Rehabilitation Counseling: Case Report on Simulated Patient Sessions

This case report analyzes a student's counseling sessions with two simulated patients, focusing on the application of rehabilitation counseling techniques. The student, in the role of a rehabilitation counselor, employed humanistic counseling and client-centered therapy to address the patients' challenges related to loss of independence and psychological contact, respectively. The report details the use of motivational interviewing, micro-skills such as open-ended questions and minimal encouragers, and the importance of building rapport. The student reflects on their performance, discussing the use of various interpersonal skills, including effective questioning, active listening, and reflection, while also identifying areas for improvement, such as incorporating more closed questions and enhancing the use of micro-skills. The report emphasizes the significance of research and statistics in understanding and treating patients effectively, highlighting the role of psychological and biological factors in mental health. The ultimate goal was to help patients change their perceptions and behaviors to live more positive lives, emphasizing the importance of self-understanding and self-efficacy in the counseling process.

Running head: STIMULATED PATIENTS 1
Stimulated Patients
Name
Institution
Course
Date

STIMULATED PATIENTS 2
Stimulated or Standardized Patients are healthy individuals that are trained to depict
physical symptoms, emotional characteristics, personal history as well as everyday worries of a
genuine patient. They are typically dynamic educational tools for a wide range of settings for
instance group demonstrations, interactive teaching environments, clinical examinations, and
depiction that are customized with the aim of meeting the needs of the client. They are typically
trained to offer productive feedback from the unique perspectives of the patients to the learners
at all levels of training (Trevithick, and Trevithick, 2010).
In this particular case, the themes portrayed by the stimulated patient 1 and patient 2 were
a loss of independence and loss of psychological contact respectively. Research suggests that
over fifteen percentage of the adult population suffer from one or more health conditions
including depressive issues, substance abuse problems, dementia-related symptoms, as well as
bipolar disorders among others (Plante, 2010).
The psychological tests normally assess a variety of mental attributes as well as abilities
including personality, achievement and neurological functioning, as well as ability. Several
psychological, biological, and social factors normally regulate the level of mental health of an
individual (Plante, 2010). Similar to the common stressors of life that are typically common to
all individuals, a najority of adults typicallylose their independence as a result of chronic pain,
frairity and physical or mental problems among other factors. These factors typically result in
loneliness, isolation, loss of independence and psychological distress in older individuals. This
was the case witnessed with the first patient (Trevithick, and Trevithick, 2010).
The work duties of clinical psychologist comprise of assessing the mental health of the
patient, attempting to determine the right treatment for that particular patient by subsequently
analyzing the interpersonal relationship of the as well as the surrounding. The second patient was

STIMULATED PATIENTS 3
shown to depict dementia-like symptom is a syndrome where there was deteroriation in memory,
behaviour, thinking as well as the ability to perform daily activities. Thus he exhibitted the theme
off lose of psycholgical contact (Plante, 2010).
In helping these individuals change their perceptions and hence behavior, I was forced to
employ various skills. Since no two individuals comprehend the same language in the same way,
the understanding of these individuals will always be associated with their personal experience
of the world (Lala, and Merchant, 2012). Thus considering this, I employed the humanistic
counselling skill on both of these patients since this technique recognizes the uniqueness of every
person. Using this technique, I was able to assume that each of these patients had an innate
capacity of growing psychologically as well as emotionally towards the objectives of self-
actualisation and hence fulfilment at a personal level (Trevithick, and Trevithick, 2010).
Considering the situations of both of these patients, I was able to work with the belief that
life events are not the main cause of problems, but how a person experiences these life events.
The main aim of the counselling session was to aid these patients in changing their perception of
things and hence live a more positive life by shanning their disillusionment. Typically, the way
we experience events in life events will subsequently relate to how we normally feel about
ourselves which in turn influencing confidence and self-esteem (Plante, 2010).
I was able to learn how to understand the way that the negative responses to the life
events led to the psychological discomfort of these two patients (Lala, and Merchant, 2012).
From this, I was then able to encourage acceptance of both the positive as well as the negative
aspects of oneself in both of these two individuals. By posing thought provoking thoughts, I was
able to make these patients explore their own feelings as well as their thoughts and thus

