PSYCHVINE

Category: cognitive behavior therapy

Earlier in the session, Dr. Smelt suggested that Fred’s self view of being stupid might not be accurate. Here’s what transpires next: Fred smirks, “Oh sure, we can look at other ways to view this, but I do believe I’m right.” Dr. Smelt notes, “Let’s not turn this into a contest of who’s right. How about instead, I give you a series of questions to think about and then see if you look at your thoughts differently once you consider…

Dr. Smelt and Fred discuss thought sheets for the first half of session four. He begins to see how situations, thoughts, feelings, and more reasonable thoughts link together. Dr. Smelt then remembers that Fred had begun this session with noting a problem at work. Therefore, she says, “Now that we’ve gone over this first thought sheet, I’m wondering if you’d like to tackle the second agenda item you mentioned at the start of this session?” “Oh, yes. I suppose we…

In previous session excerpts, Dr. Patricia Smelt paid close attention to the therapeutic alliance which she felt needed nurturance. That’s because her client, Fred, was court ordered to therapy for anger issues and demonstrated defensiveness. Let’s pick up a segment of session 3. Fred arrives at this session steaming, “Alright, doctor, now I have a real problem. My boss told me yesterday that I need a new attitude. Unbelievable. I work harder than anyone there and yet ‘I’ have an…

The following is a second excerpt from Fred’s court referred psychotherapy. Dr. Smelt continues to grapple with achieving a better therapeutic relationship with Fred who remains resistant to this point. Dr. Smelt asks for more information, “Fred, tell me a little bit more about your feeling of embarrassment. Do you feel that way because you’re coming here to see me or is there more?” “I really don’t mind coming to this office all that much. I realize that lots of…

Fred begins this session by asking Dr. Smelt, “How’s it going, Doc? Did you have a good week?” “Just fine, Fred. But I’d like to know how your week went.” “Nothing much happened. Work has been a real bitch though.” “I remember you work for the city in I.T. What kinds of problems have you been having?” Dr. Smelt queries. “I’m overloaded with crap. Too many meetings, too many bosses. Morale sucks. What else do you want to know?” “I…

“Before we go any further,” Dr. Smelt says, “I want to tell you a bit about confidentiality.” “No need,” Fred interrupts, “I know that bull shit. You tell me you’re like a priest, but if the judge wants to know something, you’ll tell him. That’s the real world. All this stuff about confidentiality is a way for you to get me to spill my guts. But, I’m not telling you anything that could get me into more trouble with the…

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