Capstone Clinical Case Study 2023

Clinical Skills Capstone
By: Amanda Wilson

Introduction
CW is a 41-year-old Catholic female struggling with Alcohol Use Disorder. She is a
stay-at-home mother to 7.5 children. (7 biological and 1 neighbor child who stays with her most
of the time) Her husband works on the railroad and spends most of his awake time at work and
often will be gone for days at a time. CW’s supports are her children, her husband (financially),
alcohol, and her therapist. Her strengths are that she is a good mom, good caretaker, her master’s
degree in child therapy, and that she is compassionate and caring. Client struggles with seeing
the good in the world but tries. She wants to be able to control the negative thoughts in her head.
Clients’ father-in-law is dying and she struggles to make medical decisions for someone that is
not her biological relative. Clients’ parents died when she was in her early 20s. Client struggles
with incontinence and takes medication daily to help. Client was diagnosed with Major
Depressive disorder 6 years ago when she was hospitalized after trying to harm herself. Client
first drank wine at 6 years old due to her religion, but it became a problem around 16 years of
age.
Treatment Plan
Client wants to work on drinking less than 2 bottles of wine per day. We worked on this goal
together, and she initially brought up the idea of going to an AA meeting with her friend. She
wanted to join her friend to a meeting so that she did not have to go alone. This intervention was
not completed. Client was never able to join her friend to a meeting due to childcare. The next
step is to provide client information to online and virtual meetings that she could attend from her
house. Client and therapist have talked before about this, but she wanted to try and in person
meeting first.
Skills
The basic counseling skills used have been CBT and active listening. We used CBT when CW
was talking about feeling like a bad mother and fighting those feelings to help her realize that
they are irrational. We also used CBT when talking about feelings about her husband and her
feelings that he runs away to work to avoid her and the kids. Active listening was used during
every session, and paraphrasing was used after CW would describe something to me.
The resource I felt would benefit CW was to attend an AA meeting. I provided her with meeting
information like days, times and locations. We both agreed this would be good for her because
she believes that her excessive drinking has become a problem for her, and she wishes to stop
drinking or at least drink less.
Another resource I felt could benefit CW was family therapy. Although it would be hard to get
her husband to come in I believe them sitting down together and talking about her needs and
feelings could be helpful for her. She believes it would be a safe space for her to admit that she is
struggling to her husband. I offered to set them up with a family therapist at our office or refer
her to another office for this service. According to Ackerman “Family therapy can
employ techniques and exercises from cognitive therapy, behavior therapy, interpersonal therapy,
or other types of individual therapy. Like with other types of treatment, the techniques employed
will depend on the specific problems the client or clients present with.”
The mind body skill used was guided journaling. With guided journaling we would pick a
prompt either together or I would choose one for her (based on her mood) and she would write
for 10 minutes about that. She did enjoy this activity and decided to start doing it at home. I then
provided a paper with several prompts she could write from. CW has asked me for more prompts
since then because she used them all. I believed she could benefit from this because it forces her
to spend 10 minutes per day focusing on herself and her thoughts. It encourages her to realize she
can set aside time, and it helped her think about something other than her children and
responsibilities. "The purpose of journaling is to awaken conscious thinking, which is simply
having an honest conversation with yourself," says Meera Lee Patel in How to Journal Your Way
to Better Mental Health. Patel says “That doesn't mean being conscious of your writing—of the
words you're using or the sentences you're forming," Patel adds. "In fact, if being hyper-aware of
your writing is causing you to censor yourself, it defeats the purpose of journaling."
A cultural issue that we could have faced was the difference in her childhood and family
dynamic. Growing up she had a lot of siblings and then they had many children of her own. I
could have struggled to understand at first why she would have so many children if she was
struggling with her own mental health. I would have then talked about it with my supervisor
about the differences and her religious background versus my own background and beliefs.
Self-Reflection
I learned how to properly use communication skills like non-violent communication and using “I
feel statements.” During this time, we learned about therapy methods like CBT, and solution
focused therapy. I feel confident using CBT and that I could successfully use this with clients or
friends. Something I still need to work on is solution focused, because I feel like I need to fix
everything myself, but I know that is not possible. My goals for the future are to use CBT more
with clients when needed, and to get better at solution focused methods. I would like to do this
by practicing it more in everyday life before I use it with clients. I will communicate this to
future supervisors by talking openly about my strengths and weaknesses, so they are aware and
ask for help when needed.
Bibliography
How to journal your way to better mental health (even if you're so not a writer). mindbodygreen.
(n.d.). Retrieved April 12, 2023, from https://www.mindbodygreen.com/articles/journaling
Courtney E. Ackerman, M. A. (2023, April 4). What is family therapy? + 6 techniques &
interventions. PositivePsychology.com. Retrieved April 13, 2023, from
https://positivepsychology.com/family-therapy/

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Clinical Skills Capstone

By: Amanda Wilson

CW is a 41-year-old Catholic female struggling with Alcohol Use Disorder. She is a

drinking or at least drink less.

responsibilities. "The purpose of journaling is to awaken conscious thinking, which is simply

ask for help when needed.

(n.d.). Retrieved April 12, 2023, from https://www.mindbodygreen.com/articles/journaling

interventions. PositivePsychology.com. Retrieved April 13, 2023, from

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