As promised, I managed to get a copy of my female owner's reflective statement of her placement.
________________________________
I enjoyed my placement at XXX tremendously. The team at the Counselling Department took great efforts to make me feel included and welcomed during my stint. They took time to answer my queries and educate me on the workings of the school system. In addition, they always made sure that I had a sufficient caseload and the resources I needed in order to undertake my responsibilities. The resources include access to students’ information, access to therapeutic materials and a dedicated office.
There were a few important takeaways from this placement which I would like to highlight. Through the encouragement and faith expressed by the team, my confidence as a budding psychologist increased. Being a perfectionist, I started the placement looking at my weaknesses and things I could have done differently. Through the patience of my clinical supervisor, I was able to identify (and acknowledge) my strengths and harness them for the benefits of my students. Being more confident of myself, I developed a stronger intuitive sense of the needs of the student and hence, was more sensitive in the choice of my words, tone of voice and non-verbal cues. Students often cried during my sessions and I became more comfortable with such expressions of emotions. In addition, I gained a deeper understanding of what therapeutic alliance meant. I became more comfortable with the notion of “being” with the student, rather than just “doing” or “teaching”.
In terms of working with the child and adolescent population, I learnt the importance of setting clear boundaries and limitations and being firm with them. For instance, there was a group of four girls who wanted to be seen together but I had to go beyond what they wanted and split them into pairs in order to enhance therapeutic outcomes. However, I did this as gently as I could, selling them the rationale for splitting them in terms of mutual benefits for everyone involved. In addition, there were students who tried to manipulate my good intentions by scheduling sessions just to escape lessons or by being flippant about their appointments. After a few such instances, I learnt to be assertive and not give in to such whims and fancies.
In addition, working with this population reminded me not to underestimate the benefits of seemingly small interventions. For example, I always wondered with skepticism, the therapeutic effects of drawing for children. I had the opportunity to use this therapeutic tool when I worked with a pair of girls who were trying to cope with their parents' divorce and friendship issues. I soon discovered that drawing out their current situations made it easier for them to verbalise their story. Starting from the negatives of their lives, the girls were later able to draw the positives of their situations. They also started to take ownership of each session, deciding beforehand what they would like to talk about.
Having the privilege to work in a team-oriented department, I soon embraced the importance of knowing “who needs to do what”. The synergy of working together to bring about the best outcome for the individual student cannot be further emphasised. Whether it would be the Head of Counselling, the counselor, teacher, year-level coordinator or even parents, it soon became clear too that timely communication among stakeholders was paramount in this line of work.
I experienced countless moments of satisfaction. These arose out of different situations: when my student gets a “ah-ha” moment, when the reticient student breaks down in front of me and shares long-bottled up feelings with me, when I know I had gained enough trust to enter into someone else’ private world and simply knowing that I restored hope into a hopeless situation.
Working from a Rogerian framework, I also began to learn to communicate (better) unconditional positive regard in a sincere and non-patronising manner. When once I looked for big changes as an indication of therapeutic success, I now learnt to slow down and celebrate small successes with my students. I realised that it was unrealistic of me to expect big changes, because defeats and rejections were big parts of the students’ life. Hence, “small successes” in my once-ambitious eyes were actually milestones for them.
Overall, my experience at XXX has been rewarding and fulfilling. Besides deepening my clinical interest in working with the adolescent population, I feel that I had become a better person through working with the staff and students. The staff taught me professional conduct and skills; the students encouraged me with their resilience, creativity, love for others and never say die attitude.
Showing posts with label placement. Show all posts
Showing posts with label placement. Show all posts
Saturday, November 28, 2009
Saturday, November 21, 2009
clocked
My female owner reached a milestone today. She finally clocked the required 100 direct client hours for her school placement. Ah, another arduous journey almost completed. That means that she can compile her placement folio and do the necessary paperwork to close this placement.
Three more workdays she says (she’s doing more than necessary because she wanna help the students as much as possible). This placement has been memorable in many ways and maybe, after she writes up her reflective statement, I will post it up for you to read (this is called working smart!).
