the more practical micro-skills involved.

[...] CLIENT: Only at times, I wouldn't of done it NURSE: Then I would suggest that on that basis you could say your leave went much better CLIENT: Not really, I still felt awful inside NURSE: Yes, but try to focus on the positive things that happened, and not just the negatives CLIENT: That's easy for you to say NURSE: I understand that, but ask yourself what benefits you get from thinking so negatively CLIENT: (Carol remains silent for a long period minute) NURSE: All I can say at this point Carol is that I see it as positive steps forward, how do you see it? [...]


[...] To allow for easier application, Burnard (1999) defines some micro-skills, which may help in the development of a client-centered approach. These include: 1. Questions 2. Reflection/Selective Reflection 3. Empathy building 4. Checking for understanding. I will continue my analyses of the recorded intervention as these skills are stated, attempting through this, to gain some insight into whether my actions were client-centered or not. 1.Questions The first to be discussed is the use of questions. These can be open or closed, leading and confronting (Burnard 1997). [...]


[...] Psychiatric nursing skills: A patient-centered approach. UK: Stanley Thorne Ltd Faulkner, A (1998). Effective interactions with patients. London: Churchill Livingstone Hanson, B & Taylor, M.F (2000). Being with, doing with: a model of the nurse-client relationship in mental health nursing. Journal of Psychiatric and Mental Health Nursing: 7 417- Harrion, L (1992). Professional issues in practical/vocational nursing. USA: Delmar Heron, J (1993). Helping the client: a practical guide. London: Sage publications Hollywood, J & Rickard, I (1994). Counseling and the role of the mental health nurse. [...]

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