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Hypothetical Working Agreement

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Hypothetical Working Agreement
Cynthia Boland
BSHS 322
December 24, 2012
Tracey Newman

Hypothetical Working Agreement

This paper is meant to focus on a hypothetical working agreement for one of the specified scenarios from our textbook. The working agreement should have four parts; Assessment, Goal setting, Contacting and Evaluation. This paper will state clearly the key elements and purpose of each of the four parts in the working agreement using this specific case scenario. The case that I chose to use from the text is the case of Thomas, a 20-year-old college sophomore who has dropped out of school. He has just been diagnosed with schizophrenia. His mother has brought him to the day center saying she hopes that “somehow he will be able to get back to college.”
Assessment
This is the stage when elaboration and exploration skills are used in assisting in assessing the story from the client. “Gathering and analyzing of information about a client is done at this stage in order to tackle the problem” (Murphy, B. C., & Dillon, C. (2011). It is also good for clinicians to do a structured assessment formally and reasonably to fulfill the purpose of diagnosis, plan treatment and carry out research on the best specialized services that are needed by the client.
Assessment
The purpose of an assessment is to get a vast amount of adequate information about the client. This can include basic information such as name, age, birthdate, address, and telephone number. It is also essential to gather vital demographic information such as, culture, family history, gender, health history, and emotional state in order to help establish the kind of help that is needed and to formulate a plan that is the right fit for the participant. My assessment will start at the first level with me asking myself some questions about the client and why he/she is seeking help. I also have to ask myself who the client was and who should be involved during their assessment. I also have to outline what I need to know and the information that is needed. I gathered information on Thomas by interviewing his immediate family, former employees, friends, and Thomas himself. The assessment took place in the office and I came up with the following outcome that is listed below.
Clients name: Thomas Falkner
Address: 7584 Juniper Drive, Austin, TX, 87459
Telephone number: 875-987-1258
Gender: Male
Age: 20
Religion: Catholic
Cultural identity: Caucasian
Relationship status: Single
Employment: Pizza delivery driver
Education: College drop out
Training: none
Significant others: Mother, Joyce Falkner. Joyce is a loving, caring mother who is worried about her son. She is hopeful he can get treatment and return to college in the future.
Presenting problems: Thomas has just been diagnosed with Schizophrenia. Due to his condition he has been having some troubles with his schooling and has dropped out of college.
Biopsychosocial stressors: Thomas’s friends have begun to distance themselves from him, he has lost his job due to outbursts, confusion and frustration have taken over his mind making it hard to concentrate on school and other points of life, and social isolation.
Client's strengths: easy to talk to, friendly, smart, funny, and eager. Thomas is aware of the complications of his illness, and he is willing to do what he can to combat it so he can live a full, rich, healthy, normal life.
Family background: Thomas comes from a family with prior history of mental illness. One uncle has Dementia, his Aunt is Bi-polar, and his Great-Great-grandmother had Schizophrenia. Thomas comes from a loving very close family. He lost his father earlier in the year to Cancer.

Partializing and prioritizing

Clinician: What goals do you think we should have for our work together?
Client: I want to be able to return to college someday and live a normal life.
Clinician: What type of thing needs to be done in order for you to accomplish this?
Client: I need to go to get on medication, get into therapy, and find ways of coping with my illness.
Goal Setting
The following is a list of goals that Thomas can use to help him on his path to becoming more independent and overcoming his illness. The first goal is to seek out the proper medications that will help him keep his illness under control. Medication alone will not help him in the long run, so getting involved in a rehabilitation therapy group is another extremely important goal for his push for success.
The third goal is to learn how to handle the illness itself. With psychosocial therapy and group meetings with others who suffer with the illness as well Thomas will develop the skills he needs to master this goal. “Anti-psychotic drugs such as Seroquel and Geodon are used to treat the symptoms of schizophrenia. However, they will not eliminate the underlying causes of schizophrenia. By providing various non-medical intervention services, rehabilitation delves into the root of the issue. Through vocational counseling, patients learn how to achieve self-identify, and are taught how to locate satisfying and realistic roles in their environment, helping them develop the maturity needed to make sound career decisions.” ("Nimh.nih.gov", 2012).
Thomas is also going to need much support from family and friends. This support will be a lifeline for him to keep pushing forward when times seem bleak and dismal. Family members should learn as much about the illness as possible, while finding ways to help minimize any chances of a possible relapse by taking advantage of the outpatient and family services available to any and all family members. All programs that service schizophrenics offer education for families of schizophrenics as well.
The Working Agreement- Contract
Counseling is a binding working agreement between two entities in which each entity has appropriate roles, expectations, and responsibilities. This is a sample Agreement for the client to read and sign which states in understandable language the roles and responsibilities of each person involved in the counseling process.