Three more workdays she says (she’s doing more than necessary because she wanna help the students as much as possible). This placement has been memorable in many ways and maybe, after she writes up her reflective statement, I will post it up for you to read (this is called working smart!).
Saturday, October 10, 2009
walk-in
My female owner went back to her placement on Thursday. It has been a fairly easy placement for her in the sense that she doesn’t need to do much after hours preparation. Might be another way of saying that she is slacking!
Anyway, she says that it was an extraordinary two days. Besides having all her usual students turning up (they sometimes forget to turn up and have to be called for), she had “walk-in” students exactly at the time-slots where she has no one booked in. This is also unusual coz walk-in students are not common and if she does, she’s usually unable to see them due to clashes in her schedule.
So all in all, she ended up with 8.5 hours to client contact hours this week. More than any preceding weeks and her prayer of 7 hours. Wat a relief. She passed the half-way mark in times of her hours! 44.5hours more to go.
Anyway, she says that it was an extraordinary two days. Besides having all her usual students turning up (they sometimes forget to turn up and have to be called for), she had “walk-in” students exactly at the time-slots where she has no one booked in. This is also unusual coz walk-in students are not common and if she does, she’s usually unable to see them due to clashes in her schedule.
So all in all, she ended up with 8.5 hours to client contact hours this week. More than any preceding weeks and her prayer of 7 hours. Wat a relief. She passed the half-way mark in times of her hours! 44.5hours more to go.
Friday, August 21, 2009
placements
My female owner is currently doing her 4th placement (or 5th, if you consider the 100hour she clocked in Woodbridge Hospital in her previous job).
1st placement: Triple P Clinic
Was a good starting place because the manualised programme (parent training) is structured and all she had to do was to adjust accordingly to the family’s unique circumstances. Supervision was good, stable and beneficial.
2nd placement: University Clinic
A highly stressful experience, due to short timeline, variety of cases and a dodgy supervisor who was neither reliable (told her to go drinking at the pubs to get a sense of Aussie culture) nor dedicated (cancelled sessions and more). To soothe her anxiety, she over-prepared for her clients by reading up on therapeutic techniques to deal with their presenting problems (i.e. content).
She also took up several neuropsychological assessments to beef up her clinical hours. That also had an exponential effect on the amount of time she had to spend on writing reports. Her hard work was unexpectedly recognised when a client wrote in to the university with a $200 donation in recognition of her “good service”. Note: she was being supervised by a neuropsychologist for all these cases. So her dodgy supervisor had no part to play in this.
3rd placement: Residential aged care
You have heard heaps about her grouses. Certainly a very dark period of 2009 for her. A great sense of frustration, stuckness and incompetence followed her through the months. Unfamiliar with older adults, she also spent a great deal of time reading up on different kinds of therapy (e.g. reminiscence, grief and loss counselling etc) and later found that she could barely use any, coz the older adults were not engaged in therapy.
Supervision was technical (“so what are the three good things you did? What are three things you can improve on? What would you have done differently?”) and a chore. She wanted to skip supervision so many times, but held on, in the name of being professional. The silver lining in the placement? Being paid for it.
4th placement: Private school
She decided to deal with her professional anxiety about over-preparing for clients. Hence, she chose to focus less on content but more on process issues. E.g. building rapport, therapeutic alliance, being with the student (rather than just doing things), a lot more reflective listening, validation, flowing with the student’s needs, being more alert and sensitive to non-verbals, giving space and being comfortable with silence etc.
A couple of significant changes she made: making sure she has enough sleep to keep herself in tip-top condition to be with her students, not wasting time reading on techniques but in-session, focussing on being with her students, reading their body language and using herself (as person) as the main therapeutic tool (as opposed to her knowledge of effective therapeutic interventions).
Supervision has been awesome. Her supervisor has been supportive and enlightening. She gently corrected my female owner’s misconceptions about different issues, and brought in alternative perspectives during case discussions. My female owner feels that her strategy for this placement is bearing fruits. She finds herself more confident and less anxious when seeing students. To top it off, a student with severe depression recently wrote in to her teacher, thanking her teacher for referring her to my female owner. My female owner had not implemented any therapeutic techniques (think good old CBT) in the five sessions she had with her. All she did was to sit and be with the student, allowing her to talk about anything that is on her mind and when appropriate, reflect to provide emotional support. Seems like process skills are highly important in working with this population.
1st placement: Triple P Clinic
Was a good starting place because the manualised programme (parent training) is structured and all she had to do was to adjust accordingly to the family’s unique circumstances. Supervision was good, stable and beneficial.
2nd placement: University Clinic
A highly stressful experience, due to short timeline, variety of cases and a dodgy supervisor who was neither reliable (told her to go drinking at the pubs to get a sense of Aussie culture) nor dedicated (cancelled sessions and more). To soothe her anxiety, she over-prepared for her clients by reading up on therapeutic techniques to deal with their presenting problems (i.e. content).
She also took up several neuropsychological assessments to beef up her clinical hours. That also had an exponential effect on the amount of time she had to spend on writing reports. Her hard work was unexpectedly recognised when a client wrote in to the university with a $200 donation in recognition of her “good service”. Note: she was being supervised by a neuropsychologist for all these cases. So her dodgy supervisor had no part to play in this.
3rd placement: Residential aged care
You have heard heaps about her grouses. Certainly a very dark period of 2009 for her. A great sense of frustration, stuckness and incompetence followed her through the months. Unfamiliar with older adults, she also spent a great deal of time reading up on different kinds of therapy (e.g. reminiscence, grief and loss counselling etc) and later found that she could barely use any, coz the older adults were not engaged in therapy.
Supervision was technical (“so what are the three good things you did? What are three things you can improve on? What would you have done differently?”) and a chore. She wanted to skip supervision so many times, but held on, in the name of being professional. The silver lining in the placement? Being paid for it.
4th placement: Private school
She decided to deal with her professional anxiety about over-preparing for clients. Hence, she chose to focus less on content but more on process issues. E.g. building rapport, therapeutic alliance, being with the student (rather than just doing things), a lot more reflective listening, validation, flowing with the student’s needs, being more alert and sensitive to non-verbals, giving space and being comfortable with silence etc.
A couple of significant changes she made: making sure she has enough sleep to keep herself in tip-top condition to be with her students, not wasting time reading on techniques but in-session, focussing on being with her students, reading their body language and using herself (as person) as the main therapeutic tool (as opposed to her knowledge of effective therapeutic interventions).
Supervision has been awesome. Her supervisor has been supportive and enlightening. She gently corrected my female owner’s misconceptions about different issues, and brought in alternative perspectives during case discussions. My female owner feels that her strategy for this placement is bearing fruits. She finds herself more confident and less anxious when seeing students. To top it off, a student with severe depression recently wrote in to her teacher, thanking her teacher for referring her to my female owner. My female owner had not implemented any therapeutic techniques (think good old CBT) in the five sessions she had with her. All she did was to sit and be with the student, allowing her to talk about anything that is on her mind and when appropriate, reflect to provide emotional support. Seems like process skills are highly important in working with this population.
Wednesday, July 01, 2009
completed
My female owner completed her first externship today. When she first started her placement at the end of March, she felt that she would never be able to see this day, although logically, she knows that this day would arrive. With a sign of relief, she walked out of the facility for the last time today, as a trainee psychologist.
She spent a total of 15 weeks, working two days a week, at the aged care facility. Clocked 100 hours of direct clinic contact hours. This included running a 9-session CBT group (it was meant to be 10 sessions but my female owner was too lazy to run the last one. Also, she was pissed at having to do a memory training as well), a 2-session memory workshop and 89 hours of individual sessions. She also had the privilege of attending two training sessions, one on experiential learning of what it is like to have dementia (participants were kept in a small room, wearing a mask on their faces and had cotton bud in one ear, mini grains in their shoes. They had to accomplish certain tasks according to a prescribed method or sequence.) and the other was on person-centred therapy for people with dementia.
In her work, she encountered residents with varying state of cognitive and/or physical impairment. Most obviously, individuals with different kinds of dementia: Alzheimer’s, vascular and even alcohol-induced . Mobility covered the whole spectrum, from those who were bed-ridden or had a leg/s amputated or used wheelers/ walking sticks to those who were perfectly mobile. Medical conditions included cancers, osteoarthritis, lymphodema, renal and urinary problems, heart problems etc. Psychological problems ranged from grief and loss over death of loved ones, independence, control and physical functioning, depression, anxiety, behavioural issues, non-adherence to medication treatments.
From the various diversional therapists, she learnt more about Australia: how to bake pumpkin scones, the existence of cane toads, how to eat vegemite with crackers and cheese (yum! She says), gardening, cooking, Brisbane music festival etc etc.
Through observing them at work, my female owner picked up valuable techniques in relating to older adults. Besides speaking louder and slower, she learnt to acknowledge them by their preferred name, to make small talk with them, to speak to them at their eye-level and before doing anything, tell them exactly what she would be doing. She began to see the residents as individuals, with years of experiences shaping them into the persons they were. My female owner learnt the importance of remembering their likes and dislikes, e.g. their preferences while drinking coffee or tea, the kind of activities they enjoyed and even, where they preferred to sit in communal activities.
As a psychologist, my female owner struggled to make herself relevant to the residents. They often saw her as an available person to listen to their life stories and were not prepared to do any active therapy (and she totally understands their point of view). Hence, my female owner did heaps of reminiscence therapy with the residents. She learnt very quickly that residents were not ready for the traditional CBT. Hence, she intervened using subtle CBT messages e.g. she drew out the positive things residents were doing for themselves, kept reinforcing them and worked with them to look for more ways to enhance their psychological well-being.
In her opinion, my female owner did not receive adequate clinical supervision. Her clinical supervisor was as naïve as her with regards to the inner workings of an aged care facility and would propose ideas that showed a lack of understanding of the practical constraints that externs faced in their placement. Often, my female owner felt like a guinea pig as her supervisor would ask her if XXX should be done for the next batch of externs who would be doing similar placements. Many times, my female owner felt like telling her to quit thinking about future batches and concentrate on supervising her current externs first.
Such a long post. Maybe one day, I will write more about my female owner’s experiences. For now, suffice to say that she is ready to move on to other things (which unfortunately includes tonnes of paperwork and writing up a folio for this placement).
She spent a total of 15 weeks, working two days a week, at the aged care facility. Clocked 100 hours of direct clinic contact hours. This included running a 9-session CBT group (it was meant to be 10 sessions but my female owner was too lazy to run the last one. Also, she was pissed at having to do a memory training as well), a 2-session memory workshop and 89 hours of individual sessions. She also had the privilege of attending two training sessions, one on experiential learning of what it is like to have dementia (participants were kept in a small room, wearing a mask on their faces and had cotton bud in one ear, mini grains in their shoes. They had to accomplish certain tasks according to a prescribed method or sequence.) and the other was on person-centred therapy for people with dementia.
In her work, she encountered residents with varying state of cognitive and/or physical impairment. Most obviously, individuals with different kinds of dementia: Alzheimer’s, vascular and even alcohol-induced . Mobility covered the whole spectrum, from those who were bed-ridden or had a leg/s amputated or used wheelers/ walking sticks to those who were perfectly mobile. Medical conditions included cancers, osteoarthritis, lymphodema, renal and urinary problems, heart problems etc. Psychological problems ranged from grief and loss over death of loved ones, independence, control and physical functioning, depression, anxiety, behavioural issues, non-adherence to medication treatments.
From the various diversional therapists, she learnt more about Australia: how to bake pumpkin scones, the existence of cane toads, how to eat vegemite with crackers and cheese (yum! She says), gardening, cooking, Brisbane music festival etc etc.
Through observing them at work, my female owner picked up valuable techniques in relating to older adults. Besides speaking louder and slower, she learnt to acknowledge them by their preferred name, to make small talk with them, to speak to them at their eye-level and before doing anything, tell them exactly what she would be doing. She began to see the residents as individuals, with years of experiences shaping them into the persons they were. My female owner learnt the importance of remembering their likes and dislikes, e.g. their preferences while drinking coffee or tea, the kind of activities they enjoyed and even, where they preferred to sit in communal activities.
As a psychologist, my female owner struggled to make herself relevant to the residents. They often saw her as an available person to listen to their life stories and were not prepared to do any active therapy (and she totally understands their point of view). Hence, my female owner did heaps of reminiscence therapy with the residents. She learnt very quickly that residents were not ready for the traditional CBT. Hence, she intervened using subtle CBT messages e.g. she drew out the positive things residents were doing for themselves, kept reinforcing them and worked with them to look for more ways to enhance their psychological well-being.
In her opinion, my female owner did not receive adequate clinical supervision. Her clinical supervisor was as naïve as her with regards to the inner workings of an aged care facility and would propose ideas that showed a lack of understanding of the practical constraints that externs faced in their placement. Often, my female owner felt like a guinea pig as her supervisor would ask her if XXX should be done for the next batch of externs who would be doing similar placements. Many times, my female owner felt like telling her to quit thinking about future batches and concentrate on supervising her current externs first.
Such a long post. Maybe one day, I will write more about my female owner’s experiences. For now, suffice to say that she is ready to move on to other things (which unfortunately includes tonnes of paperwork and writing up a folio for this placement).
Wednesday, June 10, 2009
eroded
My female owner realised that she is traumatised by the OM (outrage of modesty; police speak) incident at the placement. She was back at her placement today and definitely queasy whenever she saw that dirty old man. Save for the cursory Aussie greetings (“hi, how are you?”), she avoided him like the plague.
She did a fabulous job of preventing herself from being in a compromised situation with him alone… until the end of the day. Read on to see Murphy’s law in action.
She had just left a resident’s room with the intention of leaving for the day, when of all people who could walk by, it was him. Seeing her, he asked for help…. with something in his room.
My female owner tensed up immediately. Her breathing quickened and she felt uneasy all over again. Reluctantly, she followed him to his room. He needed help in fixing up the board at the foot of his bed. My female owner fumbled her way through this unfamiliar task, being mindful not to turn her back towards him or to allow him to come too near. She was jittery and on high alert.
The board was fixed fairly easily and quickly. Wanting to make a quick escape, she realised to her horror that he was standing between her and the exit. Dirty old man extended his hand towards her. He wanted to shake her hand by way of saying thanks. Oh no. My female owner could just envision history repeating itself.
She hastily took his hand, shook it fast, said “I’ve got to go. See you.”, squeezed past him in the hope that he would not do anything with his hands. Thankfully he didn’t.
It didn’t matter that the offender was old and that his actions were not “invasive” as other forms of sexual harassment. The very fact that your personal space is violated and your sense of safety is eroded lowers the threshold for alarm bells to be set off. Darn the dirty old man.
She did a fabulous job of preventing herself from being in a compromised situation with him alone… until the end of the day. Read on to see Murphy’s law in action.
She had just left a resident’s room with the intention of leaving for the day, when of all people who could walk by, it was him. Seeing her, he asked for help…. with something in his room.
My female owner tensed up immediately. Her breathing quickened and she felt uneasy all over again. Reluctantly, she followed him to his room. He needed help in fixing up the board at the foot of his bed. My female owner fumbled her way through this unfamiliar task, being mindful not to turn her back towards him or to allow him to come too near. She was jittery and on high alert.
The board was fixed fairly easily and quickly. Wanting to make a quick escape, she realised to her horror that he was standing between her and the exit. Dirty old man extended his hand towards her. He wanted to shake her hand by way of saying thanks. Oh no. My female owner could just envision history repeating itself.
She hastily took his hand, shook it fast, said “I’ve got to go. See you.”, squeezed past him in the hope that he would not do anything with his hands. Thankfully he didn’t.
It didn’t matter that the offender was old and that his actions were not “invasive” as other forms of sexual harassment. The very fact that your personal space is violated and your sense of safety is eroded lowers the threshold for alarm bells to be set off. Darn the dirty old man.
Wednesday, June 03, 2009
equilibrium
My female owner is ambivalent about whether her current placement is a bane or boom. Now that she has only 8 more days to work there… she can’t help but try to salvage the placement by focusing on the positive takeaways. Her newfound equilibrium was shaken today because of a dirty old man (W). Now, the CB-therapist would say that it is the interpretation of the situation that made her upset and not the situation itself. Well… I leave it to you to decide.
My female owner had always known W to be a little disinhibited with his words and actions (i.e. oozing with sexual innuendoes). Today, he was in pain due to his urinary tract infection. In a bid to distract him from the pain, my female owner decided to chat with him. W generally mumbles and half the time, people cannot really understand him. Anyway, through that short chat, he asked my female owner if she would come to bed with him that night!? Of course, she laughed it off. And later, she offered to get him a cushion for his back, he asked if he could lie on her. Just verbal teasing you might say.
My female owner then brought him back to his room. In his room, he put his arm around her waist when her back was facing him (he had previously tried to put his hand up her back, under her top). She almost wanted to aikido him and pin him to his bed. Her trauma didn’t end there. He tried to pull her towards him to hug her. Of course my female owner was strong enough to resist him and even overpower him. However, she was mindful of her strength and…. his feelings.
She ended up giving him a half-hug sort of thing. W persisted by refusing to let go of her hands. Oh my goodness… my shell is rattling even as I write this. My female owner tried to wriggle her way out. And W pulled her towards him again so that he could kiss her cheek-to-cheek. She had no choice but to reciprocate. Not to mention that he kept holding on to her hands even afterwards and she tried to move away tactfully.
My female owner didn’t really know what’s the best way to deal with such a situation actually. She just tried to escape as quickly as she could. She doesn’t even know if she’s warranted to sprout some hokkien vulgarities in the comfort of her own room. This man’s brain may be malfunctioning due to his age and multiple illnesses.
My female owner had always known W to be a little disinhibited with his words and actions (i.e. oozing with sexual innuendoes). Today, he was in pain due to his urinary tract infection. In a bid to distract him from the pain, my female owner decided to chat with him. W generally mumbles and half the time, people cannot really understand him. Anyway, through that short chat, he asked my female owner if she would come to bed with him that night!? Of course, she laughed it off. And later, she offered to get him a cushion for his back, he asked if he could lie on her. Just verbal teasing you might say.
My female owner then brought him back to his room. In his room, he put his arm around her waist when her back was facing him (he had previously tried to put his hand up her back, under her top). She almost wanted to aikido him and pin him to his bed. Her trauma didn’t end there. He tried to pull her towards him to hug her. Of course my female owner was strong enough to resist him and even overpower him. However, she was mindful of her strength and…. his feelings.
She ended up giving him a half-hug sort of thing. W persisted by refusing to let go of her hands. Oh my goodness… my shell is rattling even as I write this. My female owner tried to wriggle her way out. And W pulled her towards him again so that he could kiss her cheek-to-cheek. She had no choice but to reciprocate. Not to mention that he kept holding on to her hands even afterwards and she tried to move away tactfully.
My female owner didn’t really know what’s the best way to deal with such a situation actually. She just tried to escape as quickly as she could. She doesn’t even know if she’s warranted to sprout some hokkien vulgarities in the comfort of her own room. This man’s brain may be malfunctioning due to his age and multiple illnesses.
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My siblings and I
From top left: Dodo, Dona, me (Nooki) and Nanook