STIMULATED PATIENTS 4
consequently work their own solutions to the problems that they faced (Trevithick, and
Trevithick, 2010).
I used interchangably the humanistic counselling approach with the client-centred therapy
as this focuses on the belief that the client is typically the best expert on his own feelings,
thoughts, problems as well as experiences. Thus the client is the only person that is capable
enough of finding the best solutions to his problems (Trevithick, and Trevithick, 2010).
Emploting this criterion, I did not give suggestions to any course of action, ask probing
questions, make recommendations, or attempt to interpret anything that the client in any of these
cases said.this is because the charge for working out the problems rested wholly with these
patients. I aimed at showing warmth, empathy, as well as genuineness which I believe, was to
enable the patients to self-understand themselves and hence their growth psychologically (Lala,
and Merchant, 2012).
Normally, effective counselling subsequently reduces confusion thus allowing the client
to consequently make effective decisions which lead to positive changes in the attitude and
behavior of these clients. The ultimate objective of counselling is enabling the client to
subsequently make their choices arrive at their own decisions and to subsequently act upon these
descisions accordingly (Lala, and Merchant, 2012). To achieve this, some of the interpersonal
skills that I used included effective questioning skills, clarificationactive listening, and reflection.
I tried at every moment to build a positive amount of rapport with the patients in both occassions.
This was however not to the level that would subsequently allow them to turn out to be
emotionally involved (Lala, and Merchant, 2012).
The optimistic, as well as the humanistic theories concerning the capabilities of
individuals to exercise free choice as well as changing via a process of self-actualization, are

STIMULATED PATIENTS 5
emphasized by motivational interviewing. Throught both sessisions, I tried as much to elicite
behavioral change as well as self-motivational statements from the patents besides creating client
discrepancy in enhancing motivation for positive change (Miller, and Rollnick, 2013).
I was keen to observe the clinician practices of motivational interviewing which have five
general principles which include, avoiding argument as well as direct confrontation, expressing
empathy through reflective listening, adjusting to client resistance rather than opposing it
directly, developing discrepancy between the goals or values of the clients and their current
behavior, and support self-efficacy as well as optimism (Trevithick, and Trevithick, 2010).
In counselling, ambivalence is predominantly evident in circumstances where there is a
conflict between an immediate reward and the longer term adverse consequences. The suitable
utilization of non-verbal as well as micro-skills normally tells the patients that you as the
counsellor is with them and thus ready to listen. In this particular situation, I use opening micro-
skills, which consequently invited my patients to tell me more. Despite the opening micro-skills
being technically commands, they are ofthen soft ones, in that they are presented to the patients
in a manner that typically communicates for instance, ‘It is okay to decline.’ (Huprich, and
Richard, 2011)
These micro-skills normally help in the creation of comfort in the patient since they foster
the courage to confide subsequently. The main purpose of the openers is encouraging disclosure
without necessarily dominating the conversation. Usually, there are two wide categories of the
micro-skills which are, the encouragers, for instance, door openers and the minimal encouragers,
and the questions (Miller, and Rollnick, 2013).
I tried encouraging the patients to subsequently scrutinize parts of their lives that they
have found impossible or difficult to face before. These may be several explorations of early

STIMULATED PATIENTS 6
childhood experiences that may consequently shed some light on why a person reacts or
responds in certain ways to particular situations. This is normally followed by considering
methods in which the patients may change such behaviours (Trevithick, and Trevithick, 2010).
The micro-skill often requires small modification or distinctive stress in order to be most
effective in the case where they are used dually diagnosed patients. Generally supportive, as well
as collaborative MI style of interaction that has been established by the use of micro-skills by the
therapist is often unfamiliar to the patients who have dual disorders and who may have
subsequently become familiarized to a more directive as well as the authoritarian style of
traditional psychiatric interviewing.
Such are the thungs I feel that I should improve on next time. In traditional interviewing,
the consellor often controls the instant direction of the interview by the employment of numerous
closed-ended questions in determing diagnoses, obtaining biopsychosocial information, as well
as prescribe treatments. Since a majority of dually diagnosed patients expect a traditional
interviewing framework, a counsellor initially provides the patient with a brief as well as a
simple introduction to the DDMI prior to asking open ended questions and commencing the
reflective listening process (Trevithick, and Trevithick, 2010).
I feel that the next time I should encourage micro-skill questions more frequently. While
the non-verbal language, as well as the encouragers, are subsequently foundational to the micro-
skills of the counsellor, it is these questions that consequently provide a systematic framework
for directing the counselling session. These questions normally aid the counsellor to begin and
subsequently move the interview along smoothly. A majority of these questions may open up
new areas for discussion, and issues can be pinpointed and subsequently clarified (Huprich, and
Richard, 2011).

STIMULATED PATIENTS 7
I also feel that the use of closed questions will be more appropriate. These are questions
that ultimately lead to definite and often short, answer. Such answers may be such as ‘yes’or
‘no.' these answers normally have the benefit of focusing the interview and subsequently gaining
information. However, the burden of controlling the talk and hence the position of dominance in
any session solely remains with the counsellor. Closed questions typically begin with are, is, or
do, for instance, “Do you value your job?” “Is that the reason why you quit?”
This subsequently helps take care the patients explore them as well as their issues.
The questions are normally the backbone of an effective assessment. The questions such as the
where,who, when, what, why, and how of journalism are often recommended as they act as a
ready system for aiding the patients by guiding the manner in which the patient's talks
concerning an issue. I thus feel that this should be an area to put more emphasis on in the future
(Miller, and Rollnick, 2013).
Another area of improvement is encouragering micro-skill, the minimal encouragers. As
the counsillor, I believe that from head nods to positive facial expressions to for instance, ‘uh-
huhs,’ these are typically brief supportive statements that consequently signal attention as well as
understanding, and thus I fell that they should a point of emphasis the next time (Huprich, and
Richard, 2011).
These psychologists typically require less attention in researching biological components.
Counseling psychology and clinical psychology are similar. Psychiatrists are physicians who
have special training and qualification to work with psychiatric medicine (Miller, and Rollnick,
2013). Individuals have intense training in behavior problems and the biological components in
psychology. Thus so as to implement the above steps, I feel that I should conduct extensive
research regarding various issues so as to understand the patients clearly consequently.

STIMULATED PATIENTS 8
Research is not the only significant tool in psychology as statistics is also significant.
Statistics typically allows individuals to determine if the collected information is significant.
Statistics also determines if the information can be used upon a wider population (Miller, and
Rollnick, 2013).
Statistics with research allow a clinical psychologist to increase and develop thinking
skills. These skills are what allow a clinical psychologist to gain knowledge and design the best
forms of treatments for an individual. Statistics are similar to evidence, and allow a psychologist
to have proof that the therapy and the theories applied are valid, and reliable (Newnes, 2014).
Statistics and research allow exploration in psychology and hence counselling, and it also
offers the ability to have any question that requires being answered (Huprich, and Richard,
2011).
The statistical information normally provides validity of the tests as well as probabilities
that have been performed so as to aid psychologists to employ that information by applying it to
his or her current situation. The employment of statistics in any field may play a significant role
in collecting information, and in the field of clinical psychology, it can be used to help many
people (Miller, and Rollnick, 2013).

STIMULATED PATIENTS 9
References
Trevithick, P., and Trevithick, P. (2010). The Social work skills and knowledge: A practice
handbook. Maidenhead: Open University Press.
Miller, W. R., and Rollnick, S. (2013). Motivational interviewing: Helping people change. New
York, NY: Guilford Press.
Huprich, S and Richard, S. (2011) Clinical Psychology: Assessment, Treatment, and Research.
Academic Press.
Plante, G. (2010) Contemporary Clinical Psychology. John Wiley & Sons.
Lala, M. M., and Merchant, R. H. (2012). Principles of perinatal and pediatric HIV/AIDS. New
Delhi: Jaypee Brothers Medical Publishers.