I. My Responsibilities

As a counselor, I pledge that I will provide the following:

1) I pledge to provide safety for my client. My office location and work area is located in a safe environment, and is designed to give you the client a feeling of security so that you can feel free to open yourself to experiencing a personal and mental change. This establishment is and always will be free of any kind of abuse whether it is of sexual, drug, or physical nature. This office will also be free of any violence, threats, and dangerous/deadly weapons.
Another level of safety pledged to you is legal confidentiality. Anything that is discussed in this office stays within the confines of this office, unless deemed otherwise by the State. 2) I give you my esteemed pledge to do my best and to be more powerful in my work and counseling than the issue you are facing. If I acquire assistance in abiding by that pledge, then it is my sole responsibility to get that assistance. This can come from further educational training, reading and research, or possible consultations with other clinicians.

As this is a partnership office, I do frequently consult my partner Mr. Simms regarding clients. This is all done within the legal structure of our business and your legal confidentiality. This consultation is done in order to have each other as a "backup therapist" in case either of us is deterred by circumstances beyond our control and will not be available. 3) I have a responsibility to explain, in language you can understand, any and all evaluations regarding your presenting problems, any ongoing procedures, possible risks, consequences, and benefits of any treatments or methods prior to their use. I will do my best to explain what our treatment plans and goals are, as they are sometimes a continuously ongoing work-in-progress. What I mean by this is that our evaluations are ever changing as well as the goals and procedures to help you achieve those goals.

II. Your Responsibilities

As the Client, there will be certain responsibilities that you will need to uphold in your work with me, as well.

1) It is your responsibility to be present for any and all client sessions. Our sessions will be set up on a regular schedule of Sixty (60) minutes each week. These sessions are an integral part your "recovery" work. However, I understand that there are circumstances when a client will not be available for such a schedule of, and under those circumstances I will try to accommodate your schedule to the best of my ability. 2) Another responsibility required by you is to take the work we are doing in this office seriously. By this I mean cooperating with staff, completing any "homework" given to you. 3) One major responsibility that you as a client have is to be as open and honest with me as you possibly can. I realize that at times this can be very challenging, and I pledge that I will honor, respect, and never disregard the amount of trust you place in me with your openness during our sessions. 4) This is a drug, smoke, and violence free office so in return you are to be free of the influence of any alcohol, drugs, or weapons. Any drug use must be done with the approval of the clinician. 5) You have a responsibility to uphold the financial agreement that is established also. If there is any problem or if circumstances make this impossible, I implore you to be open, honest, and truthful with me about it, so we can make other options available for you.
I do claim the right to terminate treatment for lack of compliance, so if I feel that you are not taking your work with me seriously, or that you are not taking any of the responsibilities seriously, our sessions could be terminated. However, please keep in mind this course of action is a last resort for me. Once I have agreed to work with a client, our sessions become an important part of the therapeutic relationship and I pledge to explore every avenue to make these sessions as productive and therapeutic as possible.

YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ THIS AGREEMENT AND AGREE TO ITS TERMS. YOUR SIGNATURE ALSO SERVES AS AN ACKNOWLEDGEMENT THAT YOU HAVE RECEIVED THE HIPPA NOTICE FORM DESCRIBED ABOVE.
____________________________________________________ __________________________
Client or Guardian Signature Date
____________________________________________________
Relationship to Client
_____________________________________________________ __________________________
Witness Date

References

Murphy, B. C., & Dillon, C. (2011). Interviewing in action in a multicultural world. (4th ed.). Belmont, CA: Brooks/Cole, Cengage Learning. nimh.nih.gov. (2012). Retrieved from http://www.nimh.nih.gov/health/publications/mental-health-medications/what-medications-are-used-to-treat-schizophrenia.shtml